Caring for Seniors with Diabetes

Learn all you can about the disease so that you can recognize warning signs that your parent's blood sugar levels are out of balance and can also discuss it knowledgeably with your parent and his or her doctor.

There are three main types of diabetes: type 1, usually diagnosed in childhood, occurs when the body doesn't produce enough insulin, which is needed for cells to take in and process glucose (sugar); type 2, usually diagnosed in adulthood, occurs when the body becomes resistant to insulin, in addition to not having enough of it to keep blood glucose at a normal level; and gestational diabetes, which occurs in about 4 percent of pregnant women and refers to a high blood glucose level that usually is a temporary condition.

Since some personality changes, such as crankiness and argumentativeness, can indicate that blood sugar levels are unbalanced, it is important to educate yourself, and others who will be with your parent, about these signs. If people recognize these signs, hopefully they will immediately encourage your parent to check his or her levels.

• Signs of high blood sugar -- usually due to having eaten too much, being under stress, or having too little insulin in the body -- include:
• Frequent need to urinate
• Nausea
• Extreme thirst or hunger
• Blurred vision
• Signs of low-blood sugar -- usually due to not having eaten enough, or having exercised too much -- include:
• Shaking
• Sweating
• Fast heartbeat
• Anxiety
• Dizziness
• Hunger
• Weakness and tiredness
• Irritability

Here are some thoughts:

• Encourage your parent to follow the doctor's advice, to carefully monitor glucose levels and make the necessary dietary changes.
• If you eat with your parent, try to follow the same diet to show your solidarity. This way your parent won't feel deprived by seeing you eat something he or she shouldn't.
• Also, if you live together, or if you shop for your parent, don't buy food he or she should not eat.

Exercise can help in several ways.

• It has been shown to improve glucose tolerance -- meaning that blood sugars are controlled with less medication.
• It lowers the chance of developing serious complications from diabetes.
• It helps the body manage stress.
• It helps with weight control, which is an important part of diabetes treatment.
• It decreases one's risk of getting diabetes in the first place.

If you live near your parent, offer to exercise with him or her. If not, encourage your parent to exercise with a friend or trainer. For indoor exercise, your parent can join a gym or purchase an exercise or dance tape and work out. Or, your parent can do things he or she enjoys outside, such as:

• Walking
• Gardening
• Playing Frisbee
• Swimming
• Boating
• Playing sports

Many diabetics suffer from untreated depression. It would be helpful to have your parent evaluated for depression, which could interfere with compliance with any doctor's orders and with getting well.

People who have been newly diagnosed with diabetes have a lot to learn and many changes to make. Here are some things you can do:

• Help your parent focus on problem solving and what can be done to improve the situation.
• Encourage him or her to start small and then build on the changes he or she is making.
• Reassure your parent that it will be possible to get control over his or her health, but that it will be an ongoing process and will require practice.
• Suggest that your parent try a diabetes support group. Support groups could be very helpful during this adjustment period, and beyond.
• Participation in a local hospital's diabetes clinic -- one that educates people about the disease and teaches things such as how to monitor glucose levels -- could also be helpful.
• The American Diabetes Association has a webpage specifically geared to those who were recently diagnosed.
• If your parent's distress persists for over six weeks, have him or her evaluated for depression, which could interfere with compliance with doctor's orders and with getting well.

Relaxation techniques, practiced regularly, have been found to help people with type 2 diabetes -- for whom stress blocks the body from releasing insulin -- better manage their bodies' ability to regulate glucose and thereby avoid complications.

In most cases the pain will decrease somewhat as the blood glucose levels get under control. So encourage your parent to follow the doctor's advice carefully. In addition, your parent should:

• Check his or her legs and feet daily to see if there are any cuts, blisters or calluses.
• Wear shoes that fit properly, to avoid foot injuries.
• Care for toe nails, to avoid accidental scratches and cuts.
• Try relaxation techniques for pain management.

Unfortunately, smoking increases a person's chance of developing diabetes complications -- such as retinopathy, heart disease, stroke, vascular disease, kidney disease, nerve damage, problems with feet and more -- in addition to increasing their risk of developing diabetes in the first place. Therefore, it is very important for your parent to stop smoking.

Yes, and a support group might help your parent realize that many others have that disease, and also give him or her practical suggestions for coping with it. Many diabetics find it helpful to share their experiences and feelings with others in their situation. Call 1-800-Diabetes to find support groups in your area, check with your doctor or local hospital, or look online at diabetescaregroup.info. For those who have neuropathy, there is a specific support group at neuropathy.org.

Care.com is a website that lists people throughout the United States who provide care to seniors, includes photos and descriptions of their experience, and does free background checks for members. You can search by zip code. For specific listings, go to Care.com.