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Posted by beatle on January 08, 2000 at 22:26:20:

In Reply to: Re: diabetic help wanted posted by vinette on January 08, 2000 at 20:46:28:

: : : hi,i am a caregiver to several at home diabetics. i have a problem with one 80 yr old lady. she has a memory problem also and does not understand why she has diabeties and how it affects her. prime example was today. she told me that last night she had terrific headache and was very dizzy, almost called neighbor to take her to the hospital. discovered she had eated 2 1/2 servings of pudding (sugarless type). today between noon and 4:30 she ate 3 main meals. at noon she was eating homemade chicken noodle soup. when i got back, she had eaten the meals on wheels dinner and a neighbor had brougt her another dinner, which she had also eaten.
: : : when she complained of feeling bad, i told her it was because she ate too much. she only says that when she is hungry, she is going to eat.
: : : she can get up from the table after eating a meal, go to the front room then come back to the kitchen before i get the table cleared and want to know what is for dinner. she has forgotten she just ate. her blood sugar is usually between 260 and 360. one day it got as low as 160 and the next was up to 336. it has been as high as 430.
: : : how do i get her to understand that eating all the time is not good for her and since that is almost an impossibility, what foods can i keep around in her site that wont shoot the blood sugar high and willfill her craving to eat all the time.
: : : also she has asthma and is on tablets for control of the diabeties.
: : : any and all helpful suggestions appreciated.
: : : thanks.

: : Anything I say should not be a substitute for advice from the doctor. I would talk to the RN at your agency just to let them know what is going on with this lady. Her blood sugar fluctuates so widely that it probably isnt a good idea to get increased dose of medicine. From what you describe this is more than memory problems. She may very well have advanced Alzheimers or some other Senile Dementia. I would keep track of the blood sugars and let the doctor know on the next visit. Perhaps some non-caloric sugar free candy left around the house with some diet drinks would keep her sugars down. When the blood sugar gets over 300, give her plenty of non-caloric fluids like water and diet sodas. She can become very easily dehydrated and pass out when you get these sugars in the 300-400 range. Dont give her anything by mouth if she passes out. I dont know how long she can stay in her home, but thats for the doctor to decide.
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: thanks for the info. i keep a log of b/s levels and when it gets over 200 i notify the office. we have gotten my client the sugar free candies, and she will suck on one for a while then get rid of it. she has a dr appt on the 18 and her neighbor takes her. i suggested to the neighbor to take the log in. she agreed. i will suggest to the neighbor, who does the shopping to get the non caloric soft drinks or some thing like that for her. i keep telling her not to eat just because she is hungy, but to space out her eating. if i knew what would be good and safe for her to eat inbetween meals, i would see to having it on hand. when ever she thinks she is hungry she eats, it is frustrating.

Anything I say should not substitute for advice from the doctor. From what you have described, your patient has serious brain disease (although I dont know this). This involves being extremely unable to understand how the world around her works. Is this confusion new or is it long standing? You wouldnt expect a two year old to understand how food is spaced out and I dont think you are going to be able to get this patient to understand what diabetes is all about. She needs to have food around for calories at her meals, so I dont think the neighbor is going to be able to get her all non-caloric food. Anything with no concentrated sweets and no calories would be the ideal snack but I dont think you are going to be able to get her to stick to these between meals. I dont know how long she is going to be able to stay at her home without someone there more often. Can she afford around the clock care? I am not trying to make any money from this and am not affiliated with any Registry but I am just afraid she is going to end up in a diabetic coma.
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