How can I "make" my daughter take care of herself?
Our daughter has epilepsy.
First, how can we lead our daughter to not feel over-controlled as she gets older and wants more independence? We will have to be careful that she not swim alone, ride a bike alone, and may not be allowed to drive, etc.
Secondly, how can we encourage her to take care of her body to avoid seizure triggers (exhaustion, alcohol, missing the meds)? College years will be scary (for who, Laura?). – Laura W.
Dr. Cline’s Answer:
Well, Laura, since you are asking the wrong questions, there are no good answers! I have italicized the words in your questions that are leading you astray.
But fear not! There are great answers for the right questions! Really, the major emphasis as you asked your questions have to do with what you can do and how you handle things. Responsibility for self-care must be placed squarely on the shoulders of the individual most involved, in this case, your daughter. So let us rephrase your questions.
First, as your daughter grows older, she will need to learn to weigh her need for independence against her potential for seizures. We are weighing the parental line between being over-protective and too uninvolved in her care.
Secondly, she will need to develop an awareness of seizure triggers. How can we best encourage thoughtfulness in this area?
The answer to these questions is what Parenting Children with Health Issues is all about. So it’s difficult to give complete answers in this response. But in general:
Allow your daughter to make mistakes in self-care while she is in early elementary school. Allow her to suffer from her mistakes, (of course, protect her from mistakes that are life-threatening). When she does make mistakes, give her empathy without sympathy; kindness without rescue; understanding without lecture. Mistakes must be celebrated as major learning opportunities. Share the control by letting her make her own choices as much as possible.
There is an example of this type of parenting when the problem is seizures on page 72 of Parenting Children with Health Issues.
Laura, you are in good company. Most parents struggle with the same types of questions: How can I make my child take his medications? How can I convince him to eat properly? How can I make sure my child doesn’t drink and drive? And, yes, the college years can be scary (for us parents!).
Even medical professionals have the same questions. Right now, my son is in the hospital for IV meds. The social worker just shared her frustration with an 11-year-old girl who is refusing to take her meds (this can result in irreversible lung damage). Her question was: “How can the parents make her comply?”
The hard answer is: they can’t. Once a child is past the elementary years, it becomes increasingly difficult to “make” a kid do anything they don’t want to do. However, there are many things a parent can do to increase the odds that a child will decide to make good choices for themselves- not because someone is “making” them do something. And, as Foster said, that’s what this whole program is about.
The earlier parents start the Consultant parent approach (as we discussed in the workshop you attended), the less likely children will make really bad choices when they are older. This is true of all kids but the stakes are higher for those of us dealing with medical issues. That’s why its so critically important for us to “get” this concept. Click here for an excellent article by Jim Fay (co-founder of Love and Logic) that shows the important differences between Helicopter, Drill Sergeant and Consultant parenting styles.
And, finally, there are some “safe” areas of self-care that you could allow your daughter to learn from like personal hygiene, eating properly, etc. The mistakes she makes in these areas could be uncomfortable but not life-threatening and will teach her the value of good self-care. Examples are a rash on her bottom from not cleaning well or a tummy ache from too much candy. The wisdom she gains from these “significant learning opportunities” will directly transfer over to her medical self-care issues and she will be more likely to make good self-care choices in those (scary) college years.
Posted 3/07/07 See Disclaimer at the bottom of this page
What questions can I use to keep my child in the "thinking mode?"
I love your approach of using questions with our children to help them do the thinking rather than telling them what I think. But, I have a hard time coming up with good questions- I just don’t think that fast on my feet! Could you give me a list of good questions to use with my 11 year-old daughter for her health issues (diabetes) and the general parenting issues I also have with her like getting good grades and her attitude? Thank you, Janet B.
Dr. Cline's Answer:
Asking questions instead of providing answers actually requires much less thinking on the part of the adult. But, it does take a bit of practice because it is such a change for adults who feel like they should have all the answers.
The concept of using thought-provoking questions instead of orders, demands and solutions is a thread that runs throughout Love and Logic’s teachings. There are several examples of how parents use questions to discuss difficult issues in the book “Parenting Children with Health Issues.”
