The basics of transition

An introduction for parents and carers

Teen transition is an important process for you as a parent/carer to go through.

As a parent/carer you must cope with your own challenges as you encourage your teen to look after their own healthcare and become more independent. Your involvement in your teen’s transition is important as it will help you to support them during this time of change.

This educational fact sheet is designed to help inform and support you and your child during this transition process.

• Transitioning your teen from a paediatric to adult hospital is an important step for both you and them, but it may present you with some concerns. The transition process is helpful for parents/carers to work through the challenges of moving your teen from one healthcare system to another.
• The process will help by enhancing your knowledge about your teen’s experience and help you cope with your change of roles as you both navigate through this stage of their life.

Introductory/Planning Phase 12-15 years approx.

This phase is about introducing you and your teen to the concept of transition, starting the information exchange, and an assessment of your teen’s knowledge of themselves and their medical condition and how to manage it. This is where you might want to think about how you can assist your teen’s growing independence.

Preparation Phase 15-18 years approx.

This phase involves your teen developing a transition plan, having a transition lead assigned to them (the person who helps manage the transition process), introduction to the concept of confidentiality and ensuring it is strictly adhered to.

Correspondence will start to be addressed to your teen rather than to you. It is important during this phase that if you have any concerns or queries about the process that you talk to your teen’s clinical team or transition lead, as this is a process for you as well as your teen.

Transfer Phase 17-19 years approx.

This phase involves an assessment of how ready your young adult is to transfer. An exchange of information between paediatric and adult services will occur providing you and your young adult with practical information about adult healthcare.

As part of the process your young adult will write a letter of introduction to their new doctor. They will have their last visit with their paediatric medical team and will meet and start to have their appointments at their new adult health service on their own.

• To provide high quality healthcare that is appropriate for your teen’s age, culture and development.
• That it is flexible, responsive and relevant to their needs and given in a way they understand.
• It helps develop skills in communication, decision making, assertiveness, self-care and self-advocacy.
• It helps improve their sense of control and independence regarding their healthcare.
• To provide support and guidance for you as the parent/carer.
• To maximise your teen’s capabilities to live well and achieve their goals regardless of their condition or disability.
• To help you understand your changing role as a parent/carer.

• Understanding and accepting your changing role from managing your teen’s care to being more of a support and resource
• The feeling of being excluded or out of the loop as your teen takes more ownership of their care
• Concern about your teen’s readiness to transfer to an adult health service, adjusting to adult health services and different processes and expectations

• Encourage your teen to take ownership of their health
• Take a step back into a supporting role rather than managing your teen’s health care needs
• Transfer your knowledge i.e. Medicare, healthcare, medical history
• Encourage direct communication between your teen and the healthcare team

• If you or your teen doesn’t get along with the new doctor, it is ok to request a second referral
• Transition is a natural step for a young person and is best achieved with your support and encouragement
• You and your teen have the right to participate in the whole transition process
• Ensure that you are attending to your own needs during the transition process, self-care is important when big changes are occurring
• The timing of phases will vary between individuals and progress should occur when your teen is ready

The transition process works with your teen to help them overcome any fears and gives them skills that:

• Allow them to understand and feel familiar and comfortable with their new team
• Help them understand the level of participation and involvement required by them and you
• Help them understand the differences between the health systems, including the different expectations
• Help them build their independence and ability to manage and balance their health condition with the demands of being a teen

Trapeze (Sydney Children’s Hospital Network)

Royal Children’s Hospital Melbourne