Helping Siblings with a Diabetes Diagnosis
I remember the summer before my little sister, Jen Nash, was diagnosed with diabetes. She was six years old and always full of beans, but she didn't seem herself. She got tired a lot and didn't seem to want to play for as long. We were on holiday in the Lake District when I overheard my Mum saying to my Dad that she was worried about her. Then came the night when she wouldn't go to sleep complaining of a terrible thirst; drinking water and going to the toilet all night. The next day my mum took her to the doctor and she was diagnosed with type 1 diabetes. What followed was a spell in hospital whilst her blood sugar was stabilized and she was taught about diet, blood tests, and injections. I remember a real feeling of sorrow. I knew things would never be the same again. I was only eight at the time and I don't know how helpful I was to her, but I remember feeling protective towards her and I tried to be extra nice. The biggest thing I remember doing is trying to adapt to the new food and drink we were eating at home without complaining too much. I also made sure I didn't flaunt the fact I could eat things my sister wasn't allowed to. Obviously the age a sibling is diagnosed at will have an effect on the ways in which you might help them to cope with their diagnosis. But whether she/he is 6 or 60, there will be common feelings your sibling is experiencing.
Being diagnosed with diabetes is a similar experience to that of grieving. You have lost your good health, something which most of us take for granted. The loss of good health and the realization that you now have to rely on medication and doctors to keep you well needs to be dealt with in the same way you deal with the death of a loved one. As a sibling, it is helpful for you to familiarize yourself with the five stages of grieving, so that you can recognize what your sibling is going through. They may not necessarily go through the stages in the order below, or they might seem stuck on a particular stage.
Stage 1 is denial — "This can't be happening"
Stage 2 is anger — "Why me?"
Stage 3 is bargaining — "I'd do anything to turn back time."
Stage 4 is depression — "I'm so sad."
Stage 5 is acceptance — "It's going to be ok."
As a sibling, the best thing you can do is listen to what your sister/brother is saying and be supportive. If they are talking, let them talk. Often we think the answer is to give advice or say things like, ‘it could be worse.' Our intention is to make the other person feel better, but what we do instead is minimise how they are feeling, which may lead to them feeling misunderstood or bottling their feelings up. When you are listening to your sibling, you can make them feel heard by using what's known as ‘active listening.' You can do this by taking note of your sibling's body language and summarising or paraphrasing what they've said to you. If in doubt, it is often better to say nothing and just give them a big hug.
Dr Jen Nash talks about the idea of learning to LIKE yourself as a diabetic. Your sibling will need to come to terms with their diagnosis and incorporate having diabetes into their identity.
The L stands for learn, and is about educating yourself about diabetes. As a sibling how can you help your sister/brother with this? Could you borrow a book from the library or chat to someone on an Internet forum to get more clued up? How could you share the information you've gained in a positive way? You're not telling them how to manage their diabetes, you are sharing information they might find useful. Keep the lines of communication open. It's good to give them the freedom to tell you to ‘back off' if anything you are doing is not supportive to them.
The I stands for inquire. This is about finding ways to improve your life as someone with diabetes. As a sibling you could buy them a funky kit bag for their diabetes equipment or learn how to cook some tasty meals that are suitable for their new diet.
The K stands for kindness. This is about learning to go easy on yourself. As a sibling, showing kindness is one of the most obvious and easiest things you can do to help. You may well be in a unique position of recognising how your sibling behaves when they are dealing with difficult emotions. This can allow you to know when to listen or give them a hug. You may also know your sister's/brother's likes and dislikes and how to help cheer them up when they are feeling down.
The E is for expressing emotions. This is about allowing your sibling the space to talk and say how they are feeling. They may not want to talk to you. In which case can you encourage them to take up journaling or even help them find a therapist? You might be tempted to take them out for a few drinks to help them relax. Of course it's ok to do this now and again, but if you see your sibling starting to rely on alcohol (or any other substance) as a coping mechanism, it might be time to draw the line.
Another good way of helping your sibling is to become familiar with the basics of Cognitive Behavioural Therapy. This is about challenging automatic negative thoughts. Your sibling might be thinking and voicing some negative thoughts like, "I am a failure because I have diabetes." How can you help challenge these in a gentle way? "You're not a failure. You've achieved so many amazing things. Remember when you raised all that money for charity?" "Just because you have developed an illness, doesn't make you a failure." "You've made such a success of adapting to your life with diabetes. I'm really proud of you."
And finally, here are some ‘don'ts' to remember.
• Don't hassle/advise/blame your sibling unnecessarily if they are struggling to adapt to and manage their diagnosis.
• Don't leave them to deal with it by themselves. Let them know you are available to help and be honest if you're not sure how you can.
• Being diagnosed with diabetes is completely life changing. As a sibling, you can show your sister/brother that you don't underestimate what they are going through. Ask them how you can best be there to support them. It's better to try to help and get it wrong, than not to try at all. Good luck!
Dr. Jen Nash is a clinical psychologist who has lived with diabetes for more than 20 years. She runs www.PositiveDiabetes.com, an education, therapy and coaching service that supports people with type 1 and 2 to manage the emotional and psychological impact of day to day life with diabetes.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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