Kids Health Info

Adolescent transition - basics for young people

  • Most young people with a chronic condition who are treated at a children's hospital will eventually need to be transferred to an adult health care service. This is called transition.

    Transition is a process where your health care is eventually transferred to the most appropriate adult service. The transition process starts early, as soon as you enter adolescence. You will be given information and the chance to learn more about the hospital you will be transferring to, and how to understand and use a new health service.

    We have developed some information and education modules on a range of topics that are available on the RCH Transition website or from your clinical team. These modules have been designed to support you becoming independent and to make the transition process as easy as possible. They are all highly recommended but it is your choice whether you participate in them all.

    Adolescent transition is:

    A developmental process.  You will have an active role in helping to decide when you are ready to go to another hospital by setting goals and using a health skills checklist.

    A coordinated process that involves the department/s of the hospital relevant to your care, your health care staff, a transition lead, your parents and most importantly yourself. This team will help you develop a transition plan that can be put into action during your time at the RCH.

    An enjoyable process, and should ideally not occur during year 12 or when you are going through a hard time either medically or just in general.

    A planned process. The timing of your transition will vary depending on when you are ready. It can be anytime before you turn 19 years of age.

    Aims of adolescent transition

    There are several aims of transition. These include:

    • To provide high quality health care which is appropriate for your age, culture and development; which is flexible, responsive, relevant to your needs and presented in a way you understand.
    • To help you develop skills in communication, decision-making, assertiveness, self-care, advocacy and deciding your future direction.
    • To improve your sense of control and independence over your health care.
    • To provide support and guidance for your parents/carers.
    • To maximise your capabilities to live well and achieve your goals regardless of your condition/disability.
      [adapted from McDonagh, 2003, 2005]

    Transition phases

    There are four phases for an effective transition process:

    Introductory/Planning Phase (12-15 years approximately)

    This time is about introducing you to the concept of transition, starting the information exchange and assessing your knowledge of yourself, your medical condition and how to manage it.

    Preparation Phase (15-18 years, approximately)

    This time is about you beginning to visit your doctor without your parent/carer, developing a transition plan, having a transition lead (the person who helps manage your transition process) assigned to you, introducing the concept of confidentiality and ensuring it is strictly adhered to. Correspondence will begin to be addressed to you rather than to your parent/carer.

    Transfer Phase (18-19 years)

    This time is about assessing how ready you are to transfer, exchanging information between services, providing you with practical information about adult health care and giving you the opportunity to write a letter of introduction to your new doctor.

    Evaluation (6-18 months after transfer)

    The evaluation is follow up contact with you and your family, and gives the opportunity to for a written evaluation and feedback of your experience.

    Transition challenges

    There may be some challenges involved with the transfer of services that the Transition Program can help you to overcome, including:

    • becoming familiar and comfortable with new your health service
    • feeling uncertain about your future
    • communication between services such as transferring health information
    • the degree of participation/involvement in your health care for you and your parents/carers
    • the different health systems and different expectations
    • being independent and fitting the management of your health condition in with being a young person.


    Transition can prepare you for some of these challenges by helping you to:

    • be informed
    • plan well in advance
    • develop self-management skills
    • know your supports and resources.


    Your parents/carers will also go through some challenges of their own that they will need help to overcome.  These can include:

    • their changing role
    • feeling excluded or out of the loop as you take on more responsibility
    • concern about your readiness to transfer
    • adjusting to adult health care services
    • confidence in your new medical team.

    Questions to ask yourself…

    • What are my transition goals?
    • What gaps are there in my knowledge and health care skills?
    • What do I need to do to address those gaps?
    • What support and resources do I need and how do I find them?

    For more information

    The Royal Children's Hospital Adolescent Transition Coordinator
    T: (03) 9345 4858
    www.rch.org.au/transition

     

    Developed by the RCH Adolescent Transition Program. First published September 2012.

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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.