When someone is diagnosed with diabetes, the next step is typically to support that person in learning diabetes self-management. Managing diabetes often requires an individual to take on several new rituals including glucose testing, dietary changes, an exercise regime, and medical exams.
But what happens someone has difficulty learning or maintaining these tasks? There are many reasons this might be the case, but one of the most common among aging Americans is dementia. Instances of both diabetes and dementia increase as people age, so it is no surprise that many families across the country are trying to support their loved ones’ diabetic needs while also dealing with changing cognitive abilities. Here are some tips for how to help care for an individual with both diabetes and dementia.
1) Learn the specifics of their diabetes and dementia.
Both diabetes and dementia can carry varying levels of intensity and care requirements. For example, some people with diabetes need to inject insulin regularly, while others can use pills. Similarly, there are different stages and types of dementia.
Knowing where your loved one fits in on these continuums will help you to understand what kind of support is needed. Ask permission to join your loved one in doctor’s appointments, to review their meeting notes, or to speak with a family doctor on their behalf. If your loved one has a later stage dementia, the individual with medical power of attorney should be able to access and share any necessary details.
2) Help them to keep appointments.
Preventative care is a must for managing diabetes. Mark down important dates and times and help them to arrange for transportation to each medical appointment. This includes visits to the family doctor as well as the optometrist, podiatrist, and any other relevant specialists. These medical professionals can help to keep the diabetes controlled as well as providing insight into how your loved one is progressing with their care.
3) Recognize potential barriers to a diabetes-friendly diet.
There are several aspects of dementia that could make diabetes self-management a challenge, particularly when it comes to proper nutrition. A recent publication for diabetes nurses clarified the most common.
“Barriers to healthy eating in people with diabetes and dementia include the following:
- Memory problems: Forget to eat meals or forget that they have already eaten.
- Agnosia: May not recognise food, cutlery, or even those caring for them.
- Dysphasia: Unable to say they are hungry or feel “hypo” (have low blood glucose).
- Dysphagia: Problems chewing and swallowing.
- Dyspraxia: Can impair people’s ability to prepare food and to use utensils.
- Executive Dysfunction: Impacts on the ability to plan the preparation of food and/or drinks.”
Depending on which combination of these challenges a loved on is experiencing, you may be able to apply different solutions. Typically, this will involve supervision of some kind related to meals. This can range from preparing meals ahead of time to physically feeding the individual, with the understanding that needs can change over time. Try to be solution-oriented if a loved one is struggling with any of the above issues, as nutrition should be a priority for anyone with diabetes.
4) Regularly examine their feet and provide them with therapeutic shoes.
People with diabetes are at high risk for amputation due to nerve damage in the feet. This means that even a small foot injury can become serious for your loved ones’ lower extremities.
Like most risks associated with diabetes, prevention is the best course of action when it comes to diabetic foot care. When you visit your loved one, take the time to check each foot swelling, bruising, redness, blisters, or other issues. Nerve damage can make it difficult or impossible for people to identify these injuries themselves, and dementia may make it even more difficult for them to communicate discomfort.
Additionally, be sure to provide your loved one with the proper shoes for their daily activities. Therapeutic shoes and inserts are covered by Medicare for many people with diabetes, so all you need to do after speaking with a doctor is to order this preventative tool from nocostshoes.com.
5) Support a consistent routine.
According to a 2016 academic article published by the American Diabetes Association, “the use of environmental supports (e.g., a consistent daily routine, visual cues, and caregiver prompts) may help maintain functioning and keep older adults in their homes and managing their diabetes longer.”
For those in earlier (stage 1 and 2) dementia, this can also include the keeping of memory journals and alarms for prompting. However, even those further along in their dementia will often remember daily tasks if they are repeated on a daily basis in an orderly fashion.
Even if this does not help them to remember per se, it may make them more trusting and calm when it comes to less comfortable parts of diabetes management, such as glucose testing. Consider the need for relative consistency when making appointments and coordinating visits to ensure they stay on track with their daily program.
Managing diabetes and dementia: A group effort
Multiple support systems should come together help people to live the healthiest possible lives. This includes family & friends, case managers, nursing home staff and/or home care workers, and various medical professionals.
Most professionals who deal with aging patients are familiar with the intersection of these two conditions. Working with individuals, clinics, and suppliers who understand these unique circumstances can help those dealing with both diabetes and dementia access the support they need.
At nocostshoes.com, we hear from caregivers often and often support them in getting Medicare coverage and diabetic shoe fittings for their loved ones. For more information, please visit nocostshoes.com or call us at 1-866-923-2423.