Keri Walsh was eight years old when she first went to Camp Hodia, a diabetes overnight camp in Boise, Idaho. Diagnosed with Type 1 diabetes at age 4, she had spent previous summers at a day camp run by a diabetes clinic. But overnight camp was a big new step.
“I was a little scared because I knew I would be spending a week away from my parents,” said Walsh, now 15. “But as the week went on, I opened up and fell in love with it. The staff taught me how to test my blood sugar and count carbohydrates — and at the same time I was being a normal kid doing all the activities that other kids without diabetes do.”
Walsh, who lives in Meridian, Idaho, just outside of Boise, has returned to Camp Hodia every summer, and her enthusiasm has not diminished. “You realize that so many other kids are dealing with what you are every day. You learn how to manage diabetes better and you make new friends, and it’s great going out in the woods and being in nature. Sometimes, I don’t want to leave.”
While it’s hard to argue with such praise, and as appealing as such a place sounds, the idea of sending your child away for up to two weeks also can be scary. For most of your child’s life, you’ve probably been within minutes of attending to his or her care. But you also know that for many children, loneliness accompanies diabetes. Meeting other kids with diabetes could help your child feel less alone — and help him learn that he, too, can participate in every kind of fun that other kids can, both indoors and outside.
But every answer leads to more questions: How do I know my child will be safe and her diabetes kept under control? How do I choose the right camp? Below are answers to common questions about diabetes summer camps. You could be offering your child one of the best experiences of her life.
How do I find a camp?
The Diabetes Education & Camping Association (DECA), headquartered in Florence, Alabama, lists 199 member camps on its website, www.diabetescamps.org.
“If a camp is on our website that means it has joined our association, which cares about being on top of the best practices in diabetes,” said Shelley Yeager, DECA’s program development specialist. DECA does not accredit camps; that’s done by the American Camp Association [ACA], an important credential to check as well, said Yeager. ACA has general safety standards apart from diabetes.
The American Diabetes Association also lists camps on its website, www.diabetes.org.
Yeager suggests looking at camps geared toward your child’s interests.
Investigate several camps — and several types of camps, such as family camp that parents can attend with their child, a weekend camp, a week-long camp and an age-specific camp. “For instance, if you have a 13-year-old, will she be more comfortable with kids who are 12 to 16, or with those who are 8 to 18?” said Yeager. “Some kids like to take care of and mentor younger kids. You have to sit down and talk with your child about his preferences.”
How do I know if my child is ready for camp?
One helpful measure is to talk with your child’s doctor and school nurse. “Lots of times, kids are recommended to us by medical providers or school nurses,” said Lisa Gier, executive director of the Idaho Diabetes Youth Programs, which operate five Hodia camps in the state. “If the school nurse thinks a child is ready, she may suggest the family go to a camp gathering to meet other families.” Some bigger camp organizations also offer family camps, a good introduction to camp with Mom and Dad still nearby. There also are day camps, which can give kids an introduction to camp without staying overnight.
Some camps, such as Idaho’s Hodia camps, host community events throughout the year, encouraging families with kids of all ages to come well before they might be ready to consider camp. “We want to help families feel comfortable and get the feel of the program,” said Gier.
Most camps have open houses in early spring at which families can meet returning staff and campers either on site or at a pediatric clinic that serves the camp. Such meetings allow you to gauge the reaction of your child and discuss how he or she feels about going to camp.
Once you’ve narrowed your choices, schedule visits with your child to the camps you’re considering. “It’s hard for children to go to a place they’ve never seen with kids they don’t know,” said Yeager. “It’s important for you and your child to meet the staff and other children so your child can see that the other kids aren’t weird, but children just like him.”
After registering for a camp session, a staff member will call you to discuss any concerns you or your child might have and answer questions. “We ask about homesickness, and we ask parents for their ideas,” said Gier. “We want to know what you hope for and feel about the week to help determine if our camp is the right fit for your child.”
Most camps are for kids ages 8 to 16, said Yeager, although some accept younger children. Others offer weekend programs for parents and toddlers. “Those are immensely helpful for parents, who really can be alone and struggle with childcare issues,” she said. “Those usually have a nurse or physician who can go over technical issues of caring for a toddler with diabetes.”
Is the camp following the current medical guidelines set forth by the American Diabetes Association (ADA)?
“The camp may be accredited by the American Camping Association,” said emergency room physician Alan Bean, MD, Camp Hodia Teen and Kids Camp director, who started attending Camp Hodia at age eight. “But the American Diabetes Association is a medical body that has nothing to do with camp accreditation, so you need to ask if the camp is following ADA guidelines.” You can find the ADA guidelines online at www.diabetes.org.
What medical supervision will my child have?
All camps have physicians who review each child’s blood glucose readings every day and write adjustments to each one’s care. A nurse manages each group of campers based on the physician’s orders for that day, discussing any changes with the child. Physicians also have clinic hours during which they can see children who aren’t feeling well. “And all staff and the health-care team carry blood glucose meters, strips and supplies for low blood sugar,” said Yeager, “like juice boxes, glucose tablets, and granola bars.”
What is the staff’s training in and experience with
Most, if not all, staff either have diabetes or have a close family member with diabetes. “One third of campers age out to become staff,” said Yeager, noting that staff members are volunteers. “And the staff return rate is higher than two thirds. Most were campers or are friends or family of campers.”
What is the staff to camper ratio?
According to Yeager, typically there is one staff member for every three campers. “In a cabin of eight children, there would usually be two adults who understand diabetes very well and one medical staff member such as a nurse or medical student,” she said.
How is my child’s diabetes managed over the course of a camp day?
