Diabetes Self-Management Articles

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Resolving Parent–Teen Conflicts

by Jean Roemer, MSN, MN, CPNP, CDE

Virtually all parents and their teens have conflicts at some point. Teens are at the stage in life when they want and need more independence to explore who they are and who they want to become as adults. This exploration often includes questioning (or outright rejecting) their parents’ beliefs or lifestyle and trying out new ways of thinking and behaving.

Parents, while often proud of their teen’s growing maturity and independence, may also disagree with some of his new attitudes or fear that his behavior is destructive or will have negative consequences down the line.

In teens with diabetes, the topic of diabetes care often becomes a focal point of parent–teen conflict. Parents may want their teen to take on more responsibility for his diabetes care, and teens may want that, too. But the stakes are high, since not caring for one’s diabetes properly can lead to serious consequences. And even a motivated teen may feel overwhelmed at times by all of the daily tasks that need doing or forget to do certain things. What’s more, many teens are not motivated to take on their daily diabetes care; they may feel embarrassed or unfairly burdened by having diabetes, they may be preoccupied by other interests or concerns, or they may simply not feel like doing the work it takes to manage their diabetes. Whatever the case, when diabetes tasks don’t get done and parents find out, conflict typically erupts.

Nothing will make diabetes care or getting through the teenage years smooth sailing all the time. But there are ways for parents and teens to work together for better diabetes control without continual nagging or frequent angry outbursts.

The following story is a composite of several real cases that I have dealt with at the large pediatric hospital diabetes center where I have worked for the past 30 years. As you read it, think about whether you and your teen are in a similar place and whether the approaches modeled here might be helpful to you.

A typical scenario
Fifteen-year-old Jake and his mother are waiting in an exam room for his regularly scheduled three-month appointment to follow up on his Type 1 diabetes. When I walk into the room and greet them, there is nodding acknowledgement of my presence, but otherwise complete silence. The air is thick with tension as Jake sits slumped on the exam table with his face hidden under his ball cap and Mom sits on a chair with her arms crossed in front of her.

“How are you doing today, Jake?” I ask. Usually a somewhat quiet but articulate young man, Jake mumbles something that sounds like, “OK. How are you?” At the same moment, his mother begins to speak.

“Jake has things to tell you. He’s not counting his carbs or measuring anything. I find candy wrappers in his room and under the sofa, and last night we uploaded his pump and I see that he’s not taking all his bolus insulin. I am so frustrated with him. I remind him all the time, and he tells me he is doing it, and I see that he’s not. He falsifies numbers and tells me he’s taken his bolus insulin when he hasn’t. I am so afraid that he is going to lose his kidneys or his foot or something. I can’t stand by and watch him get sick and die, but I don’t know what else to do. I’m not with him all day, and even if I were, I can’t do it for him anymore. I just worry all the time. He yells at me for reminding him, lies to me, ignores me.”

I glance up at Jake, who remains silent. Other kids at this point might argue with their parents, blame them for the missed blood glucose checks or boluses, roll their eyes, or even start crying. When that happens, I try to help both parties calm down, stop yelling or crying, and agree to listen quietly while the other talks so that constructive dialog can take place.

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