Daily Medication - how much supervision

[Purpleartichoke]

Dd is 10 and has taken daily asthma medication since she was 5. At this point we still open the bottles of pills and hand them to her. She shakes and squirts the nasal spray herself. She uses the inhaler herself. But all of this is done with us standing there and watching.

I know by the time she is 16-17 she will need to be able to manage her own medication, possibly even keeping track of refill needs and doctors appointments.

I just can’t figure out how we get from now with total supervision to later when she will need to manage this condition on her own.

I would just make sure you’re involving her and having her see each process as much as possible. Tell her about doctors appointments as they’re made and write them on a calendar she has access to. I wouldn’t expect her to be taking much responsibility for the management of these yet but she will see how you manage this and learn some of the skills needed through observation.

Could you get a weekly pill box and at the start of each week count the pills out into the pill box together? Then check that the remaining number of pills in the bottle isn’t looking too low, and if it is you can talk about needing to book an appointment to get more.

When it’s time each day to take the pills she can just be supervised to open the pill box on the right day and take out the allocated pills?

Gradually you can reduce supervision, but I wouldn’t worry about exactly when or how yet, she’s only 10 and there are still many years before she needs to be independent. It’s also likely that as she enters her teens you’ll find she naturally pushes for more independence anyway.

I should add, she is annoyed we are not giving her more control here. The push to change is not coming from me.

Some of it will just be about you trusting her. If you’ve seen her do the spray and inhaler countless times supervised and she’s able to use them properly then at some point you have to step away and trust she’ll use them just as competently without you watching. In that way you maybe need to give a reminder ‘DD you need to use your inhaler/ spray’ but trust her to then carry out the instruction without you needing to be in the room. Then later when you ask ‘DD did you use your spray/ inhaler’ and she says yes you need to trust her.

In this way it’s much like any skill. As babies and toddlers we brush our children’s teeth then as young children we give less assistance but still supervise, but at some point we have to let them go up to the bathroom without us and just trust they’re doing it as they’ve shown us they can.

I'm diabetic and at the age of 11 I had total control over my insulin/blood tests/injections. As she gets older and wants to go on school holidays/sleepovers she needs to be able to feel confident she can do it all herself. At 10 I would definitely say it's time to let her get started. If it makes you happier use a pillbox but then trust her with a few prompts/reminders. Dd has a friend who has come for sleepovers since the age of 9 and she has cystic fibrosis. She has lots of medication and comes with her oxygen tank to sleep on but I've never helped with any of it. Trust your daughter.... it's her illness.

My ds is 12 and has had full control of all his asthma/allergy meds since he was 7 or 8. He just tells me when things are running low and I order more. He also tells me if he has been using his reliever inhaler more often and feels that he should see the asthma nurse. We started the change by issuing the then liquid medication and leaving him to deal with his spray and inhalers until he asked to do the liquid himself. When it changed to tablet meds that became even easier for him to manage.