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care and caretaking

Posted Jan 05 2011 12:58am

I honestly don’t remember the source anymore, I think someone wrote them for the original Diabetes, Hypoglycemia and Transplant Corner group. I’ve been thinking about this due to my personal situation. It applies to any of us caring for others.

COPING WITH AND HELPING A DIABETIC LOVED ONE WHO WON’T TAKE CARE OF THEMSELVES

If there is a person in your life with diabetes who isn’t taking care of themselves it’s not only affecting them. It could be affecting you too. If they’re not doing everything they can to get their diabetes under control it could be touching all parts of your life. They might feel weak from having a high blood glucose level, so your social life may suffer. They may have to be in the hospital many times if they go into ketoacidosis because they’re not taking their insulin injections. Or if they have Type II diabetes they might not be trying to lose weight so they can possibly stop taking oral medications and control their diabetes with diet and exercise alone.

You may wonder why someone with diabetes wouldn’t want to take care of themselves. There’s no one answer that can explain it. In some instances the person with diabetes might not even understand why it’s hard for them to follow their mealplans and take their medications on time, if they take their medications at all.

Understanding why a person with diabetes won’t take care of themselves might make it easier for you to cope with it and give you some ideas on how to help your loved one. There can be many reasons someone might not pay attention to their diabetes. These may include denial, anger, depression. or fear among other things. If your loved one or friend is in denial about his/her diabetes it’s going to take a lot to get them out of it.

After being diagnosed, disbelief is a common reaction to someone being told they have diabetes. “Out of sight, out of mind”, becomes the motto of a person in denial. If the person diagnosed hasn’t really felt too bad prior to diagnosis and/or they have a strong and athletic self-image they may not believe they’re seriously ill, even tho the tests show they are.

Denial can occur in all people with diabetes but Type II diabetics are especially prone to this since they may have gone undiagnosed for years and may mistakenly consider their diabetes the “mild” type. Type II diabetics do have many options when it comes to treating their diabetes (diet, exercise, oral medications, exercise, etc..), but they are just as susceptible to complications. Type II diabetics can get the SAME complications as a Type I diabetic. The complications may arise over a long period of time also contributing to the person’s denial. Neuropathy or some other complication may not show up for years.

Although the complications associated with diabetes may not show up for years following diagnosis there may also be a fear of facing them. These complications include heart disease, stroke, blindness, kidney disease, and limb amputation.

Anger and depression are also two common occurrences following a diabetes diagnosis. The person might ask, “Why me?”, and not be able to come up with an answer. If this happens the anger the person feels can be acted out. They may stop testing their blood glucose levels. Or they might eat food they know they shouldn’t be eating as a form of rebellion. The anger may be expressed verbally. The person may be upset with the physician who diagnosed them, the nurse, and any other health professional who was the messenger of the bad news. You might hear the diabetic in your life use derogatory names when they speak about health professionals.

Bouts with depression may take place at the time of diagnosis or much later. If the discipline needed for diabetes management feels overwhelming the person may feel powerless and not try to get their diabetes under control. Since diabetes is affected by so many variables, the person may not be getting good results from their diabetes management plan and that can bring on depression too. The most meticulous record keeping and eating the proper meals can not control blood sugar levels as precisely as the body does naturally. This can cause the person to feel helpless and lead them down the road to depression.

Fear can also play a role in a person not accepting their diabetes. What’s there to be afraid of? When a person is diagnosed with diabetes that sometimes means changing their life in a major way. They may have to give up eating in a way they’ve been used to. They have to start exercising if they want their diabetes to get in good control. This might all sound like simple things to do but they’re not if you’re not used to doing them. Changing behavior is one of the most difficult tasks for a person to do. The person with diabetes may have to change habits they’ve had since childhood. A diabetic can be afraid of these changes and choose to ignore their diabetes rather than face it.

Imagine if you were told that you HAD to exercise for a half hour every day. Or that you HAVE to cut back on the amount and types of food you eat when you’ve been a person who’s enjoyed food all your life. Then you’re told you “should” do these things to keep your diabetes under control. Even though you may want to make the changes it can still be difficult.

