Assisting Children with Terminal Illnesses in the Umberto I Hospital

Project location: ITALY, Rome
Project start date: December 2007 - Project end date: December 2008
Project number: 2007-09
Beneficiary: ALMA SALUS

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 Spring 2009 Project Report

 1. The project's aim: "A Servizio dei Bambini - II. Assisting children affected by serious pathologies hospitalized in the Polyclinic Umberto I in Rome (Itlay)" is to attend children (5-15 years-old) suffering from temporary and/or permanent disabling pathologies and/or terminally ill, guests in the Polyclinic Umberto I in Rome pediatric oncology ward, pediatric emergency unit , pediatric odontology , contagious disease, cardiology and allergology day hospital.

2. The project makes use of the teachers' co-operation of the "La Sapienza" University and of the "Pontificia Salesiana" University in Rome. The volunteers are professionally qualified.

The Staff includes:

- scientific manager of the project: Mr. Guido Crocetti ("La Sapienza" University in Rome) and his assistant Mrs. Sofia Tavella ( "La Sapienza" University in Rome);

- co-ordinator of the project: Mr. Alfredo Altomonte ( psychologist of the "Pontificia Salesiana" University);

- supervisor of the project: Mrs. Annamaria Coti, Mrs. Maria Magro e Mrs. Cristina Buonaugurio;

- operators: Mrs. Capobianco Daphne; Mrs. Di Biase Lucia Francesca; Mrs. Gavazzi Valentina; Mrs. Lo Bianco Maria; Mrs. Manzi Mariantonia; Mrs. Paesano Angela; Mrs. Poddi Elena; Mrs. Sauli Emariola; Mr. Turano Antonio; Mrs. Zaccarello Graziana.

3.First phase: training

In this first phase the staff was engaged with the volunteers training course. The subjects of the lessons, of the seminars and laboratory were:

· Introduction (Mrs. Sofia Tavella)

· The relation with illness in the age of development (Mr. Guido Crocetti)

· The pain and the psychological aspects with the therapeutic treatment (Mr. Guido Crocetti)

· Psychopathology elements in the age of development (Mr. Guido Crocetti)

· The disease in the age of development (Mrs. Raffaella Iuorio)

· The sick child and his family ( Mrs. Vincenza Paglia)

· Worker's profile in pediatric circle (Mrs. Maria Magro, Mrs. Annamaria Coti, Mrs. Cristina Buonaugurio)

· Emotional development and suffering (Mrs. Emanuela Puddu)

· The hospitalized child (Mrs. Sofia Tavella)

· Approach to sick children and to the wards (Mrs. Maria Magro, Mrs. Annamaria Coti, Mrs. Cristina Buonaugurio)

· Principal line: pediatric research aim. How sick children relate (Mrs. Sofia Tavella)

· Technique of administration 1-2-3 (Mr. Alfredo Altomonte)

· Technique of animation and communication 1-2 (Mrs. Cristina Buonaugurio, Mrs. Maria Magro, Mrs. Annamaria Coti)

· Clown lab - therapy 1-2 (Mrs. Francesca Berardi)

· The game: a psychological instrument (Mrs. Francesca Marchigiani)

· Manual and creative lab (Mrs. Francesca Di Nardo)

· Commitment card (Mrs. Maria Magro, Mrs. Annamaria Coti, Mrs. Cristina Buonaugurio)

At the end of the course had been done a punctual check about the development method and learning

4. Activities in the hospital wards

The entry of workers and volunteers of the project into the Polyclinic Umberto I's wards was characterized by a great curiosity for the organizing of the activities of their own departments and for the activities of the project and, at the same time, by an obvious desire to get really involved after following the training. The enthusiasm of the first entry in the ward, though accompanied by some natural fear of facing an entirely new, has given the momentum that has allowed workers and volunteers to quickly familiarize themselves with the department and its "protagonists".

As the days go by the volunteer was fully inserted and can move without embarrassment or insecurity among hospitalized children, parents, nurses and other volunteers, able to seize the natural and the different opportunities that present themselves daily to be significant figures in addition to children. In the same way they are able to make the most of the material provided by the Association specifically for the project, in addition to that present in the department, and always attentive to capture the interests and wishes of the children about working together.

In the early days the play were conducted mainly in school with all children admitted that they could carry, or that had the age to participate in the games offered. The ability to involve everyone was very important, stimulating also the participation of parents when they were present.

Since not all hospitalized children could get out of their rooms, it was necessary to carry out the play in each chamber, as well as in school.

Over the months we can observe an increasing familiarization of workers and volunteers with various departments. The initial enthusiasm gave way to a greater awareness of its role and its task, which made the whole experience of the difficulty of having to deal with everyday situations so serious. However this hasn't deterred the workers, which in fact have increased the effort to be proactive and active figure in the department.

Emotionally intense, but in another sense, it was also the experience of having to do with children in "difficult", either they are closed of character or surrounded by family members also overly protective or accustomed to having all the attention for himself and then with a behavior sometimes commanding.

The activities promoted and carried out allowed under the Day Hospital that welcomes cardiopath, diabetic children and suffering from allergies to fill the waiting time between one visits and the other through games, experiences in a graphic-pictorial group and meetings interviews with parents and relatives of young patients.

In the Oncologic Pediatrics department that play has had a greater continuity due to the different types of patients, who lived a time of hospitalization longer than the day hospital.

5. Time and verification.

The daily attendance of the department and, then, the actual meeting with reality of hospital and with the "little" patients started immediately after the conclusion of the training course at the end of October 2008 and will end in July 2009.

Since November 2008 the coordinator and supervisors, through weekly meetings, have monitored the progress of work for a constant check to modify the route done where it was useful and encouraging it when seen as positive.

Under revision is important to note, over the continuity of service and presence in all wards project's aim , the activity of weekly "supervision" and Balint groups, useful for the emotional containment and sharing, for exchange and fundamental teachings offered by Dr Crocetti.

Briefly the project "A Servizio dei Bambini - II" ensures a qualified presence of the operators-psychologists volunteers for more than 60 hours a month. In fact, for at least 60 hours monthly per volunteer per , plus three hours worked on weekends, is in addition the commitment that each volunteer devotes to the preparation and verification of work.

6. Documentation activities: the "Benessere Bambino" newspaper (the "Child Welfare")

An important activity was to create an instrument of communication and information useful to give voice to volunteer psychologists and their own experiences, particularly to disseminate and pass on what happens in the ward, the lives of children in these environments and what is being done to groped to make it more livable and less uncomfortable. Moreover is an opportunity to show the reflections, the little jobs, the drawings, the expressions of the children who play with leisure activities of this type.

 7. Conclusion

The project's experience "Benessere Bambino" continues in these wards and with it the motivation of the volunteers. Some significant expressions are the following:

What good has happened in this route is that the motivation to carry out this activity is enriched and acquires new shades every day. Clash with suffering, everytime, but also with the strength of children and their parents, echoes in my being and change me. I notice that the personal aims are increasingly harmonized with those of the project: this experience was initially out of me and lived with detachment, but now it belong to me, it's in my life and in me".

"Another month of the project has gone away and if serenity moments alternate with harder, it is true that time passes more quickly and the motivation to go on grows every day. Each day offers reflection for the volunteers, each day puts them to the test with emotions not always easy to manage.

The total experience that the operators of the project are having, from an educational, human and emotional point of view, is a valuable and significant experience, particularly in the pediatric oncology ward."