Supporting Diabetes in Elderly Populations: The Role of Caregivers and Family (2023)

Managing diabetes can be challenging—from injecting insulin to following a diet and monitoring blood sugar levels. It's especially tough for adults aged 65 years or older as they're often more at risk of developing complications like heart disease, kidney disease, and hypoglycemia.

However, with the right support, education, and adherence to a care plan, elderly loved ones living with diabetes can effectively manage the condition, feel empowered, and lead better lives.

If you're a professional caregiver caring for a family member, this guide will help you understand diabetes, your responsibilities as a caregiver, things to avoid, and more.

Diabetes mellitus, commonly known as diabetes, is a chronic disorder that results in abnormally high blood sugar levels. It doesn't have a cure, and it requires daily management.

The high blood glucose levels result when the pancreas produces little to no insulin, a vital hormone responsible for regulating blood glucose.

There are different types of diabetes, but the most common are:

• Type 1 diabetes: An autoimmune condition that occurs when the immune system attacks the insulin-producing cells in the pancreas.

• Type 2 diabetes: Occurs when the pancreas produces less than normal insulin or the body doesn't use it well.

• Gestational diabetes mellitus: A temporary form of diabetes that occurs during pregnancy. It's often the cause of high blood pressure during pregnancy and premature births.

Type 2 diabetes is the most common among older adults aged 65 or older. In fact, about half of the people living with diabetes are in this age group.

Diabetes Mellitus can significantly impact the health status of older adults. It often coexists with other age-related health conditions, making management more complex.

Older adults are also at a higher risk of developing costly diabetes complications, such as:

• Chronic kidney disease (CKD): A prevalent diabetes complication in older adults. Elevated blood sugar levels over time can damage the kidneys, leading to reduced kidney function.

• Atherosclerotic cardiovascular disease (ASCVD): Caused by plaque build-up in the arteries due to high blood pressure. It includes Coronary Heart Disease (CHD) conditions like coronary artery stenosis.

• Cognitive impairment: Occurs when someone has trouble with memory and experiences difficulty learning new things. Diabetes mellitus patients often experience cognitive decline with time.

• Diabetic ketoacidosis (DKA): A life-threatening diabetes complication that occurs when the body can't produce enough insulin. This results in the build-up of blood acids (ketones) in the body.

Not all adults with diabetes need a full-time paid caregiver. However, support from family members is often essential in long-term diabetes care.

Here's how you can care for a loved one living with diabetes.

As a caregiver, you can help a diabetic patient improve their diabetes self-care with the proper education. This means you'll be equipping the individual with the knowledge and skills needed to take control of the condition.

The self-management behavior and strategies you can teach a diabetic patient include:

• Monitoring blood sugar levels

• Administering insulin

• Making appropriate dietary choices

• Recognizing the signs of high or low blood sugar and how to respond

Living with diabetes is often emotionally taxing, especially for older adults who may face additional health concerns since the disorder comes with changes and limitations that can frustrate people.

You can provide emotional support by:

• Allowing the person to voice their fears

• Providing a listening ear

• Showing empathy and understanding

• Offering encouragement instead of criticism

Exploring diabetes-specific dietary guidelines and collaborating with health professionals are the best ways to create an effective dietary plan that can help a person with diabetes manage their condition.

Some of the tasks you can assist with include:

• Planning and preparing balanced meals

• Monitoring portion sizes to help them control blood sugar levels effectively

• Providing help with grocery shopping to select healthy food options

• Reading food labels to check out hidden sugars and other unhealthy ingredients

• Keeping a food diary to track meals, snacks, and blood sugar readings

• Creating an environment that minimizes the temptation for unhealthy foods by keeping sugary or high-carb snacks out of the house

You can support seniors by setting up a medication schedule that outlines when and how each medication should be taken to help them regulate blood sugar levels and avoid complications.

You should also remind them gently when it's time to take their medications. Take advantage of reminder apps and alarms on smartphones to ensure you don't miss a dosage.

Using pill organizers with compartments for different days and times helps simplify medication management and reduce the risk of missed doses.

You may also need to help with:

• Refills

• Disposing of expired meds

• Monitoring for side effects or adverse reactions

• Ensuring proper storage

Some patients might need help with the physical administration of medications, especially insulin shots.

Record medication, including names, dosages, and side effects or concerns. Share this information with the healthcare provider during appointments.

Could you remind the patient of the health benefits of physical activities, such as improved blood sugar, increased energy, and better overall well-being?

Help the seniors select physical activities suitable for their age, fitness level, and physical limits.

