Diabetes Presentation


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For FOP2 Child Life Studies
Please note that this presentation is posted to share with the class. The information has been sited on a handout they received.

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Diabetes Presentation

  1. 1. Diabetes Case Study Presented By: Emily, Jane, Kate M. and Margaux
  2. 3. Agenda: <ul><li>Review Case </li></ul><ul><li>Understanding Diabetes: </li></ul><ul><ul><li>What is Diabetes? </li></ul></ul><ul><ul><li>What is Type 1 Diabetes? </li></ul></ul><ul><ul><li>What is Type 2 Diabetes? </li></ul></ul><ul><li>Helping Kylie… </li></ul><ul><ul><li>Cope with her new diagnosis </li></ul></ul><ul><ul><li>Understanding her new diagnosis </li></ul></ul><ul><ul><li>Pain management and Relaxation </li></ul></ul><ul><ul><li>Going back to school </li></ul></ul><ul><li>Issues : </li></ul><ul><ul><li>With her Transition Home </li></ul></ul><ul><ul><li>With her Parents </li></ul></ul><ul><ul><li>With her Brother </li></ul></ul><ul><ul><li>With her Grandmother </li></ul></ul><ul><li>Conclusion </li></ul><ul><li>Feedback/Comments/Suggestions </li></ul>
  3. 4. Learning Objectives: <ul><li>By the end of this presentation we hope you will understand: </li></ul><ul><ul><li>Diabetes. </li></ul></ul><ul><ul><li>How to help children cope with a new diagnosis. </li></ul></ul><ul><ul><li>The impact of a new diagnosis on the family. </li></ul></ul><ul><ul><li>Possible Child Life interventions. </li></ul></ul>
  4. 5. What is Diabetes: <ul><li>Diabetes is a disease that affects how the body uses glucose. </li></ul><ul><li>Glucose is a sugar that is the body’s main source </li></ul><ul><li>This is how it should work: </li></ul><ul><ul><li>You eat. </li></ul></ul><ul><ul><li>Glucose from the food gets into your bloodstream. </li></ul></ul><ul><ul><li>Your pancreas makes a hormone called insulin. </li></ul></ul><ul><ul><li>Insulin helps the glucose get into the body’s cells. </li></ul></ul><ul><ul><li>Your body gets the energy it needs. </li></ul></ul><ul><li>Your pancreas is a gland in your belly that helps digest food and makes insulin. </li></ul><ul><li>If you have Diabetes, the glucose can not get into the cells normally, so the blood sugar level gets too high. </li></ul><ul><li>Having a lot of sugar in the blood makes people feel sick if they do not get treatment. </li></ul><ul><li>There is Type 1 and Type 2 Diabetes. </li></ul>
  5. 6. What is Type 1 Diabetes: <ul><li>In type 1 diabetes (which used to be called insulin-dependent diabetes or juvenile diabetes), the pancreas can't make insulin. </li></ul><ul><li>The body can still get glucose from food but the glucose can't get into the cells where it's needed. </li></ul><ul><li>Glucose stays in the blood, which makes the blood sugar level very high and causes health problems. </li></ul><ul><li>To fix the problem, someone with type 1 diabetes needs to take insulin through regular shots or an insulin pump. </li></ul>
  6. 7. What is Type 1 Diabetes: <ul><li>No one knows for sure what causes type 1 diabetes, but scientists think it has something to do with genes. </li></ul><ul><li>Genes are like instructions for how the body should look and work that are passed on by parents to their children. However, just getting the genes for diabetes isn’t usually enough, something else has to happen. Something like getting a viral infection, for example, can cause a person to develop type 1 diabetes. </li></ul><ul><li>Type 1 diabetes CAN’T be prevented. </li></ul><ul><li>Doctors can not tell who will and will not get it. </li></ul>
  7. 8. What is Type 2 Diabetes: <ul><li>Type 2 diabetes is different from type 1 diabetes. In type 2 diabetes, the pancreas still makes insulin, but the insulin does not work in the body like it should and blood sugar levels get too high. </li></ul><ul><li>In kids who have type 2 diabetes, insulin does not do its job as well, so glucose is less able to enter the cells. </li></ul><ul><li>Type 2 diabetes can be treated by: </li></ul><ul><ul><li>Get to a healthy weight </li></ul></ul><ul><ul><li>Eat healthy </li></ul></ul><ul><ul><li>Be active </li></ul></ul><ul><ul><li>Take medicines </li></ul></ul><ul><ul><li>Check blood sugar levels </li></ul></ul>
  8. 9. The Role of Child Life: <ul><li>Child Life Specialists can help children and their families adjust to living with diabetes by: </li></ul><ul><li>Helping children to cope with injections, blood checks, and taking other medications </li></ul><ul><li>Assisting families with management of medical treatments and schedules </li></ul><ul><li>Helping families understand the child’s view of diabetes and his or her treatment </li></ul><ul><li>Enabling siblings to understand a brother/sister’s diabetes </li></ul><ul><li>Providing ideas on how to talk to diabetes with children’s friends and classmates </li></ul><ul><li>Engaging children in meaningful play to reduce stress and increase comfort and coping during visits </li></ul>
