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7 Sep 16

Annual Camps Review

Alison Gray's review of the Camps for Young People from HD families.


Part I:
Camp Overview


Introduction
Aims of the review
Who took part in the review
Part II :
The Young People's Views


Going to camp
Which camp was best?
Who decided you would go?
Learning about HD
Coping with family members
Friends and teachers
Being at risk
Support from other young people
Knowing about HD
The camps themselves
Part III:
Parents' or Caregivers' Views


Giving permission
Arrangements, activities and
    discussions
Knowing about HD
The camps themselves

Part IV: Discussion

Part II : The Young People’s Views

Going to camp

Nine young people had attended all three camps.

Nine young people had attended two camps. Five attended the two most recent camps; four the two earlier camps. The cost of travel meant three of the four could not attend the last camp; and one person was not living at home at the time of the latest camp.

Four young people had attended only one camp, two the most recent one reviewed (1996) and two the year before (1995). The two who first attended in 1996 had only recently learned that Huntington's Disease was in their family. Of the two who went to the 1995 but not the 1996 camp, both had family commitments at the time of the second camp.

All but one of the young people said they would like to go to another camp if they could; one person who is not at risk of the disease, was unsure

Which camp was best?

Ten of the 18 young people who went to more than one camp said that although they enjoyed all the camps, the second camp was easier than the first because they "knew people and what to expect". On the other hand, four enjoyed the first camp best because they "learned more and met a lot of new people". Others enjoyed all the camps.

Who decided you would go?

Eighteen of the 22 young people said they had a choice about whether or not they attended the camps. Two made the decision jointly with their parents and two said their parents decided they would go to the first camp but they decided to go back to subsequent camps themselves. One girl, now 17, commented:

I sort of had a choice but really my father chose for me. I thought it was other people besides Huntington's Disease and didn’t want to go at first but when I was there I met people and really enjoyed it, it was awesome, it changed my life.

The young people were keen to learn more about Huntington's Disease. Eleven of the 18 who had a choice about going to the camp said that wanting to learn more about the disease was one of the main reasons for going. Six mentioned it as the only reason. The 11 included six girls and five boys aged from 13 to 17. A 14 year-old boy who has been to all three camps said:

I remember feeling a bit scared. I talked about it with my Mum and Dad. I did think it was a good idea to learn more about Huntington's Disease, to know what to expect. Not the camp aspect, although that did sound fun. It was mainly the Huntington's Disease I wanted to go for.

Eight young people thought the camp sounded fun and were attracted by the activities. (Three also wanted to learn more about Huntington's Disease.) Five were aged 14 or under and the group included five boys and three girls. A 16 year-old boy said:

I decided jointly with my mother and father (that I would go), I thought the activities would be really fun.

An 11 year-old girl was told about the camps by her mother "and when I saw what they did I wanted to go."

The third reason children wanted to go was to meet people in a similar situation. Seven gave this as one reason why they wanted to go; five of the seven were girls; the youngest in the group was 13 and the oldest is now 19. Comments from 14 year-old and 16 year-old girls were:

I didn’t really know what Huntington's Disease was and I wanted to meet other people in the same situation.

I wanted to go. I read about the camp in the newsletter. I thought I’d learn more and meet people.

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Learning about Huntington's Disease

All the young people learned more about Huntington's Disease at the camps. Some already had a reasonable knowledge of the disease, others came with little information about it or understanding of it. They said they learned about the various stages of the disease including the emotional aspects and the fact that everybody is different, as well as the hereditary and genetic aspects of it and what they might expect in the future.

All appreciated what they had learned, including a 17 year-old girl who said:

I learned so much from that camp, I didn’t want to go home, I was crying. I wouldn’t have known anything if it hadn’t been for that. Dad kept it secret till I was 15. I didn’t know anyone else who had it. My brother never went [to a camp], I was able to tell him stuff (he’s 21). I was able to talk to other people whose Mum was at a more advanced stage - I learned heaps about what it’s going to be like.

