Parents United in Diabetes Care
Teamwork and talk ease the burden and help keep goals in mind
Being a parent can be a juggling act, and your child's diabetes is another ball thrown into the air. Having a partner to share the load can make things easier—as long as you're generally on the same page.
When it comes to helping your child manage his or her diabetes, it's important for everyone to communicate openly and have the same goals in mind. That way, one parent isn't "the enforcer" or "the appeaser." Whether you live in a two-parent household, are part of a blended family, or are a single parent, there are steps you can take to make sure goals are being met across the board.
Attend Appointments Together
Whether it's a child's first diabetes care visit or not, it's important that everyone involved in the disease management is on the same playing field at diagnosis and in the years ahead. That might mean both parents attending any health care visits, says Fran Cogen, MD, CDE, a pediatric diabetologist and director of the child and adolescent diabetes program at Children's National Medical Center in Washington, D.C. If that's not possible, Cogen says she tries to get everyone involved in a child's care on a conference call during the appointment. "In order for the kid to get consistent messages, both parents need to be on the same plane," Cogen says.
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Seema Kumar, CPNP, MPH, works in the pediatric endocrinology department at Georgetown University Hospital. She says bringing in other caregivers—including stepparents, school nurses, and other adults who might be involved in a child's diabetes management—can help families address potential emergency scenarios as well as daily care. Having a sound foundation makes sharing responsibilities easier.
Divide and Conquer—Equally
No one wants to be the "bad cop," but in many parenting situations (not just diabetes management), one parent may end up taking over most responsibilities. It doesn't have to be that way. Splitting the workload, particularly with younger children, can be helpful in homes with two parents, says Kumar. For example, one parent might be in charge of carb counting, while the other might handle changing pump sites. Parents can play to their strengths. And with older children, checking in with them about their self-care regularly—and equally between parents—makes sure no one person is seen as a nag or a pushover.
If the workload seems uneven, the parent with more on his or her plate could get burned out—and the other could forget how to stay involved, which can be dangerous in case of an emergency. Keeping skills sharp is important, but so is maintaining a good family dynamic. "If it's the same parent [checking in] all the time, it can cause
a lot of stress, and cause stress on a relationship," Kumar says. "And a kid can feel that very acutely."
When was the last time someone checked the blood glucose log? Are supplies running low? Does one parent feel more burdened with diabetes care? It's important to talk about these things before problems arise. Lauren Clary, PhD, a licensed clinical psychologist with the Division of Endocrinology and Diabetes at Children's National Medical Center, says busy families should use everything at their disposal to communicate openly, so there are no gaps in care and no festering frustrations.
|When everyone involved in a child's diabetes care can access up-to-date information on the child's blood glucose levels, parents and providers can breathe a little easier. The American Diabetes Association's Diabetes 24/7 program uses Microsoft Health Vault to store that information. Visit 247.diabetes.org to start a profile today.
Written systems, such as text messages, a notebook passed between homes, or a centralized bulletin board, can be great communication tools. Clary also encourages families to schedule meetings to cut possible issues off at the pass. "Having regular scheduled family meetings [can] address any ongoing or repetitive issues," she says. "Obviously, with managing diabetes, some frustrations are going to arise, but it helps to listen to others around you and have calm discussions and really work together to manage those frustrations."
A child with diabetes is already using a blood glucose meter, and perhaps an insulin pump. Why not make technology your friend? Parents can use an online service, such as Google Docs (a free online word processor and spreadsheet program), to make blood glucose logs and other notes accessible to everyone involved in a child's diabetes care, from school nurses to primary care doctors to parents and grandparents. Many programs also track changes so it's easy to see who's updating the log.
Using an online program puts all updates at your fingertips in real time, so you also avoid parental overlap or gaps, Kumar notes. "It can be kind of a touchy subject—is it appropriate to call or text and ask about blood sugars?" she says. "With a Google Doc, you don't have to. If I see a low number, I might call … [but] it really provides another level of access and communication that way."
Maintain a Support System
Diabetes can sometimes feel isolating, for children and parents. Setting reasonable limits and expectations and having backups make the difference in avoiding stress for parents and kids, says Cogen. In single-parent families, she suggests recruiting another family member or close adult friend to help with diabetes management. "It's very hard for one person to assume all roles," she says. "It might be helpful to have another support person just for help, so [one parent is] not always the one on the front line."