Transition means :

Transition Programs in Pediatric Diabetes: One Step in the Journey of Healing & True Self-Management

Transition means: .

If you were an adolescent ready to move on to an adult diabetes clinic, you would want to have: • ______________________________ • ______________________________ • ______________________________

If you were a parent of an adolescent moving on to an adult clinic you want to be assured about and have: • ____________________________ • ____________________________ • ____________________________

Transitions: Exist in Context – Successful transitions mean comprehensive, long term preparation! In diabetes, usually addressed at HS Graduation: • Challenges: • optimal metabolic control • normal growth & development • integration of diabetes into daily life • parental stress • Challenges: • dependence vs. independence • responsible management behavior • less than optimal metabolic control • risk taking intensity • Challenges: • burnout, despair, depression • integration into work & family life • achieving & maintaining optimal metabolic control Childhood Adolescence Adulthood • Needed Resources: • optimal self management education • individual & family counseling • health care team support 24/7 • Needed Resources: • relevant, effective messaging to adolescent & family • family counseling & support • peer support • Needed Resources: • individual & family counseling & support • Access to comprehensive care • self-management long term care strategy Transition: Adolescence > Adulthood

>>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 • Competence/effectiveness • Response to initial symptoms Baker, Rosman, Nogueira, Sargent; Unpublished research data, 1979

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

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

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

educate enrich advocate emphasize

Transition means :