With a U.S. diabetic population of 26.9% age 65+, or 10.9 million, caregivers must be careful observers. If your parent or spouse has diabetes and is over age 65, read on. Their condition is unique to their age, but it's not always treated that way.
"Geriatric diabetes is not as well understood as it is for the pediatric population. Treating a 40-year-old the same way as an 80-year-old is inappropriate," says Dr. Medha Munshi, a geriatrician and endocrinologist who runs the Geriatric Diabetes Program at the Joslin Diabetes Center in Boston, Mass.
Munshi says the diabetic patient's family and physicians may not think about other complications such as heart disease, stroke, hypertension, kidney disease, blindness and eye problems, nervous system disease, amputations, dental disease and depression. Treating more than one condition at a time can be tricky. Many older people take 10-15 medications a day.
If you are vigilant and talk to your loved one's doctor about age-related issues of diabetes, you may be able to head off a crisis.
Follow these five tips for caregivers of older diabetic adults:
- Watch for low blood sugar called hypoglycemia. Symptoms might be sweating, feeling hot, shakiness and a fast beating heart. In older folks, hypoglycemia can cause confusion, irritability, dizziness, weakness, feeling faint or even a change of behavior. It's dangerous for many reasons and can result in falls or a decline in cognitive functioning.
- Make sure they can take care of themselves, if they have to, when they're sick. Are they taking their insulin on time? Are they eating? Be vigilant about excessively high or low blood glucose from being sick, weight loss, dehydration or not enough food.
- Check that they're taking the correct doses of insulin and medication and not skipping meals. It might mean there is cognitive decline.
- Notice if they act depressed. Depression is a common symptom for older adults with diabetes.
- Decide if their medical plan and regimen is too complicated for them, especially if they have multiple conditions. Are they having trouble remembering their medicine? Ask the doctor what you can do to simplify it. "You need to change their strategy to fit their coping abilities," says Munta. "Most people say you need to educate, educate, educate your patients. What we do in geriatrics is change what we are doing to see what patients can do and what they can't do."
The American Diabetes Association offers a Senior Signature Series for older adults to educate, provide resources and teach ways to reduce complications. The program is available in New York, Washington, D.C., Los Angeles, Dallas, Indianapolis, Houston, Boston and Miami.
More than 79 million Americans over age 20 may not have diabetes, but are at risk for what is called prediabetes. More than one in three American adults has prediabetes. The U.S. Centers for Disease Contro and Prevention offers information and a quiz to screen a person's risk and many local YMCAs have prevention programs to adopt healthier behavior.
What do you think is the hardest part of caring for someone older with diabetes? Any strategies you can share?
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