  9. 10. Developmental Understanding <ul><li>Young children and Type 1 Diabetes </li></ul><ul><li>May have difficulty understanding sudden changes in their lives (e.g. glucose monitoring, insulin injections, food restrictions) </li></ul><ul><li>Some children may feel they are being punished for disobedience </li></ul><ul><li>May feel shame or guilt </li></ul><ul><li>Child may act with hostility toward parents, feel that you have failed him or her </li></ul>
  10. 11. Developmental Understanding <ul><li>Young children and Type 1 Diabetes </li></ul><ul><li>Child may believe parents can make Type 1 diabetes go away </li></ul><ul><li>Child may fuss or cry with blood checks and injections at first </li></ul><ul><li>Unable to cooperate because they do not understand </li></ul><ul><li>Can learn to cooperate over time and tell parent when he/she feels low </li></ul><ul><li>May have picky eating habits </li></ul>
  11. 12. Age- Appropriate Management <ul><li>Parents will have full responsibility for all aspects of diabetes care </li></ul><ul><li>Parental approval is important at this age </li></ul><ul><li>Need to supervise, encourage, and foster independence in child </li></ul><ul><li>Avoid being overprotective, as it prevents child from developing a feeling of master over his or her environment </li></ul><ul><li>Important to involve child at early age, but with realistic expectations </li></ul>
  12. 13. <ul><li>Cannot be expected to understand diabetes treatment fully until late childhood or early adolescence, thus some planning needed to support them at school </li></ul><ul><li>Child may feel different from peers </li></ul><ul><li>Parents continue to be main caregivers, but often must share expertise with child and other responsible adults as children under supervision of parents less often </li></ul><ul><li>Child should be encouraged to participate in school and other activities in same way other children do </li></ul>School-age children and Type 1 Diabetes
  13. 14. Child Life Interventions Using Medical Play and Behaviour Modification: <ul><li>Let’s Play! </li></ul><ul><li>  </li></ul><ul><li>Explain what happens within your body when you have diabetes </li></ul><ul><ul><li>Use your paper doll for this activity </li></ul></ul><ul><li>What does sugar do? Who is its partner to make it work efficiently? </li></ul><ul><li>What happens when the pancreas stops making insulin? </li></ul>
  14. 15. Child Life Interventions Using Medical Play and Behaviour Modification: <ul><li>Medical Equipment </li></ul><ul><li>Introduce needles and finger pokes </li></ul><ul><ul><li>Blood Glucose Meter (BG meter): is a small machine that can read the level of glucose in your blood. You supply a tiny drop of your blood on the test strips made for the meter. It's important that you don't mix and match test strips. </li></ul></ul><ul><ul><li>Lancet: is this to do the finger poke </li></ul></ul><ul><ul><li>Place your drop of blood on the test strip </li></ul></ul><ul><ul><li>The adult will wait for the meter to give you your reading </li></ul></ul><ul><ul><li>Record your reading in a journal or diary </li></ul></ul>
  15. 16. Child Life Interventions Using Medical Play and Behaviour Modification: <ul><li>Medical Equipment </li></ul><ul><ul><li>Insulin: is what your body needs to use the food you eat for energy. Technically, insulin is a hormone made by beta cells in your pancreas. It acts like a key for the food (glucose) to leave your bloodstream and get into your cells. </li></ul></ul><ul><ul><li>Needle: used to put the insulin in to your stomach </li></ul></ul><ul><ul><li>Insulin Pen: closely resembles a pen but instead where the ink comes out of the pen, it is a needle under the cap and the pen is full of insulin </li></ul></ul>
  16. 17. <ul><li>Procedures: Finger Pokes and Insulin Injections </li></ul><ul><li>Demonstrate the procedure for finger pokes and insulin injections on the doll </li></ul><ul><li>Use pain scale </li></ul><ul><li>Give Choices </li></ul><ul><ul><li>Which finger would she like to use for her finger poke? </li></ul></ul><ul><ul><li>Would she like to look, or look away? </li></ul></ul><ul><li>Distraction techniques </li></ul><ul><ul><li>Give her a special job while the adult is doing the finger poke or injection </li></ul></ul><ul><ul><li>Have her blow bubbles for distraction </li></ul></ul>Child Life Interventions Using Medical Play and Behaviour Modification:
