Q: We have been giving our recently diagnosed son a lot of attention as we try to cope with this big change in our lives. This is causing our normally sweet-natured daughter to act out. What can we do?
A: In the weeks and months that follow a child's type 1 diabetes diagnosis, it's normal for brothers and sisters to experience an overwhelming mix of emotions, from fear and sadness to anger and jealousy. Yes, your daughter may be feeling very left out as you focus more attention on her sibling, but her "acting out" may actually mask the fact that she feels very scared or even guilty over her brother's diabetes.
When a child is diagnosed with type 1, it's typical for him or her to have a brief hospital stay of about three days to run tests and get a handle on insulin dosing and blood sugar management. Brothers and sisters may find it very frightening to see their sibling in the hospital and to learn about this disease called "die-abetes." They may worry that they too will develop type 1 or think that something they did caused their sibling's diabetes. It's common for both parents and kids to experience sadness or even a sense of mourning over all the changes that are suddenly taking place in their family's life.
Is there someone at school who could speak with your daughter? Children may not feel comfortable sharing their troubling thoughts with a parent, especially when they detect your own feelings of sadness or fear. The school nurse is often a good point person for starting these conversations and clearing up medical misunderstandings about type 1. Or you can get in touch with the social worker or family therapist assigned to your care team and make an appointment. At home, give children their own private 5-minute (or longer) time slots to ask you anything about diabetes. If there are any questions you can't field, write them down and ask your diabetes care team. Whatever concerns your daughter voices, let her know that her thoughts and opinions are completely valid.
Jealousy can affect siblings of a child with type 1, and carving out "alone time" with each of your children is important during this time of transition. I always say that it's special time, not a special gift that matters. Giving your daughter a new video game system to keep her occupied won't do much to meet her emotional needs. But playing video games with her, if this is something she enjoys, will. Likewise, doing things like taking a mother-daughter knitting class, going to the mall together, or just taking a walk and chatting lets her know that she is important and worthy of your attention.
If there are activities that your family has enjoyed in the past, don't let them fall by the wayside. Play family mini-golf on Friday nights? Always go skiing over winter vacation? It may be more important than ever to keep up with cherished family rituals and traditions. Life definitely changes when you have a child in the family with type 1, but spending fun time together can send the powerful message -- to all of you -- that everything is going to be okay.
-- Jennifer Rein, L.I.C.S.W., is a social worker and type 1 diabetes care team member at Children's Hospital Boston.
How Other Parents Deal
"When I finally had some alone time with my older son after his little sister was diagnosed, I was shocked by how little I had to prod before all the fear, guilt and jealousy came pouring out. We ended up having a very honest conversation. Yes, tears were shed, but this was also the moment we started to put our happy family back together again."
--Samantha, mom of Emily
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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