Whats best for toddler medical issues

My granddaughter is 15 months old, has hydrocephalus, DWS, PVL and hypoplasia of her corpus collosum as well as seizures. She is delayed and gets PT & OT up to 4 days a week. She did not start sitting up on her own till she was almost a year and just recently started trying to pull herself up. Socially she is very much a "people person", she gets very upset if someone walks out of the room, even when there are other people that she knows there.  She has recently had two brain surgeries within 10 days of each other and spent a lot of time in the hospital. She lives with her mom, her grandpa and & I and her two uncles. Her father was here the first two months of her life and since then has seen her 5 times, most recenlty 4 months ago. He lives in another state and wants to come spend a weekend to see her. He has supervised visitation due to her medical issues. He doesn't understand that to her, he is a stranger. She is very distraught when he is around, cries continually, doesn't eat, and often times just shuts down and passes out (she tends to do that when she is overwelmed). We feel shorter more frequent visits would be best for her so that her routine isn't disrupted as much and she gets used to him but because he lives in another state he feels like when he is in town he should get to see her from the time she wakes in the morning till the time she goes down for the night. He says that she knows who he is, simply by the sound of his heartbeat when he holds her. We have tried to get him to take his time and let her warm up to him but on the occasions he has seen her he rushes right in and expects her to be happy to see him. We'd like some advice as to what an appropriate length of these visits should be? We want to be fair to him and try to foster a good relationship between them but him wanting to see her for 8 or more hours at a time every few months isn't working. With all her issues we don't want to cause her anymore stress. Any advice is appreciated.

[Rebecca Resnik, PsyD]

Hello,
  you and your family have been through a lot, and it sounds like you are coping with the significant task of meeting your granddaughters needs. Children at this age do thrive on things staying the same, and are too little to understand things like why they have to go to the hospital.

I can see how it would distress you to see her experiencing anxiety about the visits, but I would encourage you to think long term about this issue. I am always so happy to hear that when parents are not able to stay married, that both parents can continue to play a role in the child's life. I would encourage you to help this father develop a bond with his daughter. I can understand that it can be downright painful to see his attempts at forming an attachment making her upset, however from what you say he is trying. It must be painful for him to have her reject his attempts to engage with her, and he is probably just not good at reading her 'cues'--you can help him learn to 'read' what she is trying to communicate because you know her so well.

I would say that a primary attachment figure (you or the mother) should be around but out of sight in case she really needs help. I think will help her most is for her father to visit more frequently if he possibly can. Children her age cry when they go to unfamiliar daycares, have new sitters or are left with someone they don't know, but it dosen't mean that she will be damaged. Perhaps he can spend the first parts of his visits with the mom and the daughter, then have the mother say a quick, low-key goodbye and let them get used to each other without her there. It will get better over time, and if this leads to her having a loving father in her life, you will have given  her a great gift.

Best wishes
Rebecca Resnik