Denial

Virtually every parent responds to the child’s diagnosis of disability with denial: "This can’t be happening to me." Remember Renee’s protest about Cassie’s alertness and Ned’s abrupt dismissal? This protective reaction provides a buffer zone that gives parents time to learn to deal with the new reality. Some parents resist recommendations from nurses and other professionals during this time, refusing to enroll the baby in appropriate early intervention programs.

Others may do everything they can to prove that their child is "normal." Naseef reminds us that most parents eventually move toward the acceptance of the reality that the child will never be normal, but is nevertheless lovable and loving. He points out, however, that the "invisible disabilities" such as autism, learning disabilities, and ADHD that are diagnosed years later are often harder for a parent to accept. It’s very, very hard to accept the idea of disability when the child looks normal in so many ways, and the parent has known and loved the child for many years.

 

Instant Feedback:
Parents of older children who are newly diagnosed with disabilities usually have a much easier time accepting the diagnosis than parents of newborns do.
True
 False
Nurses working with families in the denial stage should actively listen to the parents, providing honest feedback and accurate information when appropriate. It’s often helpful to examine decisions made by the parent and sort them into "healthy" and "unhealthy" denial. Healthy denial occurs when parents put off less-urgent recommendations from professionals while they process the overwhelming news about the child’s diagnosis. While it may be best to obtain special education services right away for a child with ADHD, for example, the child won’t be permanently harmed if the parents delay for a few weeks (or even months) while they are in the denial phase.

On the other hand, denial is unhealthy if the mother of a child with severe congenital heart disease secondary to Down syndrome decides not to administer life-sustaining medications such as digitalis and diuretics. The nurse working with the child with ADHD can provide continuing support and information to the parents while gently guiding their decisions. The nurse who is providing case management for the infant with the heart condition, on the other hand, must take more immediate action to ensure the baby’s well-being.

Instant Feedback:
When parents are in denial, the nurse should always take immediate action to help them face reality.
True
 False