I will give you some examples of questions to help get you started. Remember, like all of Love and Logic’s tools, using questions only works when they are asked with sincere curiosity and interest, not sarcasm or as manipulation. Good luck!
When poor decisions are on the verge of being made:
· How do you think this is likely to work out for you?
· Do you think it would be wise to handle your feelings differently?
· Do you think you might be making a painful choice but that you will learn from it?
· How would most kids handle this situation?
· What am I thinking right now?
· Do you think I might be changing my mind about taking you?
· Are you a little worried about losing friends?
· Are you thinking that summer school is in your future?
· What are the reasons you may not be going with us?
· If you go with us, what are the behaviors that we expect?
· What age do you think you sound like right now?
· Do you worry about shortening your life with the choices you make?
· What do you think the doctor might say when he looks at your … (teeth, weight, glucose record, etc?)
· If you had to get to the doctor quickly because of (poor care) do you know how to get an ambulance?
· If you were having a ___ (medical emergency due to poor care) and I weren’t around, what would you do?
When children make good choices, wise parents use questions rather than praise:
· Wow! How did you figure that out?
· How proud of yourself are you?
· Are you surprised at how well it worked out?
· How hard did you have to work?
· Are you going to let people know about this or keep it a secret? (Many kids hate it when parents brag about them.)
· Do you think you will always do it like this?
· How do you feel about your body after taking such good care of it?
How important is it to stay on top of your child's condition as far as asking them and checking on them?
Following is an interview question that Lisa and Foster answered for an article for iparenting.com- a popular online parenting magazine:
How important is it to stay on top of your child's condition as far as asking them and checking on them? - Teri Brown
When children are young it is obviously absolutely necessary that parents make sure they follow doctor’s orders. If they don’t, the child may die (like in the case of cystic fibrosis or diabetes). During the elementary years, it is fairly easy to make kids comply. There may be some resistance, but for the most part, we can force them into medical compliance with reminding, ranting, raving and rescuing. This works just fine up until about age eleven but then there is a new day a-dawning when children hit the teen years.
Around the time of puberty, chemistry causes a child’s brain chemistry to change so that they understand analogy and metaphor and thoughtfully weigh situational ethics. This “higher-order” thinking also means they may be less likely to simply accept their parents' view of the world. Continuing to use power-parenting methods now can backfire. Children may become rebellious about many things including medical routines. Parents understandably come down harder on the child and thus the child becomes even more rebellious and resistant. It can become a desperate, heartbreaking and downward spiraling cycle. We have heard story after story like this with teens rebelling and landing themselves in the hospital severely ill.
This is what our whole program is about- to teach parents the skills which will help them avoid this vicious and potentially deadly cycle. It is sad enough when a child rebels against his illness just because that is what kids do but it is saddest of all when a child rebels against a parent and uses his illness as a weapon in the war against being over-controlled.
The short answer to this challenge is to begin consultant parenting as early as possible. This means sharing control and allowing children to make their own choices and experience the consequences of their choices with the adult there to provide love and encouragement but not rescue (unless there is danger to life or limb). The message the consultant parent sends is this: You’d best do your own thinking because the quality of your life has a lot to do with your own decisions.
We need to stress that parents must never allow a child to experience natural consequences which can result in danger to life or limb. So with issues like diabetes or severe allergies, parents must intervene. But even when natural consequences can't be used to "do the teaching," logical (or imposed) consequences often can. And, when parents adopt the consultant parent approach around everything else like schoolwork, chores, etc. then the sense of personal responsibility carries over into the medical arena as well.
Click here to read the iparenting article titled: Parenting Special Needs Children: Top 5 Qualities of Successful Special Parents by Teri Brown
These concepts are from the book “Parenting Children with Health Issues: Essential Tools, Tips and Tactics for Raising Kids with Chronic Illness, Medical Conditions and Special Healthcare Needs” by Foster W. Cline, M.D and Lisa C. Greene.
Dr. Cline is a child psychiatrist, author, and co-founder of Love and Logic. Lisa is the mother of two children with cystic fibrosis and a parent coach. For free audio, articles and other resources, visit www.ParentingChildrenWithHealthIssues.com.