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WORKING WITH PARENT AND
CHILDREN
The Family
A. MEETING THE FAMILY
MOTHER
A FULL TIME PRIMARY
SCHOOL TEACHER
NEWLY DIAGNOSED WITH TYPE 1
DIABETES, (10 YEARS OLD)
PETER
PETERS YOUNGER SISTER,
ANN
A. MEETING THE FAMILY
FATHER
UNEMPLOYED
PATERNAL GRANDFATHER
A WIDOWER
DIABETES IN MIDDLE AGE
AMPUTATION ON HIS FOOT
PAEDIATRIC
DIETITAN, SUE
B. INTERVIEW SESSION
Mother will
answer on
behalf of his son
Peter does not
make eye
contact with
Sue.
Frequently,
interfere the
mother to deny
what she says.
Peters father is
not mentioned
Mother
describes Ann,
as fine and no
problem
B. INTERVIEW SESSION
Sue noted that Peter
close to his grandfather
She wonders if it will be
beneficial to encourage
the grandfathers support
in managing Peters
diabetes
Although she is aware
that this could cause
friction between mother
and grandfather
She is also wonder what
kind of connection his
father has with his son.
How the stress of the
unemployment is
affecting the family.
C. REFLECTION
The family is under a lot of stress:
1. Mother seems anxious and controlling.
2. Peter tense and defiant
3. Sister possibly feeling a lack of attention
4. Father absorbed in his own problems.
5. Grandfather either supportive or demanding
C. REFLECTION
PETER
1. How does he feel about his diagnosis?
2. How much does he know about diabetes?
3. Does he know anyone of his own age with diabetes?
4. Is he embarrassed at being different from his friends?
5. What is his relationship with his mother, father and
grandfather?
6. How will his diabetes affect his relationships with his
friends and sister?
C. REFLECTION
PARENTS
1. How do his parents feel about Peters diagnosis?
2. How do they think the diagnosis will affect them as a
family?
3. What role, if any, does Peters father play in
shopping and in preparing and cooking the family
food?
4. Would Peters father come with his wife to discuss
Peters diet?
5. Do they see him as a help or a hindrance?
D. CONSIDERATION
1.She considers seeing mother and Peter again and instructing them about :
what he is to eat
what he is to avoid
how to manage his diet, insulin and exercise .
2.At 10 ,Peter should be able to grasp the basic concept of balancing diet, insulin
and exercise .
3. She also considers how to reinforce her instructions by stressing the
consequences of not keeping to the diet .
4. She thinks of the others involved in caring for Peter the medical and nursing
staff and his teachers and notes the following questions :
Has the dietetic department got any notes on the grandfather?
Has a colleague given him dietary advice in the past?
Is it worth looking at his medical notes?
Have the doctors any concerns about both children being small for their age?
In the case of Peter, this may be due to his diabetes, but what about his sister?
How long has their growth been slowed?
Is their size a family characteristic?
His mother is quite petite, but what about his father?
Is his small stature a sign of deprivation, or is it of little significance?
Is anyone else in the team involved with the family?
MAKING PLAN
4. Make an appointment to see mother on her own.
3. See Peter on his own.
2. Look up the department records about grandfather.
1. Talk to the doctor.
Sue now feels ready to make a plan of action, and jots down
the following steps:
Continue
? She thinks that more information will help her to decide how best to
approach Peter about his diet . She realizes that if she can establish
a good relationship with Peter, it will make it easier for him to learn .
? It will also stand him in good stead for his contact with dietitians in
the future .
? She recalls herself at 10 years old, when she was in hospital for a
tonsillectomy (is a surgical procedure in which both palatine tonsils
are fully removed from back the throat) .
? She remembers how scared she felt in the strange environment and
how worried she was about what would happen to her . She
remembers counting the hours until she could go home . She
wonders if Peter feels anxious, like she was .
The Next Meeting
She focuses on giving him her full attention and actively
listening to what he says by using her skills of reflecting .
This is instead of questioning, which she thinks is likely to seem
interrogative to Peter .
Her intention is to demonstrate her acceptance and
understanding .
He slowly opens up to her and begins to talk more freely
about himself and his family .
She learns how much Peter values spending time with his
grandfather when he calls in for tea on his way home from
school
Peter suddenly confides in her his fear about having hypos
(apparently he had his first the previous day).
She focuses on demonstrating her empathy by reflecting,
You feel frightened about having more hypos? She then
adds, I think I would, also, in an attempt to convey that his
fear is normal in the circumstances .
She senses him relax a little . She asks him if he feels
frightened because he is not sure what to do to prevent
one occurring again . He says he does .
As the time for their interview is drawing to a close, Sue says
she will see him at the same time tomorrow and will explain
then how he can avoid the risk of hypos by having enough
to eat .
She asks him if the doctors know about his hypo or if he
wants to tell them . He shrugs his shoulders, as if he does not
care either way . Sue is aware of feeling a little irritated and
yet at the same time realizes that this may be difficult for
him .
She says she is willing to tell the doctor on his behalf if he
would like her to . He nods his head . Reflecting upon their
meeting, Sue thinks she is slowly gaining Peters trust .
She knows now about his fear of hypos, and she has a lot
more information about his eating patterns on which to
base her teaching plan .
Summary of How Sue
Worked With Peter
An example : When he referred to his favourite evening meal, which
he called a plate supper . This consisted of a specific selection of
cold snack foods, served on his own special plate and eaten while
lying on the floor, in front of the television .
Sue trying her best to build a relationship with him to gain his trust .
To achieve that, she uses her skills such as active listening to show
her acceptance, genuineness and empathy towards Peter . She
knew what is it feel like to be in Peters situation helped her to be
empathic . Besides that, to make the communication easier, she
usually use a simple words or the same vocabulary as Peter . She
also checked her understanding with Peter when he used words
that had a particular meaning for him and his family .
