Transition means :
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Transcript of Transition means :
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Transition Programs in Pediatric Diabetes: One Step in the Journey of Healing & True Self-Management
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.Transition means:
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If you were an adolescent ready to move on to an adult diabetes clinic, you would want to have:
1. ______________________________2. ______________________________3. ______________________________
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If you were a parent of an adolescent moving on to an adult clinic you want to be assured about and have:
1. ____________________________2. ____________________________3. ____________________________
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Transitions: Exist in Context – Successful transitions mean comprehensive, long term preparation! In diabetes, usually
addressed at HS Graduation:
Childhood Adolescence
Challenges:• optimal metabolic control• normal growth & development• integration of diabetes into daily life• parental stress
Challenges:• burnout, despair, depression• integration into work & family life• achieving & maintaining optimal metabolic control
Needed Resources:• relevant, effective messaging to adolescent & family• family counseling & support• peer support
Challenges:• dependence vs. independence• responsible management behavior• less than optimal metabolic control• risk taking intensity
Needed Resources:• optimal self management education• individual & family counseling• health care team support 24/7
Needed Resources:• individual & family counseling & support•Access to comprehensive care• self-management long term care strategy• Transition: Adolescence > Adulthood
Adulthood
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Transitions: Exist in Context – Successful transitions mean comprehensive, long term preparation! In diabetes, usually
addressed at HS Graduation:
Childhood Adolescence
Challenges:• optimal metabolic control• normal growth & development• integration of diabetes into daily life• parental stress
Challenges:• burnout, despair, depression• integration into work & family life• achieving & maintaining optimal metabolic control
Needed Resources:• relevant, effective messaging to adolescent & family• family counseling & support• peer support
Challenges:• dependence vs. independence• responsible management behavior• less than optimal metabolic control• risk taking intensity
Needed Resources:• optimal self management education• individual & family counseling• health care team support 24/7
Needed Resources:• individual & family counseling & support•Access to comprehensive care• self-management long term care strategy• Transition: Adolescence > Adulthood
Adulthood
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>>Must happen before launching:Assessment For Family Functioning:
While in Pediatrics in order to move to >>> Adults>
• Family emotional supportiveness– Between parents -- are mother and father emotionally available to
each other?– Availability -- is there flexibility with daily schedules?
• Family organization– Joint decision making -- between spouses– Value congruence -- between spouses– Communications patterns -- are messages about rules clear or
confusing?• Competence/effectiveness
– Response to initial symptoms
Baker, Rosman, Nogueira, Sargent; Unpublished research data, 1979
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Transition Clinics: A Bridge from where they’ve been to where they’re going:
Challenges:• Providing effective continuum of care• Adequate preparation for “launching” & associated anxiety
related to separation• Having to tell my whole story again/being an “unknown”• No “chemistry”/No show! – Lost Children/Lost Adults• Preparing for leaving home/being on one’s own
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Transition Clinics: A Bridge from where they’ve been to where they’re going:( cont.)
• at least 6 month ramp up preparation for transition – from both clinics
• effective patient & family needs assessment to help facilitate leaving home/doing daily diabetes management more independently
• Identification of on-going support personnel and resources/role clarification
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Transition Clinics: A Bridge from where they’ve been to where they’re going:
Resources Needed:• individual & family counseling – impact of past
management behavior on reality of future plans• launching & landing support – collaborative
clinical support from both peds and adult clinics working together
• adult clinicians at peds clinic & peds clinicians at adult clinic
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educate
advocate
enrich
emphasize