  17. 18. Child Life Interventions Using Medical Play and Behaviour Modification: <ul><li>Behavior Modification: Reward and Tracking system : </li></ul><ul><li>  </li></ul><ul><li>Have the child trace their hand and use their paper doll </li></ul><ul><li>Every time they get a finger poke they will receive a sticker for their hand </li></ul><ul><li>Every time they receive an insulin shot they will receive a sticker for their paper doll </li></ul><ul><li>The sticker will act as a reward for her compliance </li></ul><ul><li>It will help her keep track of how many times she has had finger pokes and insulin injections </li></ul><ul><li>She may want to make a new hand and paper doll for every week or month </li></ul>
  18. 19. Re-integration to School: <ul><li>SW is talking to school staff </li></ul><ul><li>Developmentally appropriate activities for the class </li></ul><ul><li>Kylie can help with the presentation if she would like to </li></ul><ul><li>Help Kylie understand how to explain her Diabetes to her peers </li></ul><ul><li>Activities, games, and books to incorporate information </li></ul><ul><li>Provide teacher with information necessary </li></ul><ul><li>Have medical play available if necessary </li></ul>
  19. 20. <ul><li>How will the parents ensure consistency in Kylie’s care? </li></ul><ul><li>Need to equally adhere to the treatment plan </li></ul><ul><li>It can be emotionally draining for the parents to have to give insulin injections and blood tests, especially when the child is resistant </li></ul><ul><li>Give Kylie some control over the situation </li></ul><ul><li>Prepare the materials out of her view </li></ul><ul><li>Go get Kylie when it’s time for her injection, rather than calling for her to come </li></ul><ul><li>Focus on distraction techniques that the CLS taught her </li></ul><ul><li>Explain why you have to do it </li></ul><ul><li>Provide her with praise </li></ul>Transition to Home:
  20. 21. Coping With A New Diagnosis-Sibling: <ul><li>Adam may be confused by the changes in the family </li></ul><ul><ul><li>Parents & Kylie are at the hospital, being cared for at his grandparents </li></ul></ul><ul><li>Parents may be withholding information to protect him until they fully understand the disease and its management </li></ul><ul><li>He may feel anxious, fearful, resentful or neglected due to the attention his parents are giving to Kylie </li></ul><ul><li>May also be jealous of the attention Kylie receives May think he did something to cause the hospitalization and illness </li></ul><ul><li>May fear that his sister may die </li></ul><ul><li>His feelings may be manifested as behaviour </li></ul><ul><li>May be afraid that he will get diabetes </li></ul><ul><li>May feel guilt that brother/sister has diabetes and they don’t </li></ul><ul><li>Needs to understand what diabetes is </li></ul>
  21. 22. Age-Appropriate Management <ul><li>Need to know that they are still loved </li></ul><ul><li>Siblings should be encouraged to join in the education program </li></ul><ul><li>Special time with parents may ease the impact </li></ul><ul><li>Talk with Adam about his feelings about diabetes and the changes in the family </li></ul><ul><li>Allow him to be involved in Kylie’s care, where appropriate – can assist with making snacks or participating in her care routine, distraction during injections, and watch for signs of hypoglycemia </li></ul><ul><li>Encourage him to call, write letters or visit Kylie </li></ul>
  22. 23. <ul><li>Grandmother may not understand the differences between Kylie’s diabetes and her own diabetes </li></ul><ul><li>There may be misunderstandings related to diet and insulin </li></ul><ul><li>Grandmother may want to restrict food, which is not appropriate for a growing child </li></ul>Coping With A New Diagnosis:
  23. 24. <ul><li>May assign blame for the illness. </li></ul><ul><li>Parents may mourn their old way of life. </li></ul><ul><li>May experience a variety of feelings including shock, denial, anger, sadness, anxiety, fear, anger and guilt. </li></ul><ul><li>Stress related to managing Kylie’s care – giving injections, diabetes management, worrying about blood sugar reactions. </li></ul>Coping With A New Diagnosis- Parents:
  24. 25. <ul><li>Tips for the Family </li></ul><ul><li>Both parents need to be involved in all aspects of Kylie’s care </li></ul><ul><li>Feelings of resentment, fatigue and stress can build up if the parents are not being consistent </li></ul><ul><li>Parents will need to work together to manage her care </li></ul><ul><li>Members of the extended family will also need to learn how to be responsible for her care </li></ul>Coping With A New Diagnosis:
  25. 26. <ul><li>A child with diabetes can still be healthy, happy and secure, with normal patterns of growth and development </li></ul>Conclusion:
  26. 27. A child with diabetes can still be healthy, happy and secure, with normal patterns of growth and development Conclusion: Questions? Suggestions? Feedback?