emotional health

Diabetes and the family

•  The family's adjustamente to the diagnosis of diabetes is extremely important. Family members need education, just like the patient, to help them make necessary lifestyle changes and support the patient. It is especially important that all family members living with the patient have an understanding of the demands of the diabetes self-care regimen.

The diabetes educator needs to make sure that both parents recive education in the case of a child with diabetes. It is important to involve the father and to avoid establishing the mother as the diabetes "expert", especially if it is a traditional family in which she does the cooking.

Other family members should be included in education and support (ex, children siblings, and grandparents) whenever possible.

The diabetes educator can gain insight into the interactive nature of the disease and the main dynamics by utilizang family systems theory. Family characteristics such as family conflict are predictive of adherence difficulties. Other characteristics such as family support, cohesion, and organization are associated with better adherence and metabolic control.

A patient in a dysfunctional family system may use illness-maintaining behaviors (poor managemente of regimen, noncompliance behaviors, or dependency on the sick role) as a way to organize the family.

An adolescent may use illness-maintaining behaviors to regulate marital distance or parental conflict.

A couple may avoid dealing with long-standing issues by directing their energies toward health care issues.

An adaptive reaction to a diagnosis of diabetes in a family member is characterized by involvement with the diabetes regimen and having realistic expectations. Typically the family members become educated about the disease, offering encouragement and showing concern when warranted, but remain nonjudgmental.

A maladaptive reaction by a family member may be expressed in one of two ways.

A family member may withdraw and be nonsupportive of the patient, sabotaging the patient´s efforts or putting obstacles to good diabetes management in the patient´s path. This approach often is charactrized by fear, denial, and lack of education.

A family member may be overly protective and foster dependency. This approach denies natural opportunities for risk-taking that help promote a good self-image. Overprotectiveness and enmeshment also may halt the natural progression through the developmental stages of life.
Educational Treatment Unit
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