Diabetes is a disease that prevents the body from producing or properly using insulin. Insulin is an essential hormone that helps the body convert sugar, starches, and other food into energy needed for everyday life.
There are four primary types of diabetes —type 1, type 2, gestational and pre-diabetes. With type 1, the body is unable to produce insulin, whereas with type 2, the body is resistant to insulin and not able to use it properly. Gestational diabetes causes insulin levels to increase in some pregnant women and pre-diabetes is a condition that occurs when the blood glucose levels in a person's body are higher than normal, but not quite so high for a diagnosis of type 2 diabetes.
For a variety of reasons, older adults are at an increased risk for developing type 2 diabetes. Those risk factors include obesity, a family history of diabetes, immobility or reduced mobility, and co-morbidities such as hypertension, and cardiovascular and kidney disease.
Since type 1 diabetes tends to strike an individual at birth or a young age, those afflicted learn how to manage their disease early on. Not always so with an older patient who develops type 2 diabetes later in life. These patients are faced with learning how to manage diabetes when, more often than not, they are already coping with other illnesses and conditions. That is why it is often a home health nurse who is charged with putting in place and monitoring an individualized diabetes care plan.
As specialists in the care of older patients, Hebrew SeniorLife Home Care clinicians are skilled and knowledgeable in recognizing the symptoms of diabetes in older adults, as well as helping patients manage the disease. The average age of our patients is 85 and many are considerably older.
In fact, it is often one of our home health clinicians who help discover that a patient has developed diabetes. We are always on the look-out for symptoms and, as we develop a rapport with our patients, can serve as a bridge to our patient’s primary care physicians (PCPs). Fatigue or weakness, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores are all signals that a patient should be tested for diabetes. If we observe these symptoms, we can encourage our patients to talk about them when they may be reluctant to bring it to their PCP’s attention.
Communication with the primary care provider is very important in the management of a diabetic patient. Many of our patients also receive their primary medical care from one of the Hebrew SeniorLife Medical Group’s physicians, and we work very closely with them, along with the practice’s nurse practitioners and medical assistants to help our diabetic patients manage their disease.
With all of our patients, whether enrolled in the HSL Medical Group practice or not, HSL Home Health nurses work closely with primary care providers to develop a plan tailored to the individual patients. The elements of a good program address nutrition, weight management and exercise programs aimed at symptom management that improves quality of life. As Medicare-certified home health providers, our patients are deemed “homebound.” This means that leaving the home for any reason is a taxing proposition for our patients and why improving safety and mobility is a primary goal for programs that we recommend.
The good news is that with a good plan in place, type 2 diabetes can be managed and in some cases eliminated within the comfort of a patient’s home.