When a child is diagnosed with diabetes, families must learn how to manage the condition on a daily basis. Education starts almost immediately with information to absorb and skills to be practised. The learning process introduces parents to an array of medical words and terms that describe diabetes and how to manage it; insulins, ketones, shots, pokes, tests, sugars, highs and lows, reactions, control. Until these words become a part of everyday language, however, it is easy for misunderstandings to occur.
The words that we use to describe ourselves play an important part in defining our identity. They can also influence the way we lead our lives. For example, a child who is known as a troublemaker often continues to live up to that reputation. Similarly someone who has a chronic illness may succumb to the role of being sick and incapacitated.
No one enjoys being judged, least of all children. Think of their reactions when they show you their school reports with consistently low grades. Anxiety, despondency, humiliation, a 'couldn't-care-less' attitude? None of these inspire motivation to try harder. What about your reactions as a parent? Are you supportive or critical?
All children want to hear that they are loved by their family, that they belong and that they are good enough just the way they are. Children continually seek parental approval. When this is missing, children grow up feeling that there is something wrong with them and that they are flawed in some way. This sense of shame comes about from children being told repeatedly that they do not measure up to expectations and are a continual disappointment to their parents.
Take the word control, for example. It is commonly used when talking about how effectively diabetes is being managed. For parents, whose goal is to keep their child as healthy as possible, this often means keeping a very close watch over blood sugar readings, amounts and type of food eaten and exercise taken. For a teen however, 'control' is not so much about keeping healthy but a threat to his or her need for independence. It means limiting privacy and the ability to choose for oneself. It is also easy to see how words like diet and compliance can be unintentionally viewed as restrictive.
Consequently, this diabetes vocabulary can often be misinterpreted by both parent and child, resulting in conflict where neither side feels understood. The way out of this is to talk less about control and focus more on the idea and expression of partnership between parent and child, and child and diabetes. For example, using open-ended questions such as 'How do you feel you are coping with your diabetes', or 'What are you finding most difficult about it?', or 'What would help you now?' is likely to foster a working, parent-child partnership and avoid excessive conflict. Experts are finding that this approach generates the kind of support that children with diabetes need.
Parents must be patient, flexible and willing to respond accordingly to their child's developing needs. Daily conversations between parent and child play an important part in helping to shape the child's view of himself and his world. Sometimes parents feel that they are not the major influence in their child's life and that they have been replaced by friends, movies, television and magazines. Although your child may appear disinterested, you are still an important source of experience and knowledge.
Keep in mind that what you say and how you say it can help to influence the way your child learns to live with diabetes. Here are some points to consider when you next talk about diabetes.
The words that we use to describe ourselves play an important part in defining our identity. They can also influence the way we lead our lives. For example, a child who is known as a troublemaker often continues to live up to that reputation. Similarly someone who has a chronic illness may succumb to the role of being sick and incapacitated.
A child with diabetes must reconcile his search for his own identity with having a lifelong medical condition. This is not always an easy process, particularly for young teenagers who need to feel that they fit in with their peers. Being called a diabetic assigns a particular identity and can accentuate a sense of difference. Being told that you can't do something because of your diabetes gives the condition the upper hand and sets a child apart from others.
As a parent, you can try to help your child feel that diabetes has not completely taken over her life and made her into some kind of freak. Acknowledge your child's normal developmental needs, as well as the additional challenges of dealing with diabetes, and talk in terms of having diabetes rather than being a diabetic. This will help your child develop the idea that she can be in charge of diabetes while continuing to take part in all typical daily activities.
No one enjoys being judged, least of all children. Think of their reactions when they show you their school reports with consistently low grades. Anxiety, despondency, humiliation, a 'couldn't-care-less' attitude? None of these inspire motivation to try harder. What about your reactions as a parent? Are you supportive or critical?
If given the chance, diabetes does its fair share of judging. Tests and more tests every day. No wonder children often find it harder to do these than give themselves insulin. It is not surprising that they sometimes make up blood sugar readings in order to do well and please their parents.
