Quick summary
Type 2 diabetes is an ongoing, progressive disease without a cure. It may require constant vigilance on the part of your parent to keep his blood sugar in his target range. He may also need to make changes to lifelong habits to help prevent diabetes-related complications. He -- and you -- will likely have to learn new skills and acquire new knowledge to keep on top of this disorder. And he'll need the expertise, support, and compassion of his healthcare team, caregivers, and family and friends to keep on track.
Learn about the challenges associated with this condition and how you can help your parent with type 2 diabetes stay in great shape.
Back to TopChallenge #1: Addressing senior-specific obstacles
There's no denying that elderly people with type 2 diabetes face significant hurdles to keeping the disorder under control. These include:
- Increased insulin resistance. Insulin resistance, or the body's inability to respond to and use the insulin it produces, tends to be more of a problem as a person ages, even if your parent isn't particularly overweight or inactive.
- Recognizing symptoms. Older people with diabetes often don't recognize symptoms of the disease . For example, one sign of this disorder is increased thirst, but elderly people tend to lose their ability to recognize this sensation. Or your parent may just chalk up frequent urination, another warning sign, to advanced age.
- Contradictory symptoms. When your parent does have signs of type 2 diabetes, they may be confusing . For instance, your parent may feel tired, hungry, and shaky, all typical red flags for hypoglycemia or low blood sugar, but a test of his blood glucose may reveal that he's actually experiencing hyperglycemia or high blood sugar.
- Complications. Seniors with diabetes often aren't diagnosed with the disease until a complication linked to this condition, such as vision loss, nerve damage, kidney failure, or cardiovascular disease, emerges -- which suggests your parent many have had the disorder for several years.
- Memory loss. Coping with diabetes requires a reasonably high level of cognitive or mental function, given the need to follow a treatment plan that includes diet, exercise, and medication components as well as blood sugar testing and other self-care measures. Elderly people with diabetes have a higher incidence of both dementia and Alzheimer's disease, making it even harder for them to perform multiple, complex tasks. Even garden-variety memory loss associated with aging can impact how well your parent deals with diabetes.
Potential solutions:
- Blood sugar monitoring. Encourage your parent to test regularly and often so he has a good sense of his blood sugar numbers, which takes the guesswork out of whether or not he's in his target range -- regardless of symptoms.
- Routine checkups. Make sure your parent has regular checkups and visits with specialists to address any diabetes-related complications he may have.
- Tracking sheets. Help your parent set up simple systems for monitoring his blood glucose control, such as a preformatted sheet or logbook for recording his test results, as well as a similar sheet for tracking medications. (The American Society of Consultant Pharmacists offers a downloadable medication record form. )
- Help from professionals. If you're unsure about your parent's ability to practice self-care, discuss any mental impairment issues with his primary diabetes healthcare provider. It's helpful if you provide specific examples of the difficulties your parent faces in managing his disease.
Challenge #2: Juggling dual or multiple diagnoses
Even if your parent is still as sharp as a tack, he may suffer from other aging-related ailments, such as poor vision, arthritis, or hearing impairment, that make managing this disease a greater challenge. A heart attack, stroke, or health complaints such as high blood pressure, high cholesterol, or obesity can further complicate his self-care regimen and speed up the progression of common diabetes complications. In turn, diabetes can exacerbate the symptoms of such coexisting conditions.
Potential solutions:
- Simplify pill taking. Help your parent deal with dual or multiple diagnoses by setting up a streamlined approach to pill taking. Also discuss any possible adverse drug interactions related to multiple diagnoses and medications with his diabetes doctor or pharmacist. For specific ideas, see our article on helping your parent follow medication recommendations.
- Seek professional help. Ask your parent's diabetes educator or an exercise physiologist if mobility issues such as arthritis make activity difficult. These professionals can help figure out exercises your parent can do and will advise you if your parent has cardiovascular complications that may impact his ability to be active.
- Address your parent's specific needs. Supply a tape recorder if your parent has vision loss, so he can check medical information and keep records. Make sure a hearing-impaired parent receives a written record of any medication or treatment information.
Challenge #3: Making lifestyle changes
In order to keep his diabetes under control, your parent needs to maintain a healthy weight, eat a variety of nutritious foods, get some exercise, and -- if he has a nicotine habit -- quit smoking. Of course, that's the same stock advice that a healthcare provider would offer any person, whether or not he has diabetes.
