Meeting the emotional needs of parents who have a child with complex needs

The physical and financial demands of caring for a child with complex needs are acknowledged by health professionals. However the emotional needs of parents are not often recognised by health professionals until parents are at a heightened level of stress. This paper is based on a literature review of current articles, research papers and government documentation. The focus is on how health professionals, and nurses in particular should meet the emotional needs of parents who have child with complex needs, particularly at the point of diagnosis. Giving birth to a child with severe health problems impacts upon parents at an emotional time of transition, particularly if there were no concerns identified during pregnancy. For some parents a grief response or state of chronic sorrow may be triggered. The reality of caring for a baby who is critically ill or disabled can be an enormous and unexpected shock for both parents. Parents need emotional support and guidance, as they may have to change their expectations for their child’s development and even life span. Primary support often comes from parent support groups rather than health professionals. The review discusses how home visits, practical help and early support can all help to alleviate stress. It is important for nurses to realise that if parents’ emotional needs are unmet they can lead to clinical depression or mental illness. This literature review looks at the emotional impact on parents and explores how nurses can address this issue in order to support parents more effectively. It identifies key areas that nurses could address that would help alleviate parents’ emotional stress.

Absence makes the professional try harder? Meeting the needs of socially excluded young men who become fathers

Research on socially excluded young fathers has been minimally addressed in the literature (SEU 1999, 2004). Indeed, research on young parents which informs health and social care professionals is often presented ‘through the eyes of the mother’ (Reeves 2006). Young parents in general and young fathers in particular are notoriously difficult to gain access to and engage with (Tyrer et al 2005) particularly if they have had previous negative involvement with the statutory services. Moreover, as Daniel and Taylor (1999, 2001, 2003) point out, professionals working in the health and care services often have an intense ‘maternal’ focus and this often excludes fathers from discussion and decisions about their children. The focus of this paper, drawing on two narrative studies of young fathers aged between 15-24 from the US and USA, is to evaluate the features of professional relationships that young fathers describe as finding helpful. Indeed, the findings discuss moving away from a culture of parenting classes, which all the young men interviewed described as finding problematical and in some cases embarrassing, to a culture of support which actively draws on their strengths and helps them become providers for their new families.

Grandparents and parenting: towards a theory of grandparenthood

This paper explores the changing role of contemporary grandparents with many demonstrating a willingness and ability to take on parental responsibilities for their grandchildren, where they may face challenges and opportunities in difficult times. Three main forms of grand parenting are identified in the literature, those who have primary responsibility and are raising their grand children as their main carers perhaps in response to crisis situations, those who live in extended families and participate in care, and those who provide day care while the child’s parents work. The latter has increased because of the increasing frequency of divorce, single parenting and the lack of available or subsidised child care in the United Kingdom. When grandparents step into a troubled situation and attempt to offer stability and security for their grandchildren they may have to manage the combined responsibilities of family caregivers and parental figures. Grandparenthood is a tenuous role, lacking clear agreement on behaviour norms. In the culture of advice and parenting support, while care must be taken not to undermine parenting skills or make judgements about the ability to cope with the demands of childcare, an exploration of the impact on grandparents and children must be undertaken. Due to the complex web of interrelated factors the process and outcomes of care giving by grandparents is not well known in the literature. It is proposed therefore that it is timely for research to be undertaken to explore and develop a theory of Grandparenthood.

Managing the risk of parenting

The aim of parents is to enable their children to become autonomous individuals capable of participating fully in the culture in which they live (Korbin 1997). Furthermore, the quality of parenting is reflected in an adult’s ability to recognize and adequately meet a child’s needs in a developmentally and emotionally appropriate manner (Donald & Jureidini 2004).Within contemporary society however, parents are faced with the tensions of providing boundaries whilst affording children rights. This in itself brings risks and a common thread that runs through approaches to parenting is the attempt to define a threshold of acceptable parenting. Above the threshold and a parent is good enough and below is not good enough. This paper will consider what the minimum requirements are and explore different dimensions of parenting. The concept of good enough parenting will be revisited in relation to risks that parents have to take, within the context of contemporary policy related to improving outcomes for children as enshrined in the Every Child Matters: Change for Children Agendas (Department for Education and skills 2003). The current dominance of a risk management approach to safeguarding children will be addressed within the context of a ‘risk society’ and the importance of the safety and well-being of the child will be examined It will be suggested that we need to achieve a better balance of ensuring the safety of the child, meeting the child's developmental needs, and supporting family functioning if we are to help parents manage the risks.