Caring for an Elder with Diabetes

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Caring for an Elder with Diabetes
by Allison Karp, Education Coordinator
Diabetes Care and Information

Diabetes is an increasingly common problem in America, with an estimated one fifth of all people over 65 managing it in some form. For many of them it may not yet be diagnosed. A high proportion of these people fail to properly control their blood glucose levels and this can be all the more problematic for those dependent on care, especially where several different caregivers are involved in providing them with food.

Elderly people living with diabetes experience specific problems that are less of an issue for other age groups. These can begin with possible misdiagnoses, as cases of diabetes that develop in old age can be masked by other types of health problems, for instance when confusion caused by diabetes is interpreted as a sign of dementia.

Because elderly people are more likely to suffer from problems like dementia and depression, which interfere with memory, it can be difficult for them to manage their eating patterns and medication intake. Proper documentation is vital to aid in avoiding such problems. For those comfortable with using them, mobile phone apps can be very effective, audio alerts remind patients to take their medication, allowing them to note when they have done so and alerting caregivers if this doesn’t happen.

Diet

Because diabetes interferes with glucose level regulation, it’s important to avoid giving a diabetic person sweet foods or drinks that can cause glucose levels to spike. It’s much better for sufferers to eat food containing long chain carbohydrates that are broken down slowly over time. These include cereals, potatoes, bread and most green vegetables. Alcohol should be avoided even if it doesn’t taste sweet, as it’s quickly broken down in the body to produce sugars.

Because they are more vulnerable to a range of other health problems, especially later in life, diabetics need to eat healthy, balanced diets and have a steady fluid intake throughout the day.

General health

Smoking can significantly amplify health risks for those with diabetes. Carers should always respect individuals’ wishes and should understand that the stress of being denied access to cigarettes can also have negative health consequences. However, they should do what they can to support anyone to quit smoking.

Regular exercise can help diabetes sufferers in two ways:

  • Strength training helps to build up muscles and mitigate the damage done when, due to high blood levels, the body begins to break them down to use as fuel.

  • Cardiovascular exercise; something simple like a brisk walk helps to protect against heart disease, which is more common in diabetics.

 

Diabetic crises

There are two principal types of crisis that someone living with diabetes can suffer:

  • Hypoglycemic crisis - this is what happens when blood sugar levels fall too low, leading to dizziness, confusion and, potentially, unconsciousness and dangerous seizures. A person experiencing a crisis like this needs to consume glucose fast. Often, the quickest way to do this is by giving them a sweet or a small amount of fizzy drink. This doesn’t replace missing glucose by itself, but it triggers the body’s own regulatory mechanisms to raise the level of glucose in the blood.

  • Hyperglycemic crisis - this is what happens when blood sugar levels are too high, leading to dehydration and potentially to very serious illness. People in this state tend to feel exhausted and very thirsty, and may be confused. They should be given insulin straight away and, if symptoms do not abate, should be taken to hospital for more intensive treatment.

 

Regular check-ups

People with diabetes are prone to a number of complications, so should receive annual check-ups for the following:

  • Eye problems. A full ophthalmological examination should be carried out to check for signs of retinal damage caused by high glucose levels.

  • Hearing problems. Damage to blood vessels in the ears mean diabetics face an elevated risk of hearing loss. If it’s quickly identified and a hearing aid provided, it has less impact on quality of life.

  • Kidney problems. Urine should be checked to identify any developing kidney disease. If caught early this is much easier to treat effectively.

  • Foot problems. Nerve damage caused by high glucose levels can lead to ulceration, especially in the extremities - particularly the feet and lower legs, which in severe cases can lead to amputation.

  • Heart disease. The pulse and blood pressure should be checked at least annually and as often as daily if a doctor recommends it. The heart should be scanned every five years.

 

Prognosis

Despite these issues most people with diabetes are able to enjoy a good quality of life as they get older, provided they have the right support. If their general health is good and the disease is well managed it does not need to stop them from living life to the full. Carers should also ensure that they make the time to enjoy their own lives as well.

Often, in its early stages, diabetes can be controlled by eating sensibly, exercising moderately and perhaps taking daily medications. Some medications help lower blood sugar levels, but sooner or later the vast majority of those affected will need insulin injections.

People who have lived with diabetes for a long period usually know what does and doesn’t work for them. As long as no severe cognitive impairment has set in, caregivers will often find that working closely with them, rather than making plans for them, is the most effective way to manage their condition.

 


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