Caregiving for a Loved One with Alzheimer’s Disease and Diabetes
The combination of diabetes with Alzheimer’s disease or other memory loss creates significant challenges for your loved one. Diabetes creates an inability for the body to manage blood sugar and for maximal control requires patients to eat and drink a predictable and specific diet on a regular schedule while also monitoring medication use, exercise, and rest. It’s a lot to keep track of! When you add the short-term memory loss of Alzheimer’s disease it’s a recipe for poor control. In some cases, it can create a medical emergency. It is vital for an individual with both conditions to have caregiver support.
And please realize, diabetes care in addition to dementia care is a difficult task to manage. Remember that you are doing the best you can, and you also may need to seek professional guidance and support.
Listed below are some of the steps you can take to do your best helping a loved one with both dementia and diabetes.
Learn all you can about Type 2 diabetes. Ask your loved one’s provider for resources. The Mayo Clinic website has a good overview of the disease.
Meet with your loved one’s doctor to become familiar with the care plan for dealing with the disease, including:
Learn what level of control the doctor feels is best for your loved one.
A blood test will provide the Hemoglobin A1C level, and you should learn from the doctor what the goal level is.
Be aware of the warning signs of high and low blood glucose levels your loved one has had in the past. As dementia progresses, they may be less capable of reporting these symptoms.
Learn what diabetes complications your loved one may have or is at risk for.
Learn what medication and monitoring regimen your loved one needs to follow.
Work with your loved one to set a schedule for meals, medications, exercise.
Do the best you can with this as sometimes your loved one’s interest in being on a schedule may be low.
For medication, the most important thing is to be sure they eat if they have taken their diabetes medication, especially insulin.
For exercise the key is to avoid having huge swings in the level of exertion. For example it would be better to walk 30 min each day instead of 2 hours on a Saturday and none the rest of the week.
A Registered Dietician is often available in your physician’s office or by referral and can instruct you about the ADA dietary guidelines.
Ask your doctor to prescribe one or more sessions with a registered dietician to create a customized meal plan that is not only in balance with your loved one’s diabetes medicines, but also designed to accommodate their food preferences and any other medical conditions they may have.
People with diabetes should eat a healthy balanced diet which includes some carbohydrate food at each meal. Sugars do not need to be completely excluded from the diet, but large amounts of sugary drinks and sweets should be avoided.
Exercise
It is best to ask your loved one’s primary care provider about the exercises they recommend.
Always take a patient, respectful attitude when talking with your loved one. Short term memory is required to learn new routines or keep track of daytime activities. Without a strong memory, your loved one may struggle to manage as they have in the past.
Realize you may need to write down the schedule of medications and/or meals.
It may be that you will need to practice an unfamiliar technique -- for example, learning how to use a different type of insulin pen -- more than in the past if your loved one wants to try and learn a new part of the care plan.
Other Alzheimer’s or dementia-related changes can impact a loved one suffering from Diabetes, as they may develop other issues as the diseases progress:
Forget to eat meals, forget that they have already eaten and eat again, or forget they are supposed to eat a certain food item. They may resist changes to the types of food served.
Forget they have taken medication or how to give themselves injections.
Unable to say they are hungry or feel “hypo” (have low blood glucose); the increase or decrease in blood sugar can actually make people abruptly MORE CONFUSED.
Problems chewing and swallowing.
Problems with the hand dexterity needed to give injections or use utensils.
Impacts on the ability to plan the preparation of food and/or drinks.
Choose diabetes supplies that are senior-friendly. When selecting a blood glucose meter, look for one that is easy to use, has a large display screen and does not need to be cleaned. If your family member takes insulin, consider insulin pens instead of syringes because insulin pens are usually easier and more convenient to use.
You may also benefit from reviewing the Eat Well page in the “Living with Diabetes” section of the CDC website.
Please talk with your own healthcare provider before using any of this information.
