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Diabetes Skills SelfCare

Diabetes Self-Care: What Does My Child Need to Know???
Handing over diabetes care to children
Part 1: An Introduction

Sometimes it seems there are a million steps to hand off to our kids so they can manage their own diabetes effectively; it’s common for parents to feel overwhelmed and unsure of where to start. If our goal in parenting our children is to work ourselves out of a job (and I believe it is), then we have many skills to teach in the 18-some-odd years in which they are in our care. Diabetes-related tasks represent an additional group of skills that need to be passed on to our children/teens, so that when they are out on their own they are equipped to do for themselves all the things which we have routinely done for them. (Dare to dream!)


How Do I Know What to Teach?

A task analysis is an outline of the steps involved in a particular skill. It breaks down a large, sometimes overwhelmingly task (such as diabetes self-care) into smaller component tasks (such as blood glucose monitoring, delivering insulin, correcting blood glucose highs, counting carbohydrates, adjusting for exercise and treating blood glucose lows), each of which can again be broken down into a series of steps which can be taught individually, and then linked together for mastery of the larger skill as a whole.

We have provided a task analysis below as a sort of a checklist, to give you an idea of the skills your child or teen may need to learn in order to become independent in diabetes self-care.


How Can I Use This Task Analysis to Teach Diabetes Self-Care?


Take a look at the lists of diabetes-related self-care skills we have provided (Parts 2-6 outlined below).  


Are there skills your child or teen already does on her own?

Mentally cross them off the long list in your head; breathe a sigh of relief that you don’t have EVERYTHING still to hand over; give you and your child or teen a pat on the back for what you’ve all already accomplished.

To determine if your child has “mastered” a certain skill (that is, she could and would “pull it off” by herself when you’re not around), consider not just what your child can do, but what she will do consistently. Without assistance, reminders or nagging.


Are there skills your child or teen can do as long as she has some assistance or supervision?

Ask yourself if among them there are skills he could and should be doing without assistance. Keep in mind where he’s at developmentally, emotionally, physically. Talk to your child/teen’s diabetes health care team for perspective. Get input from your child/teen; see how he feels about being more independent, ask which skills he might like to take more responsibility for. Identify a few target skills to work on in the coming weeks, and consider ways to fade out the assistance or supervision you are currently providing.


Are there skills you still “own” completely?
 
That’s okay. Some things should be in an adult’s hands. Again, keep in mind what’s reasonable for your child or teen, given her age, abilities, current emotional resources, and the other demands she’s coping with. Make a long term plan to hand these skills over by considering which skills are foundational skills (pre-requisites for other skills) and so will be taught sooner than other more advanced skills. As above, talk to your child/teen’s diabetes health care team for perspective; chat with your child/teen to get their input. Consider all of this within the context of your timeline: will your child/teen likely be living on her own within 4 months? 4 years? 14 years? Adjust your plan accordingly.


For those of you who are wondering how you can get your young child involved in his own diabetes care, this outline can provide ideas for smaller steps within the larger tasks which your child may be able to carry out.  For example, he may not be able to check his own blood glucose, but perhaps he can put the strip in the monitor and read out the resulting number. Involvement, in whatever way your child can manage (both physically and emotionally), contributes to a sense of control and responsibility. This will benefit everyone in later years.

In the same way, if you’re playing catch up and find there are lots of diabetes care tasks to hand over to your teen in a short period of time, this outline can give you a place to start. Begin by picking a few achievable tasks: perhaps your teenager is not ready to adjust his own insulin doses, but he could look for a pattern of highs at the same time every day.


What If These Steps Are Too Big? 

Some of the above diabetes self-care skills may be broken down into even smaller steps to meet your family’s needs.
 
For example, “Draw up correct amount of insulin” could be broken down into 5 (or more) smaller steps as follows:
1. Take cap off syringe.
2. Place needle into insulin vial.
3. Draw back plunger to fill syringe to desired level.
4. Tap out any air bubbles.
5. Refill syringe to desired dose level, if necessary.

If a step seems unmanageable for your child or teen, or if you have been trying to teach a given step without success, consider ways to break that skill down into smaller component steps, and then teach one of those sub-steps at a time.


For more information on diabetes-related self-care skills, see the following: 

Part 2: Overview of Skills
Part 3: Blood Glucose Monitoring and Treatment
Part 4: Insulin
Part 5: Managing Insulin Pumps
Part 6: Carbs and Exercise



Any questions? Comments? Feel free to Contact Us.



The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.



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