But unlike someone who's diabetes-free, the stakes are higher for your parent with diabetes if he doesn't follow these recommendations. Excess weight, poor diet, a sedentary lifestyle, and a cigarette addiction can all wreak havoc on your parent's blood glucose and, in turn, lead to long-term complications such as heart attack and stroke, as well as eye, kidney, nerve, and blood vessel damage.
Your parent's unhealthy habits may be long engrained and thus hard to break. But the good news is there are many ways you can help him make the necessary adjustments to living with diabetes.
Potential solutions:
- Partner with your parent. Offer to accompany your parent to a diabetes education class, if you can, or on visits to see his primary diabetes doctor, diabetes educator, or dietitian, who are all trained to help your parent make transitions toward diabetes-friendly lifestyle changes. Partnering with your parent is essential in helping him make healthier choices. You may also benefit from educating yourself about the disease by attending a class or talking with his healthcare team.
- Exercise together . Take a walk or play golf with your parent to increase his activity level, and look for other ways to help your parent exercise.
- Cook healthier food. Prepare meals for your parent that are wholesome and include a balance of vitamins, minerals, proteins, fats, and carbohydrates, and search for additional ideas on helping him make dietary changes.
- Provide a prompt. Remind your parent when it's time for him to test his blood glucose or take his diabetes pills.
- Cheer your parent on. Provide encouragement for the good choices your parent makes and the results that follow. Perhaps he loses weight by carefully watching what he eats. Or maybe he needs less diabetes medication as a result of his increased activity level. Tell him how well he's doing -- he needs to know you're in his corner.
Challenge #4: Monitoring blood glucose
The only way to know if your parent is meeting his blood glucose goals is if he routinely checks his blood sugar. How often your parent should test is a subject of discussion for him and his primary diabetes healthcare provider. But the truth is, the more frequently he does it, the more information he'll have to help him keep his diabetes under control.
Regular blood glucose testing gives your parent immediate insight into the way his body responds to food, activity, and medications. It also helps him uncover any patterns that may need addressing in his diabetes treatment plan.
That said, it's not uncommon for the newly diagnosed (or even those who've long had the disease) to find testing an inconvenient chore, or even painful. And some people with type 2 diabetes resist testing due to denial or anger about the disease.
Potential solutions:
- Hit the books. Help your parent see the value in regular testing by reviewing his testing logbook or journal with him, and point out patterns that may affect his treatment plan.
- Do it yourself. Offer to do the testing for him -- or find another caregiver who can -- if your parent has vision or dexterity issues that make testing a trial.
- Get the right gear. Talk with your parent's doctor, diabetes educator, or pharmacist about finding the right testing equipment for your parent's particular needs. Consider more ideas for assisting your parent with blood sugar testing.
Challenge #5: Dealing with denial and depression
Your parent's attitude toward his diabetes diagnosis and how he handles managing this chronic condition can have a huge impact on whether he views the disorder as a challenging opportunity to care for his body or a major medical disaster that's best ignored. You'll want to strike a delicate balance between listening to a litany of complaints about coping with the disease and staying focused on finding the positives in a situation strewn with potential negatives.
- Denial and depression. Left unchecked or untreated, denial and depression can cause the kind of pessimism and despair that leads to failure on the eating, exercising, or medications front. This can result in a vicious cycle that makes your parent's diabetes worse.
Signs of depression include a loss of interest in activities that previously provided enjoyment, blood glucose levels that are suddenly and inexplicably worse, difficulty coping with self-care regimens, or acting more stressed than usual.
- Isolation. A common problem among the elderly, isolation may exacerbate your parent's denial and depression. People with diabetes are about twice as likely to be depressed as people without this medical condition. But people with diabetes who have a network of friends are less likely to suffer from depression than those without such a safety net.
Potential solutions:
- Accentuate the positive. Link medications to something your parent enjoys, rather than pointing out the dire pitfalls if he doesn't take his diabetes drugs as prescribed. If he's an avid walker, for example, remind him that taking his diabetes pills will allow him to continue taking long hikes for years to come.
- Find a support group. Talk with your parent's diabetes educator about locating a support group of peers where your parent can blow off steam with companions who share similar concerns, or look for such a group online by searching under the key words diabetes online support group .
- Get a referral. Ask your parent's doctor or another member of his healthcare team for a recommendation to a mental health expert, such as a social worker, therapist, or psychologist, if denial or depression is a significant problem for your parent.
Comments Add a Comment