I remember being diagnosed, like it was just yesterday. From that point forward, it just felt like my whole world had changed and that I needed to change too. Having diabetes was a BIG change. I had to change and my family had to change. My mom went from drinking 4 teaspoons of sugar in her tea to drinking only 1. I’ve done a presentation on change management in my B.Com Honours and have covered it in my Masters thesis, so I thought I’d share some of my research with you. I know it’s fundamentally theoretical and that all humans deal with change differently but it’s worthwhile knowing and adapting it to suit your situation. I’ve included some of my ideas below.
Most individuals prefer things to be comfortable and familiar; and they like to feel capable and confident in their work and surroundings. Change affects people's ability to feel comfortable, capable, and confident – due to the fact that they must learn new things, behave in new ways, and accept new responsibilities. Diabetes brings along a lot of that.
Individuals facing change often go through a cycle of emotions similar to those experienced when faced with the death of a loved one. Understanding of the "grieving" process used by individuals to deal with change may make it possible to reduce some of the potentially damaging consequences, such as sabotage. "The change cycle" is a four-step cycle of emotions that individuals are likely to experience when faced with change (Crain, 2007). Any change, even positive change, results in a loss of something – tangible or intangible.
Parents can alleviate the effects of reactive depression by recognising how change impacts an individual, and by understanding that all individuals, children in this case, will go through the change cycle at various rates, and that their reactions will be dynamic – rather than at a steady progression (Crain, 2007).
Managing the cycle of change (Source: Craine, 2007)
Craine (2007) suggests the following advice to aid individuals in each cycle of change but I’ve adapted them to suit children with diabetes:
Advice for managing the cycles of change (Source: Crain, 2007)
Phase | Assist yourself | Assist others |
The Comfort zone | • Notice the situations in which you experience ease and comfort. • Notice the situations that will change as a result of diabetes. • Create a plan for the situations you want to change. | • Encourage creativity and ask your children how they will innovatively deal with some of the challenges of diabetes • Acknowledge, celebrate, and reward success e.g. good Hba1c results. • Plan for future changes e.g. perhaps you want to change to a more comprehensive medical aid. |
The ‘No’ zone | • Identify the reality of the current circumstances. • Acknowledge the losses you are experiencing. • Identify your feelings about the situation. • Reframe "danger" into "opportunity." | • Give information about diabetes to teachers, extended family members and friends. • Provide a picture of the expected outcome i.e. living a healthy life by making some adjustments such as eating a healthier diet, exercising, testing and going for Hba1c tests. • Be there for others in small, supportive ways. Your children will need your support now more than ever. • Listen to worries and fears, they probably fear a lot more than you’re aware of. |
The Chasm | • Discover what you want for the future and how you will deal with the differences in your lifestyle e.g. now you have lots more to pack when you go on holiday • Get necessary information and support from your doctor, dietician and nurse etc. • Don't let the all the negative stories about amputations etc. get you down. All those complications are perfectly avoidable if you exercise good control. | • Create new ways to communicate and share information and feelings e.g. have supper at the table in the evening and discuss the day’s events. • If they aren’t doing what they are supposed to do, e.g. snacking or testing find out why by asking questions such as ‘why do you think testing is important?’, ‘what do you think happens when you don’t snack?’ etc. |
The ‘Go’ zone | • Take action on issues within your area of control e.g. teach your child to inject and test themselves, let them choose what they want to eat and discuss the effects of their choices. • Let go of what you cannot control – going hypo or hyper is sometimes unavoidable. Provided that it doesn’t happen all the time, don’t sweat it. • Visualize yourself (positively) in the new paradigm. | • Clarity purpose and desired outcomes {again). • Involve your children in the planning and implementation of the changes. • Celebrate small successes e.g. if they are good all week use weekends for treats • Provide on-going feedback and information. |
I know that we are all different and there aren’t too many people who jump with joy at the idea of change, let alone when this change is type 1 diabetes.
There is unfortunately little you to prevent someone you love from being diagnosed with type 1 diabetes BUT there is lots you can do to manage the changes and your response to the condition.
No-one is perfect and having type 1 diabetes is as big a change for the parents as it is for the child with type 1 diabetes. It may not always go smoothly but you will get through it. There are far worse things in life than having a perfectly manageable condition. So accept and do the best you can with what you have (I know that it’s easier said than done) . Learn from the mistakes and scream silently into the pillow when your child is sleeping. Pray, smile and laugh often – it’s medicine for the soul when insulin is medicine for the body J
References:
Crain, K. (2007). Managing the cycle of change, Information Management Journal, Sept/Oct 2007 pp. 44-50.
Fazlyn
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