Whenever
possible, seek buy-in from all involved family members. Families often
have difficulty accepting additional symptoms or diagnoses. Newly identified mental disorders may be particularly hard to reconcile. Families need educaton and support to adapt. They may require assistance to understand that a diagnosis of a mental disorder in a child can present very differently from the signs and symptoms of a similar diagnosis in adults.
Grandparents too, may have difficulty accepting a child’s disability. If a grandparent is actively involved in the
child’s life or influential with the child’s parents, nursing efforts may ultimately fail unless grandparents are included in the process.
Expanding nursing education services to include grandparents, or involving them in a
family support group, can ease the way for the child’s enrollment in
special programs at school or in the community.
Instant
Feedback:
In
some families, the nurse needs to address the concerns of extended family members
in addition to dealing with the child’s parents.
Use
and facilitate negotiation as an effective problem-solving strategy. When
a child has special needs, the family is constantly stressed by the usual
demands of childhood plus all of the issues around the child’s disability.
Parents are often tired, overwhelmed, and may feel alienated from one another.
In that environment, problems can seem larger than they really are and decisions
may be made unilaterally or on the spur of the moment. The nurse can provide
real assistance to the family when she employs, models, and teaches simple
negotiation skills.
Instant
Feedback:
Disagreements
between the childs parents are private, and the nurse has no role in the decision-making
process.
Provide
honest information that is tailored to reflect the family’s information-processing
style and capacity. Each family member must be assisted to learn and adapt as they are able. Happily, a broad array of educational content and media formats (e.g., web sites, journals, or
books) are available. It is within the role of the nurse to thoughtfully
guide selection of learning resources and highlight the key concepts.
Help
the family reframe problems, putting them in a fresh perspective with constructive
action. First time parents and those with limited support systems may view problems as a challenge to family integrity. One parent may prod the child to participate in family activities that are beyond the child's ability, while the other parent may seek to restrict family activities rather than challenge the child.
The nurse may be able to highlight the character and gifts of each member to reassure the family of its combined capacity to grow and succeed.
Instant
Feedback:
When
working with parents who have very different solutions in mind for a problem,
the nurse may be able to help by introducing new ideas that address the beliefs
of both partners.