Transition planning: From pediatricians to adult care


One of the most gratifying developments in medical care and in public attitudes is the increasing acceptance of children with developmental disabilities, genetic disorders, and chronic health conditions. Surrounded by caring parents, nonjudgemental siblings, neighbors, supporting friends, and accepting educational institutions the child is likely to receive exemplary care well into adolescent years.

After that, a combination of factors begins to complicate the course that the young adult’s life will take. Parents are older, more tired, perhaps wishing to downsize their living arrangements; siblings are grown up and have likely left the family environment; neighbors change; friends disappear. The child, now physically grown, perhaps more willful—or more timid—with less acceptable and perhaps unchangeable habits, more lonely, and without the freedom of others of similar age, and perhaps without a realistic independent future in the competitive working adult world. The accepting public attitudes toward a child with disabilities begin to evaporate when the same individual, now in their late teens, 20s, or older, attempts to seek new relationships, and is perhaps unable to conform to certain social norms, or to fulfill the employment requirements of an industrial and commercial world. When distinct age maturity is reached, the formerly loved, supported, and cared for person may be completely alone, perhaps physically or otherwise unwell, and totally dependent—but on whom, where, and how? The wonderful medical advances have opened a Pandora’s box.

In BC the Services to Adults with Developmental Disabilities (STADD) navigator can help individuals and their families find their way. The navigator’s services may best fit a person with a developmental disability, or fetal alcohol and autism-related disorders, who is between 16 and 24 years old and eligible for help from Community Living BC, a provincial crown agency. CLBC provides its programs through contractual arrangement with not-for-profit and private agencies in the province.

Expressed in his recent blog post [www.bcmj.org/blog/transitioning-patients-community-pediatricians-adult-care], Dr Aven Poynter’s heartfelt recognition of the need for a transitioning process for young patients from pediatric to adult care, and the BC Pediatric Society’s project to make this important transition a reality, will be an essential part of the existing overall social plan for transition into an older life in our contemporary adult society.

Thank you, Dr Poynter.
—George Szasz, CM, MD


This posting has not been peer reviewed by the BCMJ Editorial Board.


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