Blended Families and Bleeding Disorders

Parents and stepparents must prepare
Author: Leslie Quander Wooldridge

The blended family is here to stay. According to US Census data, in 2009 nearly 12 million children, or 16% of all kids under the age of 18, lived in a blended family.

Creating a new family can be amazing and yet arduous. “We don’t all adjust at the same speed. Having a stepfamily can be more complex and more stressful,” says Chicago-based social worker Elizabeth Fung, MSW, PhD. She is a member of the National Hemophilia Foundation’s (NHF’s) Cultural Diversity Working Group.

Plan ahead. Effective stepparenting takes planning and preparation. Before you move your partner and children under one roof, discuss your expectations and develop a written plan. “When you have a child with a bleeding disorder, you need an even better plan,” says Fung. “A parenting plan should meet the needs of all children, so all feel like they belong. It should outline medical, financial, educational and any religious activities, along with family rules and tasks.” Adults should discuss topics such as family meetings; who will provide insurance coverage, make payments and order treatment supplies; and which parent will take children to appointments and activities.

You can talk as a couple, or work with a therapist or social worker. Then you can review the plan from time to time and adjust as you see fit. Once you agree on a plan, share it with your children, says Fung. Although they should not make final decisions, kids should be informed and encouraged to make suggestions, she says.

Educate yourself. Part of the preparatory process for a stepparent involves learning about bleeding disorders. Both adults should meet with hemophilia treatment center (HTC) staff, so that the stepparent can learn more about how a child might deal with pain, for example, as well as strategies to help.

“Both parents, the natural parent and the stepparent, should learn to give infusions from a nurse,” Fung says. “You can never guarantee that the natural parent will be nearby in an emergency.” While learning, the stepparent can practice on his or her spouse in front of a nurse, and then demonstrate the skills in front of the child so that he or she knows the ­stepparent can be trusted. For regular infusions, give the child a choice. If he or she is not comfortable with the stepparent doing so, that’s OK, says Fung. The stepparent should not take this decision personally. Step­children may be inwardly wrestling with a conflict over loyalty to their natural parents versus their new stepparents. So stepparents should clarify that they are not trying to replace natural parents.

Agree on discipline. “We very often confuse the word ‘discipline’ with punishment,” says Janet Weisberg, PhD, a New York City psychologist who specializes in family issues. “You’re trying to teach a child new behavior.” Kids can try to take advantage of the adult they view as weaker or nicer, she notes. This may be even more pronounced in kids in blended families.

Adults should have a united front when disciplining children. Couples should discuss parenting styles early on and how you will stand together when issues occur. “You have to listen to children’s feelings and give them credence,” says Weisberg. Remember that time and patience are key when bringing a blended family together.