When a child is diagnosed with diabetes, parents frequently experience overwhelming grief and guilt. They often ask questions like, “Will my child have a high quality life?” and “Could I have caused this disease?”
Carol M. Almeida, MSN, RN, CDE, reports in the Nov./Dec. 1995 issue of The Diabetes Educator that such grief frequently leads to depression, which is expressed in a variety of ways including sadness, irritability, tension, and headaches.
Others feel angry, either at themselves for their failure to be the perfect parent-for instance, they may serve meals that aren’t well-balanced or on time, or fail to recognize hypoglycemia. They may also be angry at caregivers who “should have” recognized the disease earlier or done something to prevent it. There may also be a perception that an educator’s suggestions are rules written in stone, setting up a system of unattainable expectations.
Although grief and its accompanying emotions are normal, when left unresolved, it can cause a multitude of problems which may lead to a decline in the child’s health.
There are four common indicators of an unhealthy family dynamic:
Enmeshment refers to a family overly-dependent upon one another. By funneling his or her emotions upon a sick child, a parent may begin to overstep personal boundaries and control the child ineffectively. Parents may feel resentment, rejection and low self-esteem, which complicates the grief process.
Overprotectiveness is a form of anger. By constantly sheltering a child, a parent actually puts the child at risk. According to Almeida, “Overprotectiveness is detrimental to metabolic control because it induces stress…Physiological changes (associated with stress) can precipitate the development of ketoacidosis.”
Rigidity refers to the family’s commitment to retaining the “old way” of doing things, rather than changing to accommodate the sick child. Families that adapt easily to the disease and its care are called functional. Those that cannot adapt are called dysfunctional. Any outside event can overload a dysfunctional family, aggravating the illness.
Detouring is another method of avoiding conflict, in which parents who seem happy are actually hiding marital conflict by overprotecting or blaming the child.
Almeida writes, “Children with diabetes who achieve metabolic control and psychosocial adjustment have families that interact in adaptive ways. These families are cohesive. They permit differentiation of the self or emotional maturity, and they offer support for individual endeavors. They are open to input from other support systems. They are flexible in response to change, and they adopt effective ways of resolving conflict.”
Support groups are a good way for parents to deal with their grief, and to help get their children on the path to good control. Support groups allow participants to learn from one another, and gain a sense of camaraderie rather than the “I’m-in-this-alone” attitude. Almeida suggests that group leaders encourage discussions of disharmony within the family, allowing individual members to speak for themselves.