My Niece Keeps Passing Out During Soccer Practice. Her Dad Claims She’s “Doing It for Attention.”

Care and Feeding is Slate’s parenting advice column. Have a question for Care and Feeding? Submit it here.

Dear Care and Feeding, 

My brother-in-law “Cyrus” is married to my husband’s sister. He’s blessed with great genes—he rarely gets sick. He believes it’s his diet and supplements, and that if other people copied his diet and lifestyle, they would also be ailment-free. Unfortunately, this means he has limited sympathy for other people’s pain. It was tough to watch him during his wife’s pregnancy and her postpartum depression afterward. We decided to limit time with them after conversations about sickness made no difference with him or his wife.

This year, their daughter Callie is in a big regional sports team with my daughter. She’s a sweet kid who works hard on the field and off. Unfortunately, the team and our kids hanging out means I’m seeing her parents in action. Callie has some type of undiagnosed menstrual issue, which means she sometimes passes out from the pain during her period. Her other symptoms around her cycle also seem concerning. As the closest responsible adult at practice, I’ve taken an unconscious Callie to the emergency room two times this season already. Her parents’ response is eye-popping; her dad argues she’s doing it for attention, or to get out of practice or school. That is not the case. She pretty much always tries to play through it and argues she can go back on the field after passing out.

With women’s health, you have to advocate if you want answers, and Cyrus had refused to sign off on or pay for any testing or diagnostics. His wife just stands there silently and doesn’t push back. Callie has asked me for help, but I don’t know what I can actually do here. More conversations with her parents? What do I say? I can’t take a 13-year-old to a gynecologist against her parents’ wishes.

—Watching a Car Crash

Dear Car Crash, 

I urge you and your husband to talk to his sister without Cyrus present. Bring some resources to her about the kinds of serious conditions this pain might be symptomatic of (endometriosis comes to mind. Though of course it’s possible that it will be something else, even unrelated to her period, and will take a few specialists to diagnose.). It sounds like the big hurdle here is Cyrus, so assure your sister-in-law that he doesn’t need to be involved in the process or even know about the treatment. Only one parent needs to consent to let a third party take their child to the doctor (excluding abortion, which have different requirements by state). Offer to do all the legwork: Tell her you’ll find a doctor and take Callie to the appointments—and that you’ll keep this between Callie and her. All your sister-law will need to do is fill out some straightforward paperwork with the doctor’s office designating you as a trusted adult who is authorized to accompany Callie to medical facilities and, on her parent’s behalf, consent to treatment. Planned Parenthood might have experience with similar situations and would be a good spot to consider for this kind of exam.

If she’s against this plan, is there a dude in your life who Cyrus might listen to? I get the feeling he doesn’t put much stake in women’s opinions, and if sending a man in to be your mole works, so be it. Whoever you send in can follow a similar approach as the one I outline above. If all else fails and Callie’s parents continue refusing to get her care, as a very last resort you can consider calling child protective services (CPS) on Callie’s behalf and file a report—if a parent repeatedly fails to provide medical care for their child, that may very well fall under what the agency considers “medical neglect.” The state may intervene on Callie’s behalf and require her parents to get her the help she needs. Involving CPS is a challenging thing, though, so do not take that decision lightly.

While you work behind the scenes to get Callie’s family on board, keep reassuring her that you do believe her and are there for her to talk through how she’s feeling. Reaching a diagnosis can take time. In the meantime, countering the messages she’s receiving at home can do her a world of good.

Dear Care and Feeding, 

My 2- and 4-year-olds are squabbling constantly. The older one tends to be more verbally argumentative, while the younger one will physically retaliate. This then leads to them swiping and pinching each other. We’ve tried setting rules that hitting is not OK, taking a child into another room so they can have some space with a parent, encouraging them to replace the hitting with hugging… Nothing has stuck. Their default behavior is still very reminiscent of Tom and Jerry. Any words of wisdom?

—Cartoon Squabbles

Dear Squabbles, 

For better or worse, physical aggression is a normal and sometimes ubiquitous part of raising toddlers. As you’re experiencing, it’s pretty prevalent at 2 years old—when kids have all the feelings and opinions, but few or none of the words to express them. Simultaneously, your 4-year-old is starting to deploy reason and logic, but doesn’t know their audience. Moreover, they might have a strong attachment to “fairness” and probably thinks they’re right 100 percent of the time. Not a great combo, so I send you strength and mojo.

