I’ve met so many people who are coping with a parent – often an elderly parent – who has been diagnosed with diabetes. Being diagnosed late in life may be tough. Many people go through stages of disbelief, sadness, guilt, worry, or all these stages and more before coming to terms with diabetes. And if it’s your elderly parent who has just gotten the diagnosis, you both may go through a period of trauma. In fact, it’s not surprising to cycle through these stages again as diabetes progresses. You’ve probably got lots of questions, such as: “How can I help?” “What will mom or dad allow me to do?” and “Will this change our relationship?”
The amount and type of your involvement may depend on your parent’s physical health. If mom or dad is spry, able to cook and shop, and takes part in rewarding activities, you may need to do little more than offer moral support and encouragement. But if your parent is frail or somewhere in between spry and frail, you may need to grab hold of several responsibilities. It’s common for our elderly parents to deny their limitations or feel fearful of the future, so you might be met with resistance. As much as possible, allow your parent autonomy. Ask how you can help, and offer choices when you can instead of making your mom or dad’s decisions.
Here are several things I advise my clients that may help:
Educate yourself about diabetes
If your parent allows it, attend as many medical appointments as you can. Tag along to diabetes self-management classes or find information from reputable sources like the American Diabetes Association. Understand that there is a lot of misinformation out there. For example, the daughter of one of my clients insisted that her mom eat every few hours. The patient complied, but it caused friction between mother and daughter. As it turns out, in this case, there was no reason to eat so frequently, so the friction was not necessary. Try to remember that everyone is different, and that everyone’s diabetes is different, as well.
Know your boundaries
Elderly or not, no one wants the diabetes police after them! If your actions are met with an argument, take a step back to examine your own behaviors and emotions. Worry may have you imposing your ideas of a good diet or proper exercise on your parent. Instead of arguing or walking away angry, simply ask, “How can I help, so diabetes isn’t a burden that you face alone?” Recognize that your parent may be both thankful for and resentful of your help – thankful to have it, but resentful for needing it and for no longer being in the position of authority. That’s understandable. Sometimes, it’s more productive for you and more helpful to mom or dad if you are as unemotional as possible.
Don’t overload your parent with information
It’s easier to learn and make changes in bite-sized nuggets. Instead of pushing your parent to overhaul his or her diet immediately after diagnosis, pick just a few simple changes such as regular meal times and proper portions. Save additional changes for another day.
Assess your parent’s self-care abilities
Does your parent have some of the more common physical challenges of old age, such as frailty, failing eyesight, or limited manual dexterity? These hardships may add to a disease that may already feel overwhelming. If your parent has difficulty using a blood glucose meter or performing other tasks, ask your healthcare provider for recommendations for products that may help elderly people adapt, such as a meter with a larger display. If your parent takes multiple medications, one suggestion is to create a chart that identifies each medication by name and picture, the proper dose, and timing.
Know the signs and symptoms of high and low blood glucose
Learn the causes and symptoms of hyperglycemia (high blood glucose), which may include blurry vision, fatigue, and excessive thirst; as well as the causes and symptoms of hypoglycemia (low blood glucose), which may include hunger, sweating, and confusion. The symptoms can be easy to confuse in the elderly; you might think, “Gosh, Mom’s awfully sassy today,” but her behavior might be part of her diabetes. Be sure to have written instructions for managing these problems from your parent’s healthcare provider. Teach them to anyone who helps care for your parent.
Focus on food
I tell clients again and again: diet is a cornerstone! Your parent’s healthcare team can be a resource for learning about nutrition. Once you both learn the specific meal plan for your parent, decide if your parent needs help with grocery shopping or meal preparation. Perhaps an occasional dinner companion is all that’s needed. Or you could prepare and deliver several meals with reheating instructions.
Look into support services
For some elderly people living with diabetes, getting involved with a diabetes support group may help keep them from feeling isolated or depressed. Boston-based Joan Hill, RD, CDE*, LDN suggests contacting the National Council on Aging (NCOA) and your local senior center to learn about available services. NCOA even has a six-week online diabetes workshop where participants interact with a trained facilitator and others with diabetes. Meals on Wheels or a similar program may be useful for those who are unable to prepare their own meals.
Be a role model
Enjoy a balanced diet, get regular physical activity, and take measures to manage stress, and ask your parent to join you in these activities. You can read more about how stress can affect diabetes here.
Finally, if you are the caregiver, please take a break before you get weary! Being a caretaker is exhausting, but when you’re caring for the person who used to care for you, it may add another level of discomfort. Ask for help from another family member or friend, or, if possible, hire someone to give you some time to refresh.
Jill Weisenberger, MS, RD, CDE*, is the author of Diabetes Weight Loss Week by Week, contributing editor for Environmental Nutrition, and has written for many publications including EatingWell, Diabetic Living, Her Sports + Fitness, and LifeScript. Weisenberger is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor, and not of Sanofi US, its employees, agencies, or affiliates.
*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services.
© 2013 The DX: The Diabetes Experience