Monitoring blood sugar levels is obviously an essential part of maintaining good health in your child, but there may be more constructive ways of approaching it. Replace the word test with check or reading and introduce the idea to your child earlier on that checking blood sugar levels is a guide or signpost for determining which way to go next.
Try to avoid using the words good or bad in relation to blood sugars as they imply more judging and results. High and low are preferable terms, but even better to leave out the descriptive word: 'Your reading is 20 so what do you need to do now?' This will help a child work with blood sugar outcomes rather than view them as the enemy.
All children want to hear that they are loved by their family, that they belong and that they are good enough just the way they are. Children continually seek parental approval. When this is missing, children grow up feeling that there is something wrong with them and that they are flawed in some way. This sense of shame comes about from children being told repeatedly that they do not measure up to expectations and are a continual disappointment to their parents.
Of course most parents have no intention of shaming their children, but as a result of personal frustrations or family background, shaming messages may slip out.
This can happen in families where there is diabetes. Parents may inadvertently give these types of messages out of intense desire to keep their child healthy. Blood sugar readings are rarely good enough, diet and exercise are never acceptable, attitudes to having diabetes are not up to expectations. The biggest disappointment, however, is when children lie about their diabetes - falsifying readings, sneaking food. For some parents, this is a form of betrayal and results in either punishment or parents giving up ('I've done all I can to help, you're on your own now'). In fact, what a child needs in this situation is support and understanding, not dismissal.
Children and adults all make mistakes. Although parents would like to see perfect control in their child's diabetes, this is not always possible and only sets up a child for failure and parental disapproval.
Working together with your child rather than against him in a blaming and critical way is more likely to help him cope better with diabetes and feel accepted for who he is.
There may be times when your child struggles with both the idea of having diabetes and with carrying out the daily tasks of taking insulin, checking blood sugars, and monitoring food and exercise. There is no let-up in this rigorous programme nor is there a vacation; therefore, it can be expected that children get tired and frustrated with it. Sometimes this results in a pattern of missing shots, forgetting to check blood sugars and 'junking out' on unhealthy foods. If this is done on a consistent basis, parents understandably become very anxious that this attitude of poor control will result in serious health problems later on. Again, out of love and desperation, parents have been known to try shock treatment (i.e., 'You'll go blind if you carry on like this!'). This doesn't work! For a start, teenagers are not thinking about the years ahead - they are living in the present, and trying to scare younger children into obedience is more likely to give them nightmares!
Try to help your child express his frustration of having diabetes. You can't make it go away, but you can help to share the load. It may be that some extra support and involvement is needed: doing some of the injections if this has been the sole responsibility of your child or teen, planning a more interesting diet or working in some extra treats if there is a craving for a particular food. Try to understand how your child feels and ask yourself, would you always have the willpower to stick firmly to your meal plan?
Above all, in dealing with your child's frustration, you also need to look after your own worries and concerns as a parent. Finding ways of dealing with your own stress and having support will help you to feel hopeful and to communicate with your child in a more positive way.
Family Communication
Conversations are constantly taking place within the daily life of a family. They are the means by which we communicate our thoughts and feelings. Sometimes they flow smoothly with mutual understanding and respect. Other times they end in anger, frustration, and hurt feelings. Communication does not always come naturally and can depend on how a parent or child feels at that moment. It takes thought and effort, both of which are not readily available when there is stress and tension in the family. We have seen how, in the case of diabetes, well-intentioned parents can sometimes miscommunicate with their children.
Conversations are constantly taking place within the daily life of a family. They are the means by which we communicate our thoughts and feelings. Sometimes they flow smoothly with mutual understanding and respect. Other times they end in anger, frustration, and hurt feelings. Communication does not always come naturally and can depend on how a parent or child feels at that moment. It takes thought and effort, both of which are not readily available when there is stress and tension in the family. We have seen how, in the case of diabetes, well-intentioned parents can sometimes miscommunicate with their children.
The good news is that everyone can learn to communicate better, and one or two changes in your language can make an important difference when you speak of diabetes with your child.
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