These might include:

• Walking

• Swimming

• Gentle Yoga

• Tai chi

You can also support them by:

• Establishing a regular exercise routine and joining them

• Setting achievable goals

• Monitoring vital signs during and after exercise

• Rotating activities

• Tracking progress

Before starting a new exercise program, consult with the senior's healthcare provider to ensure it's safe and appropriate for their condition.

Monitoring blood sugar levels is one of the most important aspects of living a good life with diabetes. Glucose monitoring involves regular testing through either a glucose meter or a continuous glucose monitor with an under-skin patch.

There are several things a senior with diabetes might need to properly monitor their blood glucose:

• Physical assistance: Some seniors living with diabetes, especially those with physical challenges, such as dexterity or vision issues, may need help carrying out these tests, from finger pricking to applying test strips and operating glucose meters or continuous glucose monitoring (CGM) systems.

• Patient education: By explaining target blood sugar ranges and the implications of various readings, they're empowered to own their diabetes management.

• Proper scheduling: A structured schedule for blood sugar monitoring ensures better tracking of blood sugar trends and patterns, which can help adjust diabetes management strategies. Diligent tracking gives seniors insights into how their daily activities and food choices affect their blood sugar levels.

• Support: Offering encouragement during difficult moments and celebrating success in blood sugar control can also improve your connection.

One of the best ways for family caregivers to support seniors with diabetes is to accompany them to doctor's appointments. These sessions are crucial for diabetes control and cognitive function assessment. 

Regular assessments help healthcare providers identify cognitive changes early and adjust the diabetes management plan.

Accompanying a senior to a doctor's appointment isn't just about physical presence but also about providing emotional reassurance. Nobody wants to feel alone when handling a life-long health condition.

You may compile lists of questions, concerns, and any notable changes in health or diabetes management to ensure no critical details are overlooked.

During the appointment, caregivers often advocate or communicate and discuss medications, lifestyle factors, and blood sugar readings with the healthcare provider. This ensures the senior gets a treatment plan tailored to their needs and circumstances.

Seniors with diabetes often have unique healthcare needs that should be addressed during unexpected situations. Caregivers and family members can help seniors create and implement detailed emergency plans to create a sense of security and resilience.

These plans should include a list of emergency contacts (medical and personal). As a caregiver, you can also verify contact information, especially for healthcare providers.

You can also help seniors compile and maintain a detailed medical information card. It should contain essential information, such as medical conditions (including diabetes), medications, allergies, and medical history. This card should be easily accessible in several copies.

Creating an emergency kit is also essential, which includes:

• Food

• Water

• First-aid supplies

• Medication

• Testing supplies

• Diet-appropriate snacks

Depending on the age and overall health condition, some diabetic seniors have a high risk of falling.

Assess the senior's living environment to uncover potential fall hazards, such as loose rugs, clutter, or inadequate lighting. The next step is to make the necessary adjustments for safety.

Besides creating a safer environment, you should also encourage healthy habits. Regular physical activity helps maintain strength and balance, reducing the risk of falls.

Maintaining open communication about any recent falls or near misses is crucial. It allows for timely intervention and addressing concerns promptly.

Caregivers, in collaboration with community health workers and healthcare providers, can help structure an intensive lifestyle intervention for a diabetic patient. These programs are particularly crucial for seniors with prediabetes or Type 2 diabetes.

Lifestyle interventions are tailored to individual needs and may include personalized dietary plans, regular exercise routines, and behavior support.

Older adults who engage in intensive lifestyle interventions can experience better glycemic control, reduced medication requirements, and lower risks of diabetes-related complications.

Caregivers, often family members, shoulder significant responsibility in supporting their loved ones with diabetes.

Proper training is essential to equip you with the knowledge and skills needed to provide optimal care and support. This includes understanding diabetes management strategies, recognizing signs of high or low blood sugar, assisting with medication administration, and promoting a healthy lifestyle.

The American Diabetes Association (ADA) offers a wealth of resources, including educational materials, guidelines, and support networks for both individuals with diabetes and their caregivers.

There are also public health initiatives that help in preventing and controlling Type 2 diabetes. These initiatives often include community-based programs, educational campaigns, and policy changes to promote healthier lifestyles and reduce risk factors for diabetes.

You can also check out the National Diabetes Prevention Program (National DPP) by the Centers for Disease Control and Prevention (CDC) for more health education support.

Professional and family caregivers are crucial in helping diabetic seniors manage their condition well. They are involved in blood sugar monitoring, medication management, and overall health tracking to ensure seniors receive the comprehensive care they need.

To offer the best support, family caregivers must learn more about diabetes and take care of their overall health.

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