Transition to Adult Care

What is Transition?

Transition means changing or moving from one stage or place to another. Everyone goes through transitions in life — like when you graduated from elementary school. Transition can be exciting, involving new experiences. But transition can also be difficult and scary, especially when you are not prepared for it.

An important transition in your life will be moving from child to adult-centered healthcare for your sickle cell disease. This transition occurs differently around the country depending on your sickle cell program, but usually involves changing your sickle cell doctor and hospital. Transition also involves other important aspects like:

Having a better understanding of sickle cell disease
Answering and asking questions at your medical appointments
Making your own medical decisions
Taking your medicines independently
Advocating (speaking up!) for yourself

With the help of this site, your healthcare team and your family, you can have a successful transition!

About Transitioning to Adult Care

Transition should not happen at any one time or age. Instead, transition should be a gradual process; it is something that you, your family and your healthcare team work on over time.
It is never too early to start thinking about transition because preparation leads to success. It is a good idea to start creating a transition plan with your healthcare team before age 14. You will be able to work on this plan for a few years before actually moving to a different doctor or hospital.
It is important to know that some pediatric hospitals have different practices and rules regarding care of older patients. For example, at some places patients over the age of 21 cannot be admitted to the pediatric hospital. At other places the age limit is 18 or 22 years. Ask your doctor about the policies at your hospital.
Policy at Children's National Hospital (PDF)
Talk to your healthcare team about this important question. Depending on your location you may have many options or one preferred place.
Transitioning allows you to become a successful, independent adult. While you might not like some of the responsibilities that come with transition, remember that you are gaining more privileges. Through transition, you earn the freedom to be in control of your own life.
Transition can be difficult because you might be leaving a pediatric doctor or healthcare team that knows you well and that you like. These individuals, however, are often not specifically trained to treat adults. Treating adults and children with sickle cell disease can be very different and pediatric hospitals are designed to take care of children, not adults.
Get prepared
This program is designed to help prepare you to transition from the world of pediatrics to adult medicine. We hope this program will help you become your own health advocate.

Becoming an Advocate for Yourself

An advocate is someone who stands up for a cause. As a teen with sickle cell you now need to start speaking up—advocating—for yourself.
STRIVE DC is a free mentoring and advocacy program in Washington, D.C. that offers opportunities to learn from young people living with sickle cell disease. Learn about how advocacy has impacted the lives of young adults with sickle cell.
To become a good advocate for yourself, you must practice talking to your doctor independently.
Read the below statements and answer "YES" or "NO" for each one.
If you can answer "YES" to most, great! You are likely ready to transition soon. If you answer "NO," to a statement, use this website and talk to your doctor for help related to that topic.
Medical History Checklist
- I know what type sickle cell disease (hemoglobin SS, SC, S beta thal, etc) I have?
- I know my baseline hemoglobin level?
- I know my baseline pulse ox level?
- I know all of my medication names and doses?
- I know what all of my medications are for and what they do?
- I know all of my drug allergies?
- I know all of the surgeries that I have had?
- I know I have developed antibodies because of past blood transfusions?
Medical Knowledge Checklist
- I understand behaviors and triggers that can cause a pain episode.
- I know why drinking a lot of fluid is important for people with sickle cell disease.
- I understand the importance of a healthy diet as it relates to sickle cell disease.
- I understand how I got sickle cell disease.
- I understand how I might pass sickle cell disease on to my child.
- (For females) I understand how sickle cell disease could affect my health if I got pregnant.
- I know about serious complications in sickle cell disease (acute chest syndrome, stroke, priapism, etc).
- I know what is considered an emergency related to sickle cell disease and what to do.
- I know how the use of tobacco, alcohol and other drugs can affect my sickle cell disease.
Medical Skills Checklist
- I can tell someone what sickle cell disease is and how it makes me feel.
- I know how to use a thermometer and what to do if I have fever.
- I answer my doctor’s questions during my clinic visits.
- I ask questions during my medical appointments.
- I know how to schedule a medical appointment.
- I keep track of my medical appointments using a calendar.
- I can get myself to my medical appointments.
- I know how to get my prescriptions filled.
- I have or am working on a medical transition plan when I leave pediatrics.
Education and Vocation Skills Checklist
- I have a 504 Plan or Individualized Education Plan (IEP).
- I participate in my 504 or IEP.
- I plan to graduate from high school/vocational school or obtain a GED.
- I have been thinking about the kind of career I would like as an adult.
- I have talked to my school counselor or a teacher about my educational/career goals.
- I know what type of training I might need for the career I want.
- I know the types of work situations that could cause problems related to sickle cell disease.
- I have practiced my job interview skills.
- I know how to write a resume.
- I know where to find information about job training and opportunities.
- I know where to find information about educational scholarships.
- I have talked with my parents about my vision for my future.
Health Benefits Checklist
- I know what kind of medical insurance I have.
- I understand the different types of health benefits that are available to me.
- I know how my age can affect my health benefits.
- I carry my own copy of my health insurance card.
- I have a plan for the future regarding my health benefits.
Social Support Checklist
- I have a good support system of family and/or friends.
- I understand what self-esteem is.
- I understand the difference between being sad and being depressed.
- I understand what "healthy relationships" are.
- I have hobbies or activities that I enjoy.
- I have a person that I can talk to about sickle cell disease.
- I have a positive vision of my future.
Note: Above checklists were adapted with permission from the Virginia Department of Health Sickle Cell Transition Intervention Program.

Transition to Adult Care

What is Transition?

About Transitioning to Adult Care

When does transition occur?

Where should I transition?

Why do I need to transition?

Get prepared

Becoming an Advocate for Yourself

What is an advocate?

Am I ready for transition?

Medical History Checklist

Medical Knowledge Checklist

Medical Skills Checklist

Education and Vocation Skills Checklist

Health Benefits Checklist

Social Support Checklist