HOW CAN YOU HELP YOUR DIABETIC LOVED ONE

It can be just as frustrating for you to deal with the denial, anger and depression that comes along with being diagnosed with diabetes. You might not have the disease but you deal with the consequences of the disease every day. One thing you can do to help yourself and your loved one or friend is to learn as much about diabetes as you can.

If you want to get involved with helping your loved one or friend you have to know what you’re talking about. There are many books that tell you about diabetes in plan language. You don’t need to get numerous medical journals and research papers on diabetes. Get yourself a diabetes book that gives you the basics. When you attempt to talk to the person about taking care of themselves knowing the correct terms to use can go a long way.

If you have children including them in this process can help them cope with a parent or other important person in their life with diabetes. The problems diabetes can bring into a family affects children too and they may need help dealing with it. You can talk to them about the situation in an age-appropriate manner and include the children in problem-solving discussions.

Food is a main issue for a diabetic. There are things you can do to try to help make it easier. Try to cook one meal for the family. That may mean cooking lower-fat lower-calorie meals for your family but it also means that the diabetic in your life won’t have to sit down to a different meal, which can be awkward. Keep healthy snacks around the house so it’s handy if needed. Try new low-fat low-calorie recipes so your meals don’t get boring. You may even want to prepare some special desserts that go along with a diabetic meal plan. There are numerous books available that can give you plenty of recipes to choose from.

Try not to feel guilty if the person with diabetes tells you you’re the reason they can’t take care of themselves. “If only you would…..” could be the beginning of a statement that can make you feel that you’re in control of whether or not the diabetic in your life takes care of themselves. You can’t control them. Either they want to help themselves or they don’t. You can help them if they take the initiative but you can’t follow them around 24 hours a day telling them what to do. Think of yourself as an assistant who helps out from time to time, and as a friend who will listen.

You may also want to take a personal inventory to see if you’re not inadvertently part of the problem. Do you push food on the diabetic in your life? Do you say such things as, “Oh, just have a LITTLE piece? It won’t hurt.” Or maybe you get upset when the diabetic in your life has to get out of a social event because their diabetes isn’t in good control. This type of behavior on your part can make it harder for a diabetic to come to terms with this disease.

Find an outlet for yourself to express your feelings and frustrations. As we said earlier, you “live” with diabetes too. It’s not in your body but it affects your feelings, thoughts, and ideas each day you interact with the diabetic in your life. Don’t keep your feelings hidden either. It’s important for you to let the diabetic in your life know how you feel about them not taking care of themselves. You may be called a “nag” at times, but that comes along with the territory. You’ll be telling someone to do something they don’t want to do so just be prepared for some negative reactions.

Try to have empathy for the diabetic in your life. If they haven’t been taking care of themselves they may be weak from their blood glucose levels being high for so long. They may not be able to read because their vision is blurry from their blood glucose levels being too high. These factors and more can contribute to them not wanting to take care of themselves, or not wanting to talk about their diabetes.

This text can only cover a small part of the reasons why someone with diabetes won’t take care of themselves properly. Each person is different so you’ll have to take that into account when you try to help your loved one. It may take awhile for you and the diabetic in your life to get through this but it’s worth all the effort you put into it.


A Caregiver’s Bill of Rights (Author Unknown)

I have the right To take care of myself. This is not an act of selfishness. It will give me the capability of taking better care of my relative.

To seek help from others even though my relative may object. I recognize the limits of my own endurance and strength.

To maintain facets of my own life that do not include the person I care for, just as I would if he or she were healthy. I know that I do everything I reasonably can for this person and I have the right to do some things just for myself.

To get angry, be depressed and express other difficult feelings occasionally.

To reject any attempt by my relative (either conscious or unconscious) to manipulate me through guilt, anger or depression.

To receive consideration, affection, forgiveness and acceptance for what I do from my beloved one for as long as I offer these qualities in return.

To take pride in what I am accomplishing and to applaud the courage it has sometimes taken to meet the needs of my relative.

To protect my individuality and my right to make a life for myself that will sustain me in the time when my relative no longer needs my full-time help.

To expect and demand that as new strides are made in finding resources to aid physically and mentally impaired older persons in our country, similar strides will be made toward aiding and supporting caregivers.

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