Harpham, Wendy S. MD
WENDY S. HARPHAM, MD
If ever an ounce of prevention was worth a pound of cure, it's when your patients have teenagers at home. While most teens do okay, rattling in my head are stories of basically good kids from basically good homes who got into serious trouble: failing school, using drugs, developing depression or eating disorders, engaging in promiscuous sex or other dangerous behaviors, and so on.
One story is one too many. So whatever the medical situation, your patients with teens must address their children's extra needs. Unfortunately this may not happen unless those parents are pushed.
Who on the health care team has the duty to broach this emotional subject? If you're a nurse or physician, you may be the one left holding the hot potato when the music stops. Why you? Because patients see you as experts in all aspects of survivorship. Given the weight of your words and the frequency of doctor visits, you have both the power and opportunity to help teens in life-saving ways.
The good news is you don't have to delve into any specific issues; you just have to get the ball rolling. Simply ask your patients one specific question: “How are you helping your teens through this?”
Patients may tell you their troubled teens are fine, because they believe it. Or they may admit they're worried about their teens but feel too overwhelmed by their health issues to deal with that now. Still other parents may report they've tried talking with their teens, only to have their children plug in and tune out.
What can you do? With your super-busy schedule in mind, here's a minimalist guide to helping your patients who have teens at home:
- Step 1: Shine a spotlight on the needs of their teens: “All teens have extra needs when a parent has cancer. Naturally, everyone is focused on your health. But we must make sure your teens are getting the information and support they need.”
- Step 2: Encourage and empower your patients: “Supporting your teens will help you and everyone else in your family. This is not something that can wait. So we are urging you to check out at least one of the online or local resources listed in a handout you'll receive before you leave today.”
To make your job a bit easier, my next column will provide a patient handout on “Caring for Your Teenagers.” If the layout and content work for you, all you'll need to do is add information about resources in your community, and you're done. Usually a quick call to an oncology social worker or child-life specialist affiliated with your local hospital or community cancer support organization will do the trick.
If nobody on your staff has time for that, you're still in luck. A terrific new book can do the lion's share of the work for you. So jot this catchy title on a slip of paper and keep it in your hip pocket: My Parent has Cancer and it Really Sucks (Cancer Sucks, for short).
This 250-page easy-to-read paperback does it all: teach, comfort, amuse, warn, cajole and inspire teens, whatever their family's situation. It works well because Marc Silver (editor at National Geographic magazine, author of Breast Cancer Husband) and his journalist daughter Maya (who was 16 years old when her mom was diagnosed with cancer) collected and organized “advice from over 100 teens and experts who have all been there.” Every detail of this book appeals to the mindset and culture of teens—from funky fonts that distinguish “survival tips” and “words of wisdom” to side-by-side insights and advice from the co-authors.
This is what I'd do if I were you: I'd suggest to my patients that they surprise their teen with an “un-birthday” present, namely, a copy of Cancer Sucks wrapped in colorful paper and left on their pillow. I would point out the many messages communicated to their children with this one easy act:
- “I'm aware my illness is affecting you.”
- “I respect you—and your right to understand what's happening.”
- “I believe you have the maturity and strength to deal with all the illness-related changes in your life.”
- “I'm still your Mom/Dad who loves you and cares about you—and your world—with every fiber of my being.”
Be sure to warn parents that some teens may show no interest in the book—or they may flat out refuse to read it. You can reassure these parents, “That's okay. If you read the 22-page parents' guide in Appendix C, the book can help your teens by helping you. If you're up to it, read the rest of the book, too, for an invaluable teen's-eye view of your illness. The vignettes and conclusions will help you understand the challenges and stresses your teens may be facing. You'll enjoy the confidence that comes with knowing the warning signs of teens' distress, as well as healthy ways to respond.”
If my years as a mother raising three children in the shadow of my cancer have taught me anything, they've taught me this: The greatest gift we can give our children is not protection from the world, but the confidence and tools to cope and grow with all that life has to offer.
You give your patients no less a gift by guiding them to resources that help them develop the confidence and tools to care for their teens in healthy, loving ways.