A 16 year-old girl made a similar comment:

I did learn more about Huntington's Disease - before I went I didn’t really know about it and thought I was alone, I learned about the different stages and what was going to happen.</p>

Even the youngest person interviewed found the information helpful:

I learned more about HD - that you can’t have all the opportunities in life. I learned that sometimes Dad keeps doing things and you want to shout but you can’t. He can’t help getting frustrated. I’ve learned how to manage that - I go away.

Several young people commented that they learned more at the first camp than at subsequent camps, which is understandable. Two said they found the scientific explanations by the geneticist at the most recent camp difficult to follow. (Participation in the session was voluntary and a number of younger people did not attend.)

The camp also provided the first opportunity for some young people to see someone with advanced Huntington's Disease when family members visited for one day. One young man who had little direct experience of Huntington's Disease found the experience challenging:

I have more understanding but it’s pretty frightening. I was pretty worried - a bit for myself, seeing how much you have to be looked after.

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Coping with family members

All the young people interviewed said that they had a greater understanding of Huntington's Disease from going to the camps. The seven who had a grandparent with the disease said they understood their grandparent’s behaviour better. Those who saw their grandparent regularly coped better.

Fifteen of the young people had a parent or step-parent with the disease. The mother of two young respondents had died from Huntington's Disease before they came to the camp. They still found the information helpful:

It was helpful - I didn’t understand at all before I went. I learned how it developed and what happens. It made me feel much better.

They were also aware that they knew more than some of the other young people at the camp which was sometimes a problem:

[The camp] helped me understand it more, it scared me a wee bit more, and makes me angry that it’s there, why me? With the others there, I felt that I knew what was going to happen to them; it was hard, sometimes there were things I didn’t want to say but I had to because they asked.

Eight of the other 13 young people said that being at the camp had changed the way they felt about their affected parent, making them more tolerant, sympathetic or understanding and helping them cope better. Five said the camp made no difference because they had always got on well with that parent. Neither age nor gender seemed to make any difference to the way young people responded to the information they received.

One 16 year-old boy commented that the camp was:

Comforting, but it hasn’t made a big difference to how I get on with my father. I’ve always got on well with him. It helped me cope with the disease. I don’t feel angry about it, there’s no point.

A 17 year-old girl said:

It’s really helped me - I think it changed the way I felt about my mum - you have to do everything for her. It made me more tolerant but sometimes I lose it.

A 16 year-old boy said the camps had helped him on an everyday basis:

It didn’t change the way I feel about it although I got more understanding about it. I cope better with my Dad. We used to have lots of fights. We still have them but I understand more about them and they taught us how to cope, like walking away so that’s got better.

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Friends and teachers

Girls were more likely than boys to have talked to their friends or teachers about Huntington's Disease. Ten of the 13 girls had talked to friends but only two of the nine boys had done so.

Very few had talked to teachers although four said their teachers know that Huntington's Disease was in the family. One person told her science teacher when the class was doing genetics ‘to make it easier for me’.

Both boys and girls who talked to friends said they did not talk about Huntington's Disease unless the friends asked and in most cases the friends did not really understand - ‘it’s not very real to them’. One chose to talk to a friend whose mother has multiple sclerosis. Another compared her own experience with friends in a similar situation:

All my friends know - my friend’s Mum died of cancer; another friend’s Mum also died so now we’re like a little club. They all know about Mum’s condition. I think it’s going to help me in the long run. I’m really factual about it, they’re not and now one’s into drugs.

Both girls and boys said that going to the camp made it easier to talk about the disease and to explain it to friends but there lack of experience was still a barrier to understanding. One had explained to friends that she is at risk. ‘That’s hard on my friends, I’m not sure if they understand it.’

Being at risk

Twenty of the 22 children were at risk and one had already taken the predictive test.

