Diabetes Care for a Senior with Cognitive Impairment
Generally when an adult patient is diagnosed with diabetes, the patient is included in their own care team. When a senior patient has diabetes, the diabetic management plan can become more complicated. Sometimes, special help is needed for the senior diabetic patient. This is especially so if a senior patient has cognitive impairment.
Diabetes is a disease that is unfortunately common among Americans. According to the Center for Disease Control and Prevention, a 2017 report stated that there are over 100 million adults in America with diabetes or prediabetes. Of these, around a quarter are seniors.
Insulin is the hormone responsible for breakdown of sugar in the blood. Diabetes is caused by the body not producing insulin in the correct amount, or insulin resistance, where the insulin cannot be used properly.
Individualized Diabetic Care
A senior diabetic patient may need special support since the senior needs diabetic care tailored to them individually.
The individual factors that a care team has to take into account include:
- The specific nature of the diabetes itself.
- Diabetes complications caused by other medical conditions.
- Cognitive impairment in a senior adult.
- Depression in a diabetic sufferer.
- Physical limitations that affect the diabetic care.
A senior who has any of the limitations or challenges listed above, may need special help in managing their diabetes.
Cognitive Impairment and Diabetes
Diabetes can cause cognitive impairment, which, if it worsens can become dementia. Studies found that when diabetes was not properly managed in mid-life it was more likely to result in a decline in cognitive function after two decades. Medical sources found a neurological connection between diabetes and dementia: insulin controls some of the neurons in the nervous system.
A doctor needs to follow the cognitive functioning of a senior diabetic patient closely.
The doctor needs to ask: Is the patient capable of their own diabetic care? Must the instructions be simplified or made more clear? Is the patient able to properly perform their personal self-care?
Compare a list of points that a person with diabetes needs to be aware of, and, possible problems with a senior with cognitive impairment.
Examples of diabetes care points
Management of diabetes includes:
- Having an exercise regime and keeping to it
- Knowing how to test blood sugar levels
- Understanding the results and what the numbers mean
- Understanding the correct way to eat and drink for a diabetic
- Being prepared to adjust the diabetic treatment if needed
Examples if a senior patient has cognitive impairment, and may need extra care :
If there are memory problems, a patient may for get to take their insulin or make it to appointments.
A patient might be unaware of the passing of time and neglect to take insulin or eat at the right time.
The patient might have a hard time understanding the instructions of the care provider.
There may be difficulties in injecting insulin correctly, reading and recording glucose checks.
Patients might not remember, or be aware of, what to do when blood sugar levels are too low.
What can be done for Senior Diabetic Patients?
The caring aims of a doctor working with a senior diabetic patient would be these:
- Find ways to prevent cognitive decline.
- Find strategies and tools to manage diabetes, where there is cognitive impairment.
A doctor or care management team would be careful not to overload the patient with instructions that cause fear, or, are too complicated or expensive to carry out.
There ways to simplify the instructions if a senior patient has cognitive impairment. Ask the doctor also, to give repeated education, constant messages to the patient about care that is related to safety.
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