Parent Information – Encouraging independence in your son or daughter

Parent Information
Encouraging independence in your son or daughter

Introduction
As a parent or carer of a young person living with diabetes, helping them to make their own decisions as they learn to gain their independence is a daunting prospect. The transition period is a time of growth and change and it is hoped this will help your son/daughter to become confident and competent in navigating their way through the adult diabetes service. This journey can be challenging but is very worthwhile and should result in the best possible outcome for their personal development and diabetes management.

During their adolescent development, a young person with diabetes will become increasingly involved and independent in their decision making related to both their health and decisions about their life in general.

‘Letting go’ and feeling confident that a young person has the skills and capacity to manage their own healthcare completely, can be difficult.

Promoting independence in young people will lead to them gradually developing greater capacity to take care of themselves as well as increased confidence, self-esteem and self-worth.

The need to gain independence and engage in risk taking behaviours is typical in adolescence. It is during this time that young people learn about life and how to make their own decisions. Making informed decisions is important as they embark on the road to adulthood and can help them avoid taking high-level risks.

Practical matters
Supporting your son or daughter in taking some practical steps towards becoming an independent adult can make a significant difference to their perception of independence.

Every young person’s journey to independence will be different. Gaining independence in all parts of life including healthcare may require a different approach for each individual. Some young people may already be living away from home or attending their medical appointments on their own. Other young people may enjoy not having to make big decisions and prefer to leave certain decisions or discussions to their parents/carers. Each young person is different but it is important to keep encouraging independence.

Many parents/carers have a significant role in their son/ daughter’s diabetes and general health care over many years. This may include informing doctors and nurses about their son or daughter’s current status, responding to and asking questions in consultations, booking appointments, filling prescriptions and providing transport to appointments.

As you promote independence in your son/daughter you could;

• Encourage your son/daughter to respond directly themselves to questions from the diabetes team and ask any questions they may have themselves. It may be helpful for your son/daughter to write down a list of thoughts or questions with them to their appointment.
• Ask your son/daughter to describe what has been going on to the doctor/nurse at the beginning of the appointment and gently prompt them to recall more if you think they have left out some important details.
• Encourage your son/daughter to take more responsibility for ordering their insulin and necessary equipment.
• Encourage your son/daughter to have some time alone in each consultation building up to a point where they have most or all of the consultation time alone, with you getting an update of key issues at the end of the appointment.
• Encourage your son/daughter to book their own appointments.

Ensure that both you and your son/daughter are comfortable with this process. It may take some time to adjust, so move slowly through these steps.

At home
While encouraging independence in your son or daughter’s healthcare it is also equally important to encourage increasing independence at home, at school and in relationships.

Depending on the stage your child is at, these suggestions encourage independence at home;

• Assign chores to promote responsibility.
• Allow your son or daughter to go out with friends unescorted, with a clear message about letting you know where they are going and what they are doing and when they will be home.
• Teach your son/daughter to cook a meal once a week.
• Teach your son/daughter how to drive.
• Encourage your son/daughter to take up an after school activity or sport, or get involved with a community or voluntary group.

Communication and negotiation during adolescence
Adolescence can be a challenging time for young people as they begin to engage with the world in new ways. Communicating and negotiating with your son or daughter may prove to be difficult at times. Remember to give your son or daughter space when they need it and make time to listen to what they have to say.

Communicating with your son/daughter
Communicating may be challenging and frequent disagreements may happen. Here are some tips that may help avoid conflict.

1. Start a discussion with your son/daughter at a time when you are both free to talk, such as during a car trip or at the dinner table.
2. Remain calm and rational throughout any discussion. No one will benefit from the conversation if you lose your ‘cool’ or get upset.
3. If your son/daughter is becoming frustrated or argumentative, pause the discussion and return to it when you’ve both had time to think. Use a neutral sentence such as ‘I don’t want to argue with you so perhaps we’ll take a moment to think and return to this discussion at a later time’.
4. Give your son/daughter signals that you are listening when he/she is talking, such as nodding your head and asking questions.
5. Don’t interrupt your son/daughter when they are speaking as they will feel that you aren’t listening to their point of view.
6. Try and come up with an option that suits you both.
7. Let your son/daughter know that you love and support them.

Negotiating with your son/daughter during adolescence.
Finding an option that suits everyone isn’t easy. Negotiation involves taking into consideration all opinions before reaching a solution. Try these tips;

1. Allow time for both of you to have your say. Really listen to what your son/daughter is saying and repeat back what you think you’ve heard, to show you are listening. Encourage them to do the same. Try not to talk over each other whilst you do this, but give each person the time to fully explain.
2. After both of you have expressed your individual concerns, give time for you both to offer solutions and then decide between you which to try first.
3. If you disagree with an idea that your son/daughter suggests, clearly explain the reasons why. Then offer an alternative or ask them to propose one.
4. If your son or daughter becomes unreasonable or irrational, or you find yourself becoming less calm, quietly explain that you will continue the discussion when everyone is calm.
5. Remember, you are much more likely to be listened to, if the other person feels they have been listened to.

References:

Adapted from: The Royal Children’s Hospital Melbourne (2012). Adolescent Transition Education Package.

NHS Scotland: Psychosocial interventions for improving adherence, self-management & adjustment to physical health conditions. Children and young people.

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