Helping the Older Teenager Cope with Chronic Medical Conditions

A few years ago, I wrote a blog about helping teenagers cope with chronic illness, especially when it means they have to take medications or do daily monitoring tasks like checking blood sugar or doing breathing treatments. It is not easy and as teenagers start to transition to adulthood, it becomes even more difficult.

I wanted to pick up on that earlier blog and talk about that transition and how parents can help the teenager cope with growing out of the pediatric setting and being more independent.

Older teenagers are still in a risky age group when it comes to complying with medication and treatment regimens. With many demands on their time, these young people are trying to become independent in all ways and face demands on their time like school, jobs, finding housing, and learning to budget and live more independently. Adding in medications and treatments can seem overwhelming.

Here are some ideas for parents to focus on to help. I partnered with Diane Tanaka, MD, medical director of the MyVoice Transition Clinic and the High-Risk Youth Program in the Division of Adolescent and Young Adult Medicine at Children’s Hospital Los Angeles.

If your teen is having problems complying with medical treatment, here are some of the reasons they may be struggling:

• They may not understand the reason for all the medications. Encourage your teen to understand and verbalize what the medications are for, when they are to be taken and if there are side effects.
• They don’t want to be different from their friends. Some may even be teased or bullied.
• They may feel isolated (e.g. low blood counts may prevent them from hanging out with friends or asthma may keep them from participating in sporting activities).
• Some have low self-esteem and may be suffering from depression or anxiety over their health.
• They may also feel like their health is unpredictable and frightening and that they are expected to be able to handle the stress and “know better.”

They may feel that the medications do not change how they feel and are not useful. Acknowledge this and start a conversation about how the teen feels when they start to feel sick after not taking their medications for a while.

All of these things can contribute to a teenager not taking medications or treatments, which could lead to hospitalization or other complications.

Helping the Older Teen Cope and Comply

I've also been able to read up on research about strategies that have been effective in helping teenagers cope and comply with their treatments. As far as it is developmentally appropriate, help your growing young adult be more independent by advocating for education and support and encouraging more active participation by the teen.

Education

• Teenagers need individualized education to understand their diseases and medications, why they are necessary and when to take them.
• Make sure your teenager understands and can verbalize each medication and what it does for his/her health and body.
• Next time you are at the doctor’s office, have him/her ask for individualized instruction for things like blood glucose checks, albuterol inhalers and, of course, medications.
• Encourage him/her to verbalize medical history, baseline health, symptoms of medical problems, baseline vital signs or lab values.

Participation

• Lessen the “help” you provide and have your teen do more.
• Have him/her call and make the appointments and check into the appointment.
• Have him/her answer the questions during medical appointments and encourage preparing questions in advance to ask of the provider.
• Have him/her call to get refills of medications.
• Encourage him/her to carry information on insurance, the list of medications or treatments, the names and numbers of providers and pharmacy information.

Social Support

Social support is important for teenagers. They feel better when they can share with others who have the same conditions. Many parents have concerns about Facebook and social networking, but when teens feel isolated, Facebook could be the best medicine. If they can’t find a social network that fits their needs, encourage them to start a group. You may see your teen receiving moral support from peers and providing it for others as well.

Support from Mom and Dad

Try using tools your kids already use, such as text messaging, to send supportive reminders. Also, be realistic about compliance and monitor it in a non-judgmental way. Even though your teen wants to be independent, recognize that being teenager makes non-compliance very likely. So, don’t leave it all up to them.