Nine of the 20, including seven girls and two boys aged between 11 and 17, said they knew they were at risk but rarely thought about it. Some thought the matter would become more relevant later when they had to make decisions about their future. A 17 year-old girl was typical of young people’s response to being at risk:

After the camp I was quite upset about being at risk - I kept a diary for about a year but now I don’t really think about it. You don’t really look in the future much. You think the worst and hope for the best - lots of teenagers are like that. It made me think about how I’m going to support myself. I don’t want to be a burden to anyone. I don’t want to live like that but I haven’t made any specific plans.

Two 15 year-old girls commented:

We talked about being at risk - I don’t worry because Dad’s old and he hasn’t got it yet.

I feel OK about it. Dad hasn’t taken the test so I don’t worry. I would take the test if Dad gets it so I would know about having children.

Seven were still unhappy at being at risk, although again they could do little about it till they became eligible for the test. Even then they were unsure whether they would take the test or not. These comments are from two 16 year-old boys.

We mostly talked about what HD is and how it affects you rather than about the predictive test. I thought about the test but I can’t take it for two years. I will have to wait and see how I feel before I decide. I want to do as much as I can in life, in case

I don’t feel very happy about being at risk - it’s your whole life being ruined. A doctor came and talked about it. As soon as I heard about the test I wanted to take it. I want to get it over with and find out. I would want to know.

Four said the discussions at the camp made them feel better about being at risk. A 17 year-old girl was typical of other girls who said they would consider predictive testing should they become pregnant or want to start a family. She said being at the camp:

Made me feel better about being at risk. We talked about the test. I might wait. They told me about the research which made me hopeful. It’s made me feel differently - I always wanted kids. Now I think if I had kids I don’t want them to go through what my parents did. Sometimes I think, why have a career and do all that, there’s no point. I’d rather travel so I’m thinking about that now.

A 14 year-old girl was philosophical:

It made me feel better about being at risk myself, it doesn’t scare me. If I get it, I do. I will worry about that when I’m 18. It’s not really in my life at present. I thought if I do get it I’ll deal with the things I want to do.

None had made any specific plans or done anything differently as a result of knowing they were at risk. Even the person who had taken the predictive test had, within a few months of getting the results, settled back into her former life.

I felt better about being at risk. It didn’t frighten me to know. I did make different decisions at first - I thought about quitting my job and getting a better paid one and going round the world. But now I’ve relaxed because it’s hard to get a job - reality gets in the way. I just get on with life.

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Support from other young people

All the young people said they got enough support from others at the camp, and for many , being with others in a similar situation was clearly the best part. It is hard in a written report to convey their enthusiasm on this topic. Their comments included:

Really good support, OK to have heart to hearts with everyone.

Getting support from others was really good. The second camp was good because I knew everyone - we could just walk in and start talking.

Plenty of support then and since - letters, phone calls and so on. X is the greatest help, she been through the test, and told me what it’s all about. We keep in close touch.

Knowing about Huntington's Disease

Every one of the 22 young people interviewed was glad they knew about Huntington's Disease. All said they would rather know than not know. One who first found out about the disease at 15 thought she should have known much earlier.

They also agreed that children should be told "as soon as they are old enough to understand." Estimates of when that might be ranged from five to 13 or 14 but were always at least two years younger than when the young people themselves had first heard about the disease.

Hiding it from people makes it harder to take - like basically tell the truth, especially if it’s their parent who’s got it and especially if they’ve got symptoms.

Three people qualified their comments:

Being told you’re at risk might be scary for younger children - you need to be 13-14 onwards to talk about it

If the parent is not showing symptoms maybe you don’t need to know - it depends on the symptoms and on the child.

Tell them when they’re 13 or 14 when they understand. I noticed the younger ones handled it really well so you could tell them early. I guess it depends on the situation.

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The camps themselves

All the young people wanted the camps at least once a year because a larger gap would mean "you’d lose touch". Two would like to have them more often while one thought that if the numbers dropped it would be appropriate to have them every two years but he hoped that would not happen. All wanted national camps rather than separate camps for the North and South Islands and none wanted parents to be involved. They saw the camps as an opportunity for families to have time away from each other and for young people to have the opportunity to talk freely about things they could not talk about at home.

