Diabetes: Caregiving for an Older Adult

Overview

Caring for an older adult with diabetes may feel like a lot to take on. Caregiving can be challenging at times because what seems best for that person may not be what they want. You may worry about invading their privacy or free will. There's also the stress of learning how to manage diabetes and often other health problems. No less important, you need good health and balance in your own life.

How can you be a good caregiver and take care of yourself? First, team up with the person and their doctor. And don't try to do it all.

Learning the art of caregiving

Caregiving is a selfless way of thinking, asking, listening, and responding. That can mean:

• Doing your best to see things from the other person's point of view.
• Asking questions like "What do you need help with?" and "How do you like to do this?"
• Offering new ideas gently, such as saying "Let's try to get out for a walk today" or "Would you like to try yoga with me?" instead of "You need to get some exercise."

A main goal of caregiving is to help the person you're caring for have the best quality of life possible. To learn what that means for them, try asking questions like:

• "What do you consider a good day? What can we do to help you have more of them?"
• "What are you looking forward to doing in the next few months? How can we keep your health on track with those plans?"
• "What part of your medical care is hardest for you right now? What else about your health is hard for you? How can you and I make that easier on you? Is there something your doctor can help with?"

Help and support in any way you can, based on your time and ability. If there are critical needs that you can't meet, talk about them with the person you are caring for. Think about having more than one caregiver, or maybe a home health aide.

Teaming up with the doctor

Here are some ways to help the person team up with their doctor to get the best care.

• Help them work with the doctor. During doctor visits, you can help the person to:
  • Take an active part in each appointment. Encourage them to ask questions and tell the doctor if following the prescribed treatment will be hard to do.
  • Ask for care instructions, such as written information or links to videos and websites.
  • Make follow-up appointments.
  • Find out when to call the doctor if the person is having problems.
• Act as a go-between, if needed. Depending on how well the person can think, speak, and remember, you may be able to play a go-between role. Try asking them guiding questions in front of the doctor, such as, "Do you understand this information? What do you think of that idea?"
• Support shared decision making. The later years of life are an ideal time for the doctor and their patient to share in medical decisions. Together, they can decide what to treat and how to treat it, based on the patient's health and preferences. If you see a need, help the person you're taking care of think through medical decisions such as these:
  • What medical care is most likely to improve or protect the quality of their life?
  • Are there treatments or tests that make their daily life harder? If so, how do these treatments or tests balance against the health benefits they offer?
  • What type of pain relief do they prefer?

Helping them make healthy food choices

A person with diabetes doesn't need to eat special foods. They can eat what other people eat, including sweets once in a while. But it's important to pay attention to how often and how much they eat of certain foods.

To prevent big jumps and drops in blood sugar, it helps to:

• Eat meals and snacks on a regular schedule.
• Combine several nutrients in each meal or snack. Carbohydrate raises blood sugar faster than protein, fat, or fiber does. When carbs are combined with these other nutrients, blood sugar rises more slowly.
• Some examples of snacks that combine nutrients are an apple with peanut butter or a turkey sandwich.

When a person with diabetes isn't eating well, it's easy to take on the role of "food police." If you are struggling with this challenge, try to shift your approach. Here's an example.

• Think about a food that the person really enjoys. This might be a sweet snack at bedtime.
• Rather than saying "no" to this favorite food, think about helping downsize the portion. For example, for someone who loves a big bowl full of ice cream, fill a smaller bowl.

Taking care of yourself

Taking care of yourself is your most important step as a caregiver. Caregiving can be stressful and cause feelings of depression and anxiety in some people. Here are some important things you need to find time to do—just for yourself.

• Try to take a class on caregiving. You will meet other caregivers and learn new ways to manage challenging situations. To learn about caregiving, contact the Family Caregiver Alliance (www.caregiver.org).
• Get some exercise. You may feel better and sleep better if you exercise. Experts say to aim for at least 2½ hours of moderate activity a week, but any amount of regular exercise may help.
• Eat healthy meals and snacks. When you are busy giving care, it may seem easier to eat fast food than to prepare healthy meals. Healthy eating will give you more energy to carry you through each day.
• Get enough sleep. If you aren't getting enough sleep at night, try to take a nap during the day.
• Make time for an activity you enjoy. For example, make time to read, listen to music, paint, do crafts, or play an instrument—even if you can only do it for a few minutes a day. If you like to go to faith-based activities or take classes, ask a friend or family member to stay with the person you're taking care of for an hour or two once or twice a week so you can do those things.
• Get regular medical checkups. This includes dental checkups. Even if you have always been healthy, you need to stay healthy. Know about the signs of depression, and watch for them not only in the person you are caring for but also in yourself. If you have feelings of lingering sadness or hopelessness, talk with your doctor.
• Get the support you need. Helping a person with health problems can be emotionally difficult. If you are having trouble coping with your feelings, seek advice and counseling from family members, trained mental health professionals, or spiritual advisors.