Diabetes: Caregiving for an Older Adult
Helping or caring for an older adult with diabetes can feel like a lot to take on. There's the challenge of caregiving—because what seems best for someone isn't always what that person wants to do. You may worry about invading your loved one's privacy or free will. There's also the stress of learning how to manage diabetes and often other health problems. No less important, there is your need for good health and balance in your own life.
How can you be a good caregiver and feel good about it? First, team up with your loved one and his or her doctor. And don't try to do it all.
Caregiving as an art
Stop to think a moment. When you're in need, how does it feel to accept help from another person? Do you feel relief, or gratitude? Maybe something else? How does it feel when you and your helper don't agree? No one likes to be told what to do, right?
As a caregiver, it's likely that you've run into this problem when offering help. For example, the more you try to change how someone eats, the less agreement you get.
That's why caregiving is an art. At its best, it's an other-centered way of thinking, asking, listening, and responding. That can mean:
- Doing your best to see things from your loved one'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 "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 your loved one have the best quality of life possible. To learn what that means for your loved one, 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 diabetes 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 however you can, based on your time and ability. If there are critical needs that you can't meet, talk about them with your loved one. Think about having more than one caregiver, or maybe a home health aide.
Learning about diabetes care for the older adult
Knowing your loved one's treatment plan helps you to be a better caregiver. If you can, go with your loved one on doctor visits. The doctor can help you know what care is most important, such as preventing and treating low blood sugar.
Don't be surprised if the doctor's treatment approach becomes more relaxed. That's because for a lot of older, sicker people with diabetes, strict blood sugar control doesn't offer the health benefits it used to.
Supporting shared decisions with the doctor
The later years of life are an ideal time for a doctor and 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 your loved one think through such medical decision questions as:
- What medical care is most likely to improve or protect the quality of your life?
- Are there treatments or tests that make your daily life difficult? If so, how do they balance against the health benefits they offer you?
- Do you need relief from pain?
Partnering with the doctor
During doctor visits, support your loved one in partnering with the doctor. Help your loved one follow these guidelines:
- Be an active participant in each appointment. Listen carefully to what your doctor says. If you don't understand something, ask questions. And tell the doctor if you think that following the prescribed treatment will be hard for you.
- Have someone with you during your appointment, if you can. He or she can take notes, ask questions to clarify information, and help you remember what your doctor says.
- Ask for instructions. Before you leave the doctor's office, make sure you know what you are supposed to do to care for yourself. Ask for written information, links to videos and websites, and any other instructions.
- Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Depending on how well your loved one can think, speak, and remember, you may be able to help by playing a go-between role. Try asking your loved one guiding questions in front of the doctor, such as "Do you understand this information? What do you think of that idea?"
Try to use food to prevent big jumps and drops in your loved one's blood sugar. This does not mean "no sugar" and "only special diabetic foods." Instead, eating smart with diabetes means:
- Spreading snacks and small meals throughout the day.
- Eating a mix of carbs, fat, and protein for each snack and meal. For example, eating only noodles makes blood sugar jump up, and then drop—it's the simple carbs. But eating noodles with some protein and fat, such as cheese, might help slow down the jump in blood sugar.
When a loved one with diabetes isn't eating well, it's pretty easy to take on the role of "food police." The problem is that no one likes to be told how to eat. If you are struggling with this caretaker challenge, try to shift your approach.
- Think about a food that your loved one 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, choose a smaller bowl to fill with ice cream.
Taking care of yourself
When you're a caretaker, your loved one depends on you to also care for yourself and stay well. That can be hard to do when someone else's needs seem more urgent. So if you haven't thought much about your own needs lately, ask yourself some questions.
- How do I feel about this change in my life? Am I giving myself permission to have negative feelings, like anger or guilt? (These feelings are common.)
- How is caregiving affecting my health? What are my health care needs?
- Do I have free time for myself?
- Do I have someone to talk to?
- Do I need more medical information and support?
- Am I giving more time and energy than I have to give? If so, what needs to change?
- What are the good things about caregiving for my loved one?
Give this a little thought. And decide what support, help, or change you might need to help your loved one have the best quality of life possible.
Current as of: December 19, 2019
Author: Healthwise Staff
Kathleen Romito MD - Family Medicine
Adam Husney MD - Family Medicine
David C.W. Lau MD, PhD, FRCPC - Endocrinology