Activities between camps

Only the Wellington Huntington's Disease Association offers activities for young people in between the camps. These have ranged from visits to a fast food restaurant to sleepovers at a local house. The young people were very positive about these gatherings and several who lived out of Wellington wanted to hear more about the Wellington activities in case they were able to attend. While some of the young people wanted adventure activities like bungy-jumping, others wanted less activity and more time to talk, particularly during an overnight stay. All wanted some kind of activity in each of the main school holidays.

I don’t want to go horse-riding or to Pizza Hut. I want more time to talk rather than doing things. We went to somebody’s place once and that was really good - it was casual rather than organised.

All but two of those who lived out of Wellington also wanted local activities but none had access to them at present. They acknowledged problems of cost, difficulties in organising activities and shyness as inhibiting factors. As one person said:

I would like local things, we don't really have them. I wouldn’t go without knowing anyone - at the picnics they do have you stay with your family.

I would like local activities. I think there are about 11 families here but I don’t know them. I don’t mind what we do.

Age-mixing

All but one of the young people wanted the age groups to remain mixed as they are now. One person, who is now 19, wanted the age groups split, with separate camps for 10 to 15 year-olds and 16 year-olds and over. Those who supported age-mixing said it was good to have the younger ones there, even though they could be annoying at time. They suggested that any problems could be solved by having some split time within the camp, perhaps including an overnight camp for older children. They also suggested there could be separate discussion groups:

All in one camp but certain activities for 10 and up and 9 and under; some of the stuff we talk about is pretty scary - intimidating for small children - you could have some spilt discussion groups

Ages could be split or joined - good to have older ones for little ones - they were able to support little ones who got upset.

Age mixing was fine and there was an age limit to the activities we did and separate dormitories. You felt you could be with people you wanted to be with.

Discussion time

Thirteen of the 22 young people thought the amount of time they had for discussions was about right; nine thought some of the discussions were too long. Two girls aged 14 and 15 said that they had learned most of what they needed to know at the first camp which made later discussions somewhat repetitive but both were happy to accommodate that:

First time was good, the second time there was too much. I knew most of the stuff but others wanted to learn and I was OK about that. I was happy to sit and listen

The nine who thought that some of the discussions were too long included four girls and four boys aged between 11 and 16. All felt that individual sessions were too long and would have preferred more shorter sessions possibly during the day rather than in the evening when people are getting tired. A few suggested having more separate sessions for older children but the youngest person disagreed with this:

There were some things only 10 and up could go to - we should all have the chance to go to all groups; we listened through the wall. It sounded interesting. You’re allowed to get up and go if you get bored so it would be OK.

The young people particularly liked being able to ask questions and to put them in writing so that they are anonymous. They felt they had ‘plenty of chance to have a say’ and none could think of any topics they wanted to talk about that were not covered. Some found the talk by the geneticist at the latest camp too long and technical but generally the format and content of discussions was acceptable. Two people specifically said they liked the ‘craft’ activities such as building a sculpture or model of a place where they feel ‘safe’ from Huntington's Disease but two others said they found these activities boring and unhelpful.

The format of introductions and the counselling ‘activities’ caused some comment. Three young people wanted different introductory games - "we do the same things every year’ - and they did not want to have to wear name tags. Others made no comment.

Free time

Seventeen young people thought the amount of free time they had at the camps was about right. They had time to socialise, to prepare skits and to write their diaries.

Two people thought there was too much free time at the last camp but that was because there was not a lot to do at the site. They preferred sites with scope for some leisure activities they organised themselves.

Three would like more free time but did not feel strongly about the issue.

