Foster Caregivers’ Perspectives on the Medical Challenges of Children Placed in Their Care

Greiner, Mary V.; Ross, Jennifer; Brown, Courtney; Beal, Sarah J.; Sherman, Susan N.

doi:10.1177/0009922814563925

Cited by 33 publications

(14 citation statements)

References 22 publications

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“…This may include facilitating record gathering and record review, providing developmental, educational, and mental healthcare screenings and service referrals, enhanced anticipatory guidance and education for nonparental caregivers, and multidisciplinary collaboration with all stakeholders involved in the care of the child (i.e., child welfare; 65) For researchers, there are several gaps in the literature on children in nonparental care that should be addressed. First, there is currently only one publication of findings from the NSCNC (3,55), and further examination of that cross-sectional data is warranted.…”

Section: The Interplay Between Nonparental Care and Social Antecedentmentioning

confidence: 99%

Children in nonparental care: health and social risks

Beal

Greiner

2015

Pediatr Res

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Section: The Interplay Between Nonparental Care and Social Antecedentmentioning

confidence: 99%

Children in nonparental care: health and social risks

Beal

Greiner

2015

Pediatr Res

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“…Health information is often lacking on entry into foster care. 26,27 Foster parents in our study identify obtaining medical records as an area in need of improvement. Because most CMC in our sample entered care because of medical neglect, their history may include multiple "no-show" appointments, resulting in missing records and fragmented care.…”

Section: Qol Datamentioning

confidence: 99%

Exploring Medical Foster Care as a Placement Option for Children With Medical Complexity

Seltzer

Raisanen

Williams

et al. 2019

Hospital Pediatrics

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BACKGROUND: Medical foster care (MFC) offers a family-home setting for children with medical complexity (CMC) who cannot be cared for by their parents. We explored MFC as a placement option for CMC via in-depth interviews with the individuals providing and monitoring care. METHODS: In collaboration with an MFC agency, we recruited care team members for 15 CMC. Semistructured interviews were audiotaped and transcribed. Descriptive analyses were performed on care team composition and roles, the placement process, and child medical, placement, and quality of life (QoL) characteristics. Foster parents completed child QoL questionnaires. Conventional content analysis was applied to participant suggestions for MFC improvements. RESULTS: Fifty-eight interviews were conducted; a median of 4 care team members interviewed per child. An extensive network of individuals and systems are involved in providing care. Each child received care from multiple subspecialists (median 5 5). Most children were technology dependent (87%), developmentally delayed (87%), and entered MFC from the hospital (73%) because of medical neglect (86%). Nearly half were in care for .2 years. Changes in placement and/or care team were common. QoL scoring showed impairments in multiple domains, whereas respondent interviews described positive aspects of QoL. Participants provided suggestions to improve care within MFC. CONCLUSIONS: MFC is a promising placement option for CMC. Because many CMC are entering MFC directly from the hospital and require ongoing care from pediatric subspecialists, pediatricians should be familiar with MFC, the placement process, and the various systems and individuals involved. Pediatricians can play important roles in ensuring that children in MFC receive coordinated and high-quality care.

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“…Data describing medical foster families are not robust, but suggest that foster parents often feel inadequately prepared to care for children with medical complexity. Greiner et al (46) reported that foster parents frequently receive fragmented medical information about children placed in their care, such as missing information about medication schedules and prescriptions. They report feeling ill-prepared to navigate the health system and access services, and worry that medical information is withheld when a child is placed in their care to deter their potential refusal.…”

Section: Medical Foster Home Environmentmentioning

confidence: 99%

“…States assign variable authority to foster parents to obtain medical care for a child. Foster parents are typically responsible for determining when a child needs medical attention, and may possess information important to medical decisions (46,49). But unless parental rights are terminated or relinquished, biologic parents are legal custodians and usually retain authority for consenting to medical treatment (49).…”

Section: Shared Medical Decision-making For Foster Childrenmentioning

confidence: 99%

Medical foster care: what happens when children with medical complexity cannot be cared for by their families?

2015

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Medical interventions for life-threatening pediatric conditions often oblige ongoing and complex medical care for survivors. For some children with medical complexity, their caretaking needs outstrip their parents' resources and abilities. When this occurs, the medical foster care system can provide the necessary health care and supervision to permit these children to live outside of hospitals. However, foster children with medical complexity experience extremes of social and medical risk, confounding their prognosis and quality of life beyond that of similar children living with biologic parents. Medical foster parents report inadequate training and preparation, perpetuating these health risks. Further, critical decisions that weigh the benefits and burdens of medical interventions for these children must accommodate complicated relationships involving foster families, caseworkers, biologic families, legal consultants, and clinicians. These variables can delay and undermine coordinated and comprehensive care. To rectify these issues, medical homes and written care plans can promote collaboration between providers, families, and agencies. Pediatricians should receive specialized training to meet the unique needs of this population. National policy and research agendas could target medical and social interventions to reduce the need for medical foster care for children with medical complexity, and to improve its quality for those children who do.

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Foster Caregivers’ Perspectives on the Medical Challenges of Children Placed in Their Care

Cited by 33 publications

References 22 publications

Children in nonparental care: health and social risks

Children in nonparental care: health and social risks

Exploring Medical Foster Care as a Placement Option for Children With Medical Complexity

Medical foster care: what happens when children with medical complexity cannot be cared for by their families?

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