Adapt Play for Hospital

It is important that volunteers are able to facilitate activities that are hospital appropriate and that children can continue to have fun when they are in hospital for the short or long term.

There are lots of different types and ways to play and it is important to remember that not all children like all the same activities and to pay attention to what each child enjoys doing, what they choose to do and what activities they can stick at for longer periods of time.

Even when fully well and at ease, on average a child will be able to focus on any given task for approximately 2-5 minutes per year of age e.g., a four-year-old should be able to focus in the range of 8-20 minutes. This may be reduced because of illness, fatigue, or simply the hospital environment.

The following are tips for adapting play activities in the areas CIH volunteer’s support children, young people and their families:

Play in the Playroom:

• Many CIH volunteers are based primarily in playrooms.
• These rooms are generally well-stocked with toys, games and arts supplies and may be supervised by a hospital play specialist.
• In the playroom, the volunteers may facilitate free play and/or organise some play activities such as arts and crafts, games or story time.
• Some hospitals also have outdoor playgrounds or play areas so volunteers can organise play activities outside when appropriate.
• However, children in hospital do not always have access to a playroom or outdoor play area so CIH volunteers also facilitate play in a number of other settings.

Play in the Ward:

• Some children in hospital are not able to visit the playroom and some hospitals do not have play facilities. In these cases, CIH volunteers bring play to the bedside.
• The children that volunteers visit on the ward may be waiting for or recovering from treatment or surgery.
• They may be feeling unwell and in need of distraction; they may be tired and have a short attention span; or they may be well into recovery and eager for something to do.
• In any case, opportunities to play are essential.
• CIH volunteers can spend a few minutes talking to the child and/or their parents/carers to find out what they might like to play with before going to the playroom or trolley to get supplies.
• Children may already have toys with them in the wards.
• The most valuable thing you can share with them is your time and your company.

Play in Isolation Rooms:

• Some paediatric patients require isolation due to reduced immunity, infectious conditions or as a result of a treatment they have had.
• Where children are in isolation rooms you may be able to bring in material which must be left with the child or disposed of afterwards, or you may not be able to bring in any materials at all. Always check with a nurse first.
• Please see below suggestions for when visiting a child in an isolation ward:
  • Bring a paper plate with a selection of paints and paper – if you don’t have any paintbrushes to spare, bring some cotton buds.
  • Print or write out their name on paper and let them decorate it as a sign for their bedside.
  • Bring colouring pages/activity sheets and single-use crayons, suggest making a poster based on their favourite movie or TV show.
  • Make a butterfly/angel/spider out of a paper towel or other disposable materials – this can be kept by the child as bedside decoration or become a prop for a story.

Play in the Emergency Department:

• Children coming to the Emergency Department may have no previous experience of hospital and are likely to have had little or no time to prepare for the experience.
• They may have long waiting times for treatment and their parent or carer may be anxious or upset.
• Play can provide a welcome distraction and a way of relieving stress and frustration.
• There may be very little play material available in the Emergency Department so volunteers provide play materials from trolleys or storage areas.
• Appropriate materials include board games, jigsaws, colouring pages and activity sheets, quick craft activities and books suitable for a range of ages and interests.
• Children can be called away for treatment so activities with flexible time spans are most effective.
• Depending on how busy the Emergency Department is and how much space is available, some play activities could include:
  • Story time – Bring along a story book or make up stories with the children.
  • Board game tournament – Set-up some games that don’t take too long (for example, Guess Who or Connect Four) and invite the children to take turns playing each other. The small, portable versions of games are good for busy spaces. Games that are familiar to the children are good as there is usually no need to explain rules.
  • Pretend play – use simple props such as toy phones or pots and pans to encourage children to use their imaginations.
  • Opportunities for movement – Children can become frustrated or distressed when expected to sit still for long periods so games that provide opportunities for gentle movement and exercise can be very welcome.
  • Quick and easy activities–
    • Using blank paper sheets – Noughts and crosses  (Xs and Os)
    • I spy (I spy with my little eye, something beginning with “H”)
    • Using blank paper sheets – make and decorate a paper boat, a paper airplane or a paper mask

Play in the Outpatients Department:

• The Outpatients Department may see children in a number of different situations.
• For some children, this may be a one-off appointment or an initial consultation; other children may be regular attendees.
• The provision of play can make children feel welcome in the hospital.
• Play volunteers can lessen the impact of waiting, reduce boredom and often help a nervous child to focus on something else.
• Children may be called away for their appointments so activities with a flexible time span are a good idea.
• If there is space, you might set up some board games, jigsaws, building blocks and drawing materials to play with.
• Arts and crafts activities are always popular – choose crafts which can be quickly finished to take home (for example, simple puppets or greeting cards).
• Colouring pages and activity sheets can be especially helpful when the waiting area is busy.
• Card games & word search are a good way to involve a wide range of ages.

Play involving the whole family:

• Hospital visits can be difficult for parents and siblings too.
• Volunteers can make a real difference through fun and games or even a smile and a chat.
• Encourage families to play together to pass the time and make the experience a little less stressful.
• Some ideas for including the whole family in play:
  • Play Snap, Go Fish or other simple card games
  • Make puppets and put on a puppet show
  • See who can go the longest without laughing
  • Play ‘What Am I?’ using questions that should only be answered with either Yes or No
  • Play memory games, like ‘I went to shop and I brought …’
  • Play Snakes and Ladders, Frustration or any board games
  • Build the tallest tower – use building blocks, Lego, Magformers, Stickle bricks – whatever you can get your hands on
  • Tell stories or jokes

Switching Up “Play” For Adolescents:

• Hospitalisation can impact a teenager in terms of them missing out on their usual activities and not being around their peer groups. Peer groups are so important to this age group and hospitalisation is very disruptive to the teenager’s life.  This can cause low mood and feelings such as sadness and anger.
• As a volunteer it is important to approach a young person in a positive and non-judgmental manner and to be prepared to ask questions to build a rapport and have a fun activity to engage with them.
• Sometimes teenagers may not want to do a “planned activity” but would just like to have a conversation, to be heard, so your role could be just to listen and take an interest in what they have to say. This can be just as valuable as a planned activity like arts and crafts.
• Some young people may find eye contact really difficult and that sometimes sitting side by side or having something to focus on e.g. a puzzle or playing cards can help with this.
• To build a rapport with a teenager and to avoid yes/no answers it is important to ask open ended questions such as the following, to encourage some light conversation.
  • What’s your favourite movie and why?
  • What kind of characters do you like in movies?
  • What kind of sports do you like?
  • What is your favourite song/singer?
  • What is your favourite TV show and why?
• If they are playing a game on their phone/computer/x-box, ask them about it and perhaps they might tell you about what they are playing.
• A simple, fun and interactive game which works well in pairs is “take a guess” – write out celebrity names on sticky notes and place in a bag. One of you takes a sticky note and places it on your forehead and then will ask questions such Am I a singer? Am I on TV? and the other person is only allowed provide yes or no answers.  Once you have guessed who the person is – swap over.
• Playing card games with teenagers provides a great distraction. Ask the young person what card games they like or suggest one yourself.
• Other activities can include making a jigsaw together or craft making. Playing board games can be fun, but pick ones that are quick to play as you won’t be able to stay a long time with each young person.
• It is important that the activities create a safe, supportive environment which allows for teenagers to cope with hospitalisation in their own way.
• CIH have some activity ideas for engaging with teenagers and some games and materials to help you create ideas and build your confidence in this area.