Helping diabetics who have dementia.
Here in the United States, we are facing a rise in both diabetes and dementia. Some studies are now showing that diabetes may either kick off the dementia process or even make it progress faster. According to statistics, between 15 and 20% of dementia patients also have diabetes. As a geriatric care manager and a nurse, these cases tend to be hard to manage. Diabetes alone is like a part time job in the amount of focus and energy that it takes to manage it. Adding dementia to the problem, diabetes often becomes a job an elder cannot manage on their own.
Let’s be realistic.
When you are helping the individual with early-stage dementia manage their diabetes, you need to take a very realistic and pragmatic approach. First, understand where they are in the dementia process. If you want to go over the stages of dementia, the article is linked HERE. People who are too far progressed will probably not be able to manage taking her blood sugars routinely, or use insulin injections. If the diabetes is managed on oral medications, and they’ve been stable for quite some time, they may be okay. A common sign of a problem may present as weight loss. People with dementia are at a higher risk for having their blood sugars drop too low. The higher risk comes from eating and taking medication inconsistently. There is some evidence that shows these dips in blood sugar actually make the dementia get worse over the long-term.
Where they live and what support they have in place.
Individuals with a supportive (and capable) spouse do much better than those living on their own. If you, as the adult child or caregiver, are able to stop by daily to check if they have taken their medication and check their blood sugar, that goes a long way to stabilizing the picture. Of course, seniors who live in assisted living or supported living communities can often access this level of care as well.
There is no “one size fits all”.. but there are some guidelines.
- Talk to the doctor to see if there is any way to simplify the diabetes management program. The simpler the better; less things to keep track of.
- A person who has been good at managing their diabetes will generally slowly get worse.
- A person who has never been good at managing their diabetes will just fall apart quickly.
- Take note of the types of mistakes and see if there are common issues or times that they fail.
- Daily check ins become mandatory. Early on – because the forget to take the meds or check the blood sugar. Later – because they will not be able to manage the medication or blood sugar testing at all.
- Consider a medication reminder system. Tons of great options: https://www.epill.com
Set Up a Routine.
Problem-solving together with your loved one can be hard as they are often defensive and can be embarrassed about errors. Keep it positive and non-shaming; this is a problem to solve, not a judgement. Trying harder is not always an option, especially where health is concerns. Set up a better system and set a routine and things will work better.
Structure, Structure, Structure.
Help them build a rhythm into their day. I’m sure you don’t need to be reminded to brush your teeth? It’s established into your day. This establishment of structure is how you need to manage diabetes into their day. After you have done that …
Monitor, Monitor, Monitor.
Folks with dementia will eventually start to stumble in self-management. This is why you need to monitor. And as the doctor may change the regimen, you will have to establish a new structure. No system is perfect, and no system is permanent. Keep an eye on the process and be prepared to adjust.
Diabetics with dementia need intensive support, and some of it can be technical. If you need help, contact your doctor. HopeBridge, as a specialized home health and case management agency, can also be a resource.