Be sensitive, but be the boss.
It's important to acknowledge your child's feelings and let her know that you know she does not feel well. But at the same time, the treatment is non-negotiable. "The best way to deal with the struggle is to ignore it, and be firm and consistent. Stay the course and even a struggling child will give up," says pediatric nurse practitioner Joan Lokar.
Offer choices whenever you can.
"The taking of the medicine is non-negotiable but other things are," advises social worker Mary Mathews. "Even the simplest choices give the child a needed sense of control." You might ask, "Do you want the medicine before you get dressed or after?" Or, "Would you like apple, orange or grape juice with your medicine?" Mathews observes that "sometimes people don't think choices work, but they really do. Offering a choice gives a child control of the situation, and over her body." Mathews's general rule is offering two choices, not five or six, because then it turns into a negotiation and parents can lose control.
Make the medication taste better or easier to swallow, if your doctor approves.
Joan Lokar recommends, "keeping liquid medications cold to make them more palatable." She also advises you "ask your doctor and pharmacist if the medication will taste bad, and if it's safe to add a flavoring. You can also inquire if it's safe to mix a liquid medicine with juice or food. But check with your doctor or nurse practitioner to make sure, before you do."
Give medications at the same time and in the same place.
It helps to create a designated spot in your house for giving medicine, preferably not your child's room. This puts the treatment of the illness in perspective, so it doesn't take over your house -- and your child's life. "Set up a routine for taking the medicine, and do it the same time and even in the same place, if you can," recommends Mary Mathews. "A general rule is you should try not to give medication regularly in bed (as long as this is medically possible) or in the child's room. It helps the child to have her own space, separate from treatment of the illness." To stay on schedule, put a checklist on the refrigerator or your child's door. With every dose of medication, have your child make a check or put a sticker on the list.
Choose clear, age-appropriate words when you speak.
Since many children interpret things literally, the specific words you use to describe your child's treatment are very important. Some words may scare children and make them more resistant to treatment. "Don't say, 'you're going to get a shot,' " says Mary Mathews, "use the word `injection' instead, because some kids may literally think they are going to be shot with a gun." Older children will want and need a full explanation to ensure their participation or to start treating themselves.
Don't blame the child for the illness; instead praise him for accepting the treatment.
Many children will feel responsible for getting sick or injured. It helps to remind them that they did not cause this, and then praise them for following the treatment plan. "Children want to feel well and they want praise," relates Mary Mathews. But she also advises parents to be specific with their praise. "Instead of simply saying 'good boy,' say, 'I like how you took your medicine.' In this way, you are not placing a value judgment; you are instead recognizing behavior that works. By the same token, you can let the child know what you would like to have seen happen more quickly or without negotiation. In this way you are letting a child know what you expect, instead of blaming her for what she didn't do."
Explain how the medicine will help your child get well.
Adults sometimes assume that a child knows what medicine and treatments can accomplish. But young children generally don't understand this connection, advises Mary Mathews. "You could explain it by saying, 'You didn't wake up at all last night. That's because the medicine took your pain away.'" To excite a child about getting well, you might compare how she used to feel to how she feels now -- and remind her of the activities she couldn't do yesterday that she can do today. "Children love to learn, and often feel proud when they learn something new about their health," Mary Mathews says.
Listen to how a child feels--and assess his illness accordingly.
If a child says he is not feeling well, the first thing you do is acknowledge it and take it seriously. "Then, you can ask even the youngest child what he thinks you should do," relates Mary Mathews, "and his answer will help you assess how sick he is. If he says, 'I think you should get me an ice cream cone,' that's telling you he might not be that sick. If he says, 'I think you should put me to bed,' he's letting you know he's really not well. I'm not recommending you let your child diagnose himself, but this is a way of assessing what's going on."
Recognize that a child who's been sick a long time, may just be sick of feeling sick.
An extended illness can create a resistance to treatment. It may be useful to help a child identify his feelings before taking medicine by using phrases such as "This seems to bother you today more than it did yesterday." Or, "You're stomping your feet a lot. Can you tell me why?" Once you talk about it, taking the medicine may be a little easier.
Avoid physical struggles to force a child to cooperate.
While being firm, it's also essential you don't physically struggle with your child while trying to get her to take her pills. "If you start holding a child down to give her medicine," relates Mary Mathews, "you may have to do it again and again, so we don't recommend it. This might seem to help in the moment, but it doesn't solve the problem long term. If you find you are physically forcing a child to take her medicine on a regular basis, this may be a sign you should talk with your doctor, nurse or social worker for professional advice."
Explain the consequences if a child refuses to comply with treatment.
If a child refuses to take medicine, he needs to know that he is making a choice and that the choice has consequences. "You need to tell him that his behavior means he won't get to do something he likes," advises Mathews. "For example, you might say, 'I see you're choosing to stay in the house and not go outside and play until you take this medicine.' " With a more serious illness, or when timing is essential -- like getting out the door for school -- you could say, "I see you're choosing to have me give you the medicine, instead of taking it yourself."
If your child still resists, give him an "out."
Sometimes a child will still refuse to cooperate. Before you take away a privilege, you can try giving her an "out" as this allows her to save face. Mathews recommends in instances like this that you take a short break. "You might say, `Let's both take a five-minute break and do this then.' But you need to mean it about the five minutes -- it can't be an hour." Giving a child this "out" is very important because she may physically and emotionally need to regroup -- and you may need to as well. "Perhaps you just take a moment and give your child a hug, or get a drink of water and briefly break the cycle," advises Mathews. She also notes that the same strategy can work with brushing teeth or going to bed.
Let another adult take over.
For kids who are truly resistant, parents should divide up the responsibility of who gives the medicine or supervises the treatment. This gives one parent a necessary break, and helps the child realize that both parents are capable of handling this. For example, if one parent never does this, the child might think he doesn't know how to do it.
Involve your child in her treatment plan.
This approach works for almost every age and excites kids about getting well. For example, a 2-year-old can go get the spoon for his medication, while a 16-year-old can be responsible for taking his own medications. "The earlier you do this, the less resistance you will encounter. If you wait until a child is a teenager, it could be too late," notes Mary Mathews. "We also recommend that children speak with the doctor about how they are feeling, so even at a very young age, they are involved," Matthews adds. "You can also teach even a young child the name of the medicine. When he gets older, teach him the dosage, and if there are any side effects or things to avoid when taking it."
Jordan Friedman, Social Worker
Joan Lokar RN, Pediatric Nurse Practitioner
Mary Mathews, Social Worker, Director of Family Programs
Lauren R. Sorce, Pediatric Nurse Practitioner
Joy Ruzic, Social Worker
|This information is not intended to be a substitute for professional medical advice. Please consult your health care provider about diagnosing or treating health care problems.