I think you’re on the right track with telling them “no hitting,” separating them when they get into an altercation, and providing a distraction (in the form of parent attention). I’d stop the “replace hitting with hugging” tactic. Your children are hitting because they are angry or frustrated—those are natural and appropriate feelings. Hugs, on the other hand, come from a place of love and should be freely offered, not forced in a moment of strife. By insisting they replace one with the other, you’re confusing and confounding the two.

For your little hitter, you can offer alternatives for when they’re angry. For example, some parents encourage toddlers to hit or scream into a pillow. Some parents tell kids to grab a crayon and paper and scribble as hard as they can. You could give them a phrase to yell, such as, “I don’t like that!” Basically, choose whatever outlet works with your parenting style and kid’s personality. In an ideal situation, you would stay on alert and intervene just before the squabble turns physical, coaching both kids through de-escalating their feelings. Proactive intervention is often easier said than done, but it’s something to shoot for.

For your arguer, you can start introducing the concept of “Is it true, necessary, or kind?” With young kids, I often replace “necessary” with “helpful,” but the basic idea is to teach kids that their opinions don’t always need to be shared and they aren’t always right. The next time you hear your oldest kid arguing, ask them, “Is what you’re saying helpful right now? What could we try instead?” I’d also remind them that the toddler doesn’t necessarily understand turn-taking and other “fairness” protocols, so seeking adult intervention rather than arguing is sometimes the best bet. It’s not tattling, it’s asking for help.

Even with this advice, you aren’t going to prevent or minimize all squabbles. My best tip, then, is to remember that while each day feels long and exhausting, this is ultimately a phase that will pass. Take a deep breath, put one earbud in with your favorite podcast to minimize the chaos around you, and ask your mom friends to throw some memes your way to remind you that you aren’t alone.

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Dear Care and Feeding, 

I feel very guilty and ashamed that my father is having to spend time in an assisted living facility because my mom can’t care for him at home anymore and neither of us can afford or logistically manage in-home care. I was super angry with my mom for putting him in there, but she told me today that a team of three doctors at his previous rehab facility strongly recommended that he be transferred to an assisted living facility, rather than coming home. Dad agreed with the doctors’ recommendations and seemed grateful to still be in the same town as my mom where they have lived for 40 years now.

My mom will be visiting several times a week, and my sister probably once or twice a month, so he isn’t being neglected or forgotten, but I still feel ashamed that I’m not moving home to take care of him. I’m also quite upset that his doctor, the rehab facility, or assisted living (I’m not sure who) decided to put in a catheter. What is the point of paying for 24-hour care when they aren’t willing to change my father’s clothes when he wets himself, and he “must” wear a catheter 24/7? They also charge extra for laundry, after charging $4,200 a month for taking his vitals several times a day, bathing him, and feeding him. Elder care so expensive and yet the facility doesn’t want to change his clothes more than twice a day! I assume they do help him get dressed in the morning and help him get into pajamas at night.

I also worry about the effect on my father of being separated from his home and belongings. But it’s really not my decision to make. I feel like the foundation is coming out from under me with my dad in a facility. What should I do for my dad, and how do I feel better about myself despite allowing this to happen to him?

—Lolly

Dear Lolly, 

I’m so sorry; I can tell you’re hurt about this. We cannot always help our loved ones in the ways we want or the ways they need. It can make us feel powerless, sad, angry and cynical. That is understandable and normal.

Let me start with something you might want to consider about your dad’s care—namely, that the things you’re worried about might not be the things he’s worried about. For example, he might find the reality of a catheter far more acceptable than the indignity of wetting himself each day. He might feel relieved to be in an assisted living facility rather than feel guilt about how much your mom had to do to care for him. He might even feel safer in assisted living than at home with your aging mom—and that’s not intended to slight her! Depending on the facility, he might be excited to meet new friends and have social activities with other residents.

This is a situation that many of us adults will go through as our parents age, and no one ever says that it’s easy. But consider that for all the negatives spiraling in your head, there might be positives that balance them out. Talk to your mom and dad—and even his facility—to learn more about his care. The facility might be able to recommend resources like support groups if you need a little more help processing this new chapter in your dad’s life. Individual therapy is also something to consider, if you can afford it.

Meanwhile, have a heart-to-heart with your dad. Don’t lay your guilt at his feet—he doesn’t need that burden—but share your concern that he may start to feel isolated and ask him how you can help avoid that. Maybe you set up a weekly call where you chat, watch a show concurrently, or play an online game. Hopefully, the more you know about his new normal, and the more you participate in it, the more peace you will find. It may not be perfect, but I hope it can still be pleasant.

—Allison

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