Published : Tuesday, May 17, 2016
The number of adults 65 and older living with diabetes continues to climb. Recent data reveals 42 percent of the diabetic population is in this age group, while that proportion is expected to grow to 53 percent by 2025 and 58 percent by 2050. Health care providers are paying close attention to this data as this group of Americans face an increased risk of cognitive decline and physical disabilities compared to those who do not have diabetes. As home health care professionals care for an aging population, they are increasingly becoming an essential component in the daily management of patients’ diabetes.
Diabetes Management Goals
It is important for both patients and their family to understand the goals of any diabetes management program when working with home health professionals. Within the first patient home visit, goals establishing the following should be communicated, documented and easily accessible for patients and family. These include:
-Identifying signs and symptoms that require emergency medical attention or
reported to a health care provider immediately.
-Firm understanding of medication and what the patient should do if a dose is missed.
-Correct usage and storage of insulin.
-Identifying potential obstacles that need to be addressed in the home environment to keep the patient safe.
As these goals are established, communicated and met, new goals can be set to further understand and manage the patient’s condition including:
-Naming three to four signs and symptoms of low or high blood sugar and what the patient should you do as a result.
-Identify optimal blood sugar level readings.
-Understanding the correct usage of a blood sugar meter.
-Identify a plan to manage daily activities like personal care needs and shopping.
-Identify family and friends available for help and support as needed.
-Identify potential obstacles to meet diabetes management goals.
Additionally, home health care professionals can work with patients to further understand how a variety of aspects of diet, exercise and medication could potentially affect blood sugar levels and what to do in response. Administering insulin correctly through the use of an insulin pen helps patients have better control over their diabetes in between home health care visits. Through demonstrations with a home health care professional, patients understand proper usage to reduce medication errors and better blood sugar control. Further, blood sugar levels are susceptible to fluctuation with exercise. Home health care professionals work with patients to establish a plan on testing blood sugar levels before, during and after exercise and how to ensure they are exercising within safe limits.
Establishing a Diet and Exercise Plan
Unfortunately, when it comes to diet, there is not a one-size-fits-all approach for all patients. From the plate method and exchange method to counting carbohydrates, patients can work with a registered dietitian to design a meal plan that works best for them. Overall, the goals of the meal plan are the same for all patients with diabetes – control blood pressure, blood sugar levels and cholesterol levels – and the patient’s home health care professional can help implement the meal plan established.
Within a diabetes management program, patients learn the importance of eating well-balanced meals and snacks at regular times throughout the day, as well as limiting cholesterol to 200 mg per day and sodium to 2400 mg per day. It is better to eat fresh or frozen produce, rather than packaged or canned foods, which contain more sodium. However, did you know if you rinse and drain canned food thoroughly you could reduce the sodium intake by as much as 40 percent?
Staying properly hydrated is also an important component of a meal plan. In fact, drinking water with meals is a better choice than drinks containing sugar or calories – as these are empty calories and affect blood sugar levels. Also, talk to your doctor about any alcohol consumption.
Home health care professionals help support the patient’s meal plan by creating and reviewing the patient’s food or diet log tracking the date, time, type and amount of food and drinks consumed. This will help explain any blood sugar level instability and how to better manage that through diet. They can also work to establish food substitutions to keep the meal plan tasty and easier to follow through a variety of foods.
When it comes to exercise, there are special considerations for patients with diabetes, but the effort is well worth the benefits. From weight management, to mood enhancement and reduced risk of cardiovascular disease, stroke and other serious health conditions, exercise is an important element in any diabetes management plan. However, with all physical activity, blood sugar levels can be affected. Home health care professionals work with patient to identify safe, caution and high-risk blood sugar level thresholds and what the patient should do in each circumstance to continue exercise safely and effectively.
Patients will test their blood sugar 30 minutes prior to exercise, every 30 minutes during exercise and even throughout the day following exercise. Every day is different and even though a patient had no problems going on a 45 minute walk the day before, they may not have the same experience the next time. It is important to carefully monitor blood sugar levels while exercising to help prevent serious complications like dehydration and ketoacidosis. Patient should aim to exercise around 150 minutes per week. This could include anything from walking, swimming, hiking, biking, playing tennis, yoga, or even taking an exercise class.
At Scissortail Healthcare, experienced and trained staff work with patients to help set and meet goals, understand how to use insulin and other medications, as well as develop and implement a diet and exercise plan. For more information, please call 918-508-7333.