Hospice care is not just for adults, nor does it only care for the dying. A variety of children’s grief programs are available for free thanks to Mountain Valley Hospice and the Kids Path conglomerate.
“Kids Path is basically a consortium of hospices started by Hospice and Palliative Care of Greensboro,” explained Kristie Byrd, Director of Family Services with Mountain Valley Hospice and Palliative Care.
Through Kids Path Mountain Valley and other hospices can share information and ideas supporting one another as they support local children in their suffering.
Mountain Valley does this in several ways the most obvious being comforting those young people who are gravely ill.
“The same thing applies [to children as adults],” stated Byrd. “They have to have a six months or less prognosis and some type of life limiting illness and then we can take care of them in hospice.”
“We also offer palliative care to children who maybe aren’t ready for hospice or might not quite make the prognosis requirements. They can maybe go into our palliative care program for some type of symptom management.”
Palliative care is comfort care whereas hospice is for end-of-life care.
“Palliative care is a symptom management program [for those who] have some sort of life limiting illness but don’t have that prognosis of six months or less. You might have years to live but you are getting some sort of treatment or your illness [that] causes you to have shortness of breath, pain, nausea/vomiting, whatever that something might be, then we can act as a specialist,” explained Byrd, “because what we do in hospice is comfort care so we’re really good at that.”
Hospice is also good at coordinating the various medical professionals and services required with a significant illness.
“Our physician or nurse practitioner will go out and make a visit to the patient and help figure out ways to take care of that symptom. We work with the primary care physician so everybody’s kind of involved in the care,” described Byrd, “so it’s a good holistic approach.”
This is no different than the care given to adults at Mountain Valley Hospice and Palliative Care.
“We do everything in hospice like we do for an adult. They get a nurse. They get a social worker. They get a chaplain if they request it, volunteer if they request it and even an aid if they request it,” stated Byrd, “although most of our parents are pretty good at taking care of the personal care of the children but we offer it as one of our services.”
“Really it’s patient centered care,” claimed Byrd. “We want to care for children how their families feel it’s best for them to be cared for and if a child’s old enough how they feel they can be best cared for.”
One program available to children that is not available to adults is the Transitions program.
“Our Transitions program is a supportive care program. They don’t have a symptom to manage, they don’t really have the prognosis, but they just need some sort of support in the home,” explained Byrd, “or they want to get to know us before they’re ready for hospice and we can already be involved with that child’s family.”
Although there is no hands-on care in the Transitions program, spiritual care and volunteers may be available as well as a nurse or social worker who can help the patient’s family connect with local resources.
“What we can do in Transitions [is] provide supportive care and maybe help connect with community resources,” stated Byrd, “be the liaison between primary care physician and a specialist or something like that.”
Concurrent Care is also something children can receive that is not available to adults and is funded through Medicaid as a way to allow children to receive aggressive treatments like chemo as well as the comfort of hospice.
The primary goal of hospice is comfort and that is available to children who are not ill as well.
“The other thing that we do is bereavement support,” stated Byrd, claiming there are 35-50 children in the program at any one time.
“That’s all of our service area of North Carolina and Virginia so all 18 counties that we cover. Surry, Yadkin and Wilkes counties are the majority of where our bereavement is and we probably have around 20 to 25 children in that program now,” claimed Byrd.
“Most of the children we care for in bereavement support have suffered a loss to death,” described Byrd however there are other kinds of loss addressed by the counselors dedicated to Kids Path.
“We would take care of a child who is suffering maybe through a divorce or change in homes, suffered any kind of loss really. We’ve had children who are in foster care in our bereavement support program.”
“We have had schools reach out to us when a teacher’s passed, when a student passed or when they know a child who is grieving because they’ve suffered a family loss,” said Byrd, noting there has been an increase in communications with schools through cooperative programs.
“We are actually so blessed [because] this past year we have really kind of grown this year in this area.,” stated Byrd. She explained that Mountain Valley Hospice has been able to have staff meetings at schools to help provide education and support.
“When a child dies it’s usually a tragic death. There’s this crisis intervention team that schools have that helps but we’re now starting to be able to bridge the gap between what they’re doing and the long term effects of that grief,” described Byrd.
“Where they’re there in the moment when it happens we can follow through after that. I’m excited about being able to work with the schools and do that.”
This program also helps establish a relationship for when a child needs to be seen at school.
“In our bereavement program and we can take care of them wherever the best place is to do that,” stated Byrd. “If it’s at home we’ll make a home visit. If it’s at our office they can come to our office. If it’s at their school and the school is willing and their family’s willing we’ll go to the school.”
It is often the school that notices a child is in need of such services as Mountain Valley’s bereavement program offers.
“A child who is typically outgoing and is kind of the life of their class might begin to sort of withdraw,” described Byrd of a child who might be suffering, “or if you have a quiet child that begins to act out. A child who maybe never backtalked and now they began to backtalk or they might see anger kind of manifest in ways that it’s never manifested before.”
It might be even more difficult to detect signs of intense grieving in a younger child.
“With small children who don’t really know how to express their anger you might have a kindergartner or a first grader start to wet the bed again where maybe they hadn’t done that for years,” claimed Byrd reminding at any age, “of course if they see crying that sort of thing may be an indication. Not that that [crying] is not normal.”
Changes of behavior in even younger children can also be indicative of a need for grief counseling however not for the child.
“They’re probably going to notice more the changes in the adult who is suffering the loss and so they may latch onto that and act on out based on the adult’s actions,” observed Byrd, “because it’s hard for them to understand that death is concrete and that they’re not going to see that person again.”
Fortunately Mountain Valley Hospice works with the whole family.
“A lot of times we will have [the Kids Path bereavement counselor] working with the child and have another bereavement counselor working with the adults,” explained Byrd. “They can even make joint visits.”
This allows the counselors to work with the family individually as well as as a group.
“Then they can work together with the family to make sure that everybody’s understanding what the child is going through, what the parents are going through and how they can make that an easier process.”
“Grief is hard,” declared Byrd. “It’s hard work.”
To receive assistance with that hard work whether it involves a Mountain Valley Hospice patient or not, community members can call 1-888-789-2922 for assistance.
Beanie Taylor can be reached at 336-258-4058 or on Facebook at www.facebook.com/TBeanieTaylor.