Camps vary, but generally each day begins with blood sugar testing in the cabin and a discussion of the readings with the cabin’s medical expert, said Bean. At each camp meal, the carbohydrate content of the foods is presented through visual displays: for example, one half cup of hash browns has 23 grams of carbohydrates. Each child then decides — in consultation with his or her cabin’s medical expert — how many carbohydrates to eat and how much insulin to take before the meal. “We’re there to encourage the campers to stay within their carbohydrate budget so they won’t overeat just because it looks good,” said Bean.
After each meal, each child and a nurse review what that child has eaten to make sure the insulin dose is correct. If the kids are headed for a hike or to the beach, they take box lunches. “If a kid’s blood sugar gets low or he gets tired, we can have an on-the-spot training about what to do,” said Bean. “The campers can problem-solve on their own and correct their dosing. We’re there to support them and help correct them if their assessment is off.”
At dinner and again at bedtime, the campers repeat their blood sugar testing. At around 2 AM, medical staff test any children who had a blood sugar reading under 100 before bed to make sure their blood sugar has not dropped further.
What are campers’ typical problems and how are they handled?
“The number one problem is low blood glucose because the kids are so active,” said Yeager. “But camps are so good at taking care of that; we’re used to it.”
Each child checks his or her blood sugar first thing in the morning, at meals, during activities and before bed. Staff always have glucose tablets and snacks on hand.
Another possible problem is homesickness, said Yeager: “Usually, it manifests on day two and is gone by day five, if it’s going to happen. I’ve probably sent six kids home in 20 years.”
Often, the yearning is reversed, said Gier: “Lots of kids say, ‘We don’t get homesick at camp. We get campsick at home.’ Camp provides the fuel that propels them the rest of the year.”
To minimize the possibility of homesickness, Yeager suggests parents go with their children to camp open houses and include them in discussions and decisions about camp. Once your child is at camp, send words of love but don’t talk about how much fun his siblings are having and how much Fido misses his playmate. “And don’t call your homesick child,” said Yeager. “That makes the homesickness worse.”
What do camps typically offer?
Camp activities vary depending on location and season, and the ages of the campers. “If the camp is on a lake, there’s swimming and boating. If it’s in the mountains, there’s hiking and climbing,” said Yeager. “You can pick almost any activities, from wilderness camps to ski camps. Diabetes camps probably offer anything your child wants, but they know how to tuck diabetes into the activities so your child is safe.”
Camp is not one long class on diabetes, either. “One of the greatest misunderstandings is that diabetes camps are weirdly different from regular summer camps and not fun,” she said.
Still, the camps do hold some educational sessions and also seize on impromptu learning opportunities. For instance, at Camp Hodia, after dinner kids gather for a one-hour session addressing diabetes questions the campers leave in a box throughout the day. “The campers might say what works for them,” said Bean. “Their responses help kids know that there’s science to diabetes care, but also trial and error.”
Another evening activity might be a quiz bowl with diabetes-related questions, said Bean. “The judges are medical staff, who explain why a certain answer may not be quite correct.”
At Hodia’s camp for the younger children, one of the evening activities is a carnival, which includes both typical carnival games and booths and others specific to diabetes, said Gier. “One of the most popular is the foot care station. Staff members give campers foot checks and talk about the importance of caring for their feet, plus the kids get a little pampering, which is fun — a foot rub, a pedicure. It’s a neat teachable moment.”
“At Hodia camps we try to balance a lot of education for the kids in the form of teachable moments,” said Gier. “We try to take advantage of those on-the-spot opportunities.”
What is the cost of camp and is there a waiting list?
Prices vary depending on the camp and the length of the sessions (from a weekend to two weeks). Many offer scholarships or suggest fundraising ideas to parents.
“We’ve never turned a child away because of inability to pay,” said Gier. She suggests calling the specific camp you are considering to ask about financial options.
Also, not every state has diabetes-specific camps, so in some parts of the country it can be harder to get a spot. According to Yeager, the majority of diabetes camps in the U.S. fill up quickly and have waiting lists. “It’s important for parents and children to research camps, discuss going to camp with their health-care providers and make decisions early in the year,” she said. “It’s very important to engage health-care providers in the discussion.”
January and February are key months for researching and registering for summer camps, she added, as many camps already have their forms and materials available and returning campers often register early.
What are the benefits of camp?
At camp, your child will be, perhaps for the first time, just like all the other kids.
“I realized that there were so many other kids who were dealing with the same thing I was, and that we could all do activities together, and no one would ask me about my diabetes,” said camper Keri Walsh.
Walsh also loves the lasting friendships she’s made: “If my [camp] friend is having a bad day, she can call me. We’re just best friends who also have diabetes.”
Diabetes camp offers children a safe route to independence, learning to handle diabetes with medical experts as an ever-present safety net. And campers learn that kids with diabetes can do anything other kids do — from white water rafting to horseback riding as long as they manage their diabetes.
Your child also will see adults with Type 1 diabetes leading active, successful lives — adults who become role models, said Gier. “Your children see that when they grow up, they can become whatever they want to be. Your children can see life in a more optimistic way and know they are not bound by this chronic illness. Life with diabetes is so hard, and for this small time at camp, your child can feel like its burden is just the norm.”
Or, as campers at Camp Tanager in Iowa agree, “We’ve got each other’s backs.” Said camp director Donald Pirrie, “it’s a simple, yet powerful statement that defines a common culture at diabetes camps across the country. Steeped in tradition and packed with learning opportunities, camp provides a home away from home where kids and teens can unite with lifelong friends to share both the highs and lows of living with diabetes.”
Want to learn more about caring for a child with Type 1 diabetes? Read “Type 1 Diabetes and Sleepovers or Field Trips,” “Writing a Section 504 Plan for Diabetes,” and “Top 10 Tips for Better Blood Glucose Control.”