Activities

The young people were most enthusiastic about the activities. Their eyes and voices lit up in discussing these. They were most enthusiastic about the ‘high adrenalin’ activities such as bridge-swinging, abseiling and white water rafting. The latter was especially popular because it meant the whole group was together having fun. The least popular activity was caving. The young people were aware that the range of activities depended on the camp site

They preferred outdoor to indoor activities although two 15 and 16 year-old boys were enthusiastic about the video parlour visit. One girl summed up the group feelings by describing the activities as ‘wicked’. Comments from two boys are typical:

Loved the bridge-swinging, the adrenalin stuff, caving is boring but I liked rafting - the whole group having fun, I liked the golf, liked different things each time.

Liked caving and tramping least. The best were the physical and group activities - rafting, canoeing, bridge-swinging, abseiling. Would like small overnight camp with a subgroup of the main group.

Only two new activities were suggested - four-wheel motorbike riding and an overnight camp with small groups of older children.

Child with Huntington's Disease

As part of the interview, the young people were asked how they would feel about having a child with advanced Huntington's Disease at the camp. Only one person answered a clear ‘Yes’ to this question and even those who said they would not mind were cautious.

Ten of the 22 said they would not mind having a child with Huntington's Disease at the camp although one added that he had not seen anyone like that. Two acknowledged that "it would be a bit scary" and a reminder of what could happen to them

Eleven were unsure or thought the child should not come. One girl familiar with the advanced stages of the disease said:

I’m not sure what I would feel like. Talking about it is one thing, seeing someone your own age would be the scariest thing. Some people would be able to handle it, others wouldn’t. I might want to leave if I saw a 15 year-old girl with Huntington's Disease. I wouldn’t know how I felt till I saw them.

One girl thought the camps were for children at risk and that having a child already showing symptoms would be too upsetting. Another suggested the child could visit rather than stay the whole time. It would be difficult to include them in the activities, although the environment may be supportive.

Dislikes

Very few people had any dislikes about the camps. Three did not like the food at one particular camp; one did not like having to travel a long distance to the camp and two of the younger members did not like having to go to bed early.

One of the 14 year-olds who had been to all three camps had noticed a difference as the young people became teenagers and the nature of their relationships changed. ‘Some are more distant now, moving apart and less interested in Huntington's Disease.’ He added that the changes were not enough to stop him looking forward to the next camp. For one girl, the worst thing was going home.

They had few suggestions for improvements. Some would like the camps held out of the Wellington area, but that would require other Associations to become involved in the organisation. They generally preferred longer camps with five days rather than three, even if ‘we only had organised activities on three of the days, we could spend time round the camp.’

Good Things

The people were clearly the best thing about the camps - making friends, getting to know people in a similar situation and being able to talk to people the same age who feel the same way. All the young people mentioned friendships as one of the best things about the camps. One 15 year-old girl summed up the responses:

The people were the best, not the activities, it’s the people and how well they get along, talking and comparing my own situation. I learned what to expect in the future, like one child’s mother was in a wheelchair. My mother wasn’t then but now she’s finding it hard to hold drinks and do things for herself.

A 15 year-old boy made a similar comment:

Freely talking about it with the people round, the openness of it and the activities.

The activities were also popular. Nine people included them among the best things about the camp. Two of the young people described themselves as ‘lucky’ for being able to go to the camps:

Friends from the camp are very different to friends we have locally. At every other camp you get bored at some point, never at a Huntington's Disease camp. The people are special, maybe because we don’t see them very often. The activities are special as well - you’re lucky if you get to do them I feel we’re lucky kids.

The social worker who organised the three camps was much appreciated by the young people. They described her as ‘a legend, she’s awesome, I trusted her, she’s a trouper’ and as ‘really helpful. She gives us a shoulder to lean on, and helps us try to sort things out ourselves. I want her there again’.

A comment from a 17 year-old girl summed up people’s feelings about the camps when she described the best thing as:

The whole thing - this great big bond, all the support, I don’t feel alone.


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Appreciation and thanks must go to Judy Lyon for compiling the wealth of information available
on this site, and to Graham Taylor for maintaining the original site for so long.

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