SCHOOL AGE CHILDREN
- These children need a short but accurate reason why they need to take the medicines. Complicated explanations about lung anatomy and other details are too much. However, never lie to a child or give them wrong information.
- Be more flexible and give them choices. Consistency and firmness are still very important. However, a little flexibility is needed at this age. For example, instead of giving an exact time, ask “do you want to take your medicine before or after this TV show?”, or “do you want to take your medicine with juice or with water?” Notice that one of the choices is not “not to take” the medicines. Small choices go a long way to helping your child feel some control. Give a little advance warning, especially for nighttime medicines. For example: “remember, asthma medicines are due in 5 more minutes”.
- Give rewards. Verbal praise is still the best reward. However, sometimes a small reward can help a lot. Never bribe a child to take their medicine. Rewards should be given for taking the medicines well in general, not for one particular time. Never say “I’ll give you a toy if you take this medicine”. Do say “You’ve done such a good job taking your medicine this week that you get a toy”. However, be careful that your child knows that they have to take the medicine even if they don’t get a reward, and that rewards are not always given.
- Set up a system. You can make a daily chart or calendar with the medicines written on each day. You can use stickers to help remind your child to take the medicines. The medicines can be linked together with other common activities. For example, the medicines can be kept near your child’s toothbrush, so they are reminded about the medicines at least twice a day when they brush their teeth. Or the medicines can be kept near the dining table, so they are reminded about the medicines around breakfast and dinner time. There are many creative ways to keep track of the medicines.
OLDER CHILDREN AND TEENAGERS
- These children need a clear explanation of why they are taking the medicines and what might happen if they stop. They also need to know about possible side effects or other problems that can be caused by medicines.
- Give responsibility. Older children need to learn to take responsibility for their own health. As they grow older, these children should be remembering to take their daily medicines by themselves and administer all their own medicines.
- Trust your children (but not all the way). Older children should be trusted to take their medicines responsibly. But it is still a parent’s job to look over their shoulders once in a while. Make sure they are not needing a lot more albuterol inhaler refills. Also, make sure that they are refilling their daily controller medicines. If you see your child’s asthma acting up, make sure you check how and how much medicine they are taking.
- Set up an incentive system. As always, bribing or punishing a child to get them to take their medicines is not advised. A positive incentive system, that is, a reward system based on a “contract” between parent and child can be useful. Your child and you may agree ahead of time that if your child takes their medicine every day for a week, they get a small reward. If they make 4 weeks in a row, they get a larger reward. It is important that each of you keeps up their end of the deal. You may set up a deal that a reward is given for “taking asthma medicines at least 6 days out of 7”. If your child really takes his/her medicine 6 out of 7 days, then you must give them the reward that was previously agreed upon. If your child only does 5 days, then they need to understand that they don’t get the reward.
Your clinician also has a role in compliance. It is easier to remember to take a 2 times a day medicine then a 3 times a day medicine, and even easier to take a 1 time a day medicine. A medicine that tastes good to one person can taste bad to another. Some medicines can cause unpleasant side effects. You and your child should bring up any problems you are having sticking to the plan. It is possible that the medications can be changed or adjusted to make them easier to take. Your clinician should be willing to make changes in the medicines if at all possible. Some people don’t want to “bother” their clinician, or are afraid that the clinician will get “upset” if the family is not following the plan. These families will sometimes tell their clinician that they are following the plan exactly, when in reality they are not. When this occurs, the clinician will have no way to tell if the medicines are working, will not be able to help control your child’s asthma, and will lose trust in future problems. It is always better that all people in the plan be honest. Remember, we all have a common goal – keeping your child as healthy as possible.
