Chronic Illness and Transplantation Issues and the Teen
The teenage years are a stressful time even for physically healthy teens. Chronic illness happening during these years makes a teen's development even harder. The chronic disorder, treatment needs, hospitalization, and surgery (when necessary) all make concerns about physical appearance more intense. They also interfere with the process of gaining independence and disrupt changing relationships with parents and friends. Also, developmental issues complicate a teen's transition toward taking responsibility for managing their illness and learning to follow recommended treatment.
Developmental impact of chronic illness
Teens who are faced with acute or chronic illness are more likely to have more concerns and fears when their illness or healthcare needs conflict with these normal developmental issues:
Body image issues
Teens are normally focused on the physical changes occurring in their bodies. Chronic illness intensifies these concerns with fears or distortions related to their illness (such as fearing a surgical scar will interfere with physical attractiveness or the ability to wear certain clothes, or how medicines will change their appearance, such as weight gain). It is helpful to:
Encourage teens to share their concerns related to their body and how it may be affected by their illness or treatment.
Inform teens about possible physical effects of medicines and treatment. Encourage discussion about ways to reduce or cope with the effects.
Chronic illness often interferes with a teen's comfort in becoming less dependent on parents. Parents of chronically ill teens often are more resistant to the teen's efforts to act independently. Some ways to address the conflict between normal development of independence, while still addressing healthcare needs of the chronic illness, include the following:
Involve teens in health-related discussions (for example, current concerns about their illness, treatment choices).
Teach teens self-care skills related to their illness.
Encourage teens to monitor and manage their own treatment needs as much as possible.
Encourage the development of coping skills to address problems or concerns that might arise related to their illness.
Relationships with peers
Chronic illness and treatment often interfere with time spent with peers or in the school setting, which is the teen's primary social environment. Self-esteem issues related to acceptance of one's self and concerns about acceptance by others are intensified by chronic illness and related treatment needs. To address these concerns, consider the following:
Encourage spending time with friends as much as possible.
Discuss concerns about what to share with friends.
Help teens find ways to respond if teased by peers.
Encourage and assist friends in being supportive.
Provide an educational environment for peers concerning chronic illness. Stress that it does not need to interfere with having normal relationships.
Noncompliance with medical treatment and teens
As teens with chronic illness learn more about their illness and are encouraged to take responsibility for its management, they may want to make their own decisions about management. He or she may make changes in their medicines without talking with a healthcare provider. While this behavior may be normal, it may create the need for additional healthcare. Angry or self-conscious feelings related to having a chronic illness, or poor judgment in how to cope with their feelings about their illness, might also affect following the recommended treatment or management techniques. For example, teens with diabetes are more likely to make poor food choices when they are with their friends. It is important for parents and healthcare professionals working with teens to help them develop emotionally healthy ways of living with their chronic illness and its management needs. Some ways to help teens deal with the complications chronic illness often imposes on development may include the following:
Encourage teens to share their ideas and concerns with healthcare professionals.
When a teen's chronic illness reaches an unstable state due to not following the treatment recommendations, encourage discussion of what happened rather than scold the teen for not following the recommendations.
Teach and encourage use of problem-solving skills related to their illness. Ask questions such as: "What do you think you would you do if……?" or "What do you think would happen if……..?" Encourage teens to ask you the same kinds of questions.
Seek mental health services when:
A teen seems overwhelmed with emotional issues related to living with a chronic illness.
A pattern of not following treatment continues.
A teen's development regresses, overly dependent behavior continues, and/or the teen withdraws from or gives up interest in age-appropriate activities.
Transplant-related issues and teens
The need for an organ transplant is hard to understand, accept, and cope with for anyone. The emotional and psychological stress impacts all family members.
For teens who are developing the ability to think in new ways and explore new thoughts, the idea of facing transplantation stimulates thoughts, concerns, and questions about their bodies, their relationships, and their lives.
Important factors in helping teens cope effectively with a transplantation experience include the following:
Be honest with your teen about his or her illness and his or her healthcare needs.
Include your teen in discussions and decisions related to the need for transplantation, the benefits, and the risks involved. This is very important to helping him or her cope with the process and life after transplant.
Supportive communication is vital. Encourage your teen to ask questions and express his or her fears and feelings about how this affects his or her life.
Concerns about death and the possibility of dying are hard to talk about. However, it is important to address this topic with teens in any life-threatening situation.
Encourage humor, as it helps to reduce stress.
Encourage friends to visit your teen in the hospital, when possible.
Enlist the help of mental health professionals in addressing fears, feelings, and behaviors that are problematic for your teen or for other family members.
If possible, put your teen in contact with others of his or her age group who have had a successful transplant experience.
June 29, 2018
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Adler, Liora, C., MD,Dozier, Tennille, RN, BSN, RDMS