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When You Care for Someone with Diabetes, You Need Care too.

Recognizing the stress that comes with caring for someone who has a chronic condition, especially when elderly, deserves to be acknowledged for both the carer and the care recipient.

With Anis Rehman, MD, and Robert Courgi, MD

Millions of Americans are looking after loved ones who are sick or disabled. In fact, some 25% of US adults reported providing care or assistance to someone with a long-term illness or disability in the past month,1 according to the Centers for Disease Control’s state-based Behavioral Risk Factor Surveillance System.

Caring for a loved one with a chronic illness such as diabetes or is elderly is important and necessary to their wellbeing. And while satisfying, being a caregiver is often stressful and can extract a toll on your own health.2 Both men and women caregivers experience stress, though women report more mentally and physically unhealthy days than men,2 according to findings of a study in the Journal of Women & Aging.

The needs of the caregiver are just as important as the needs of the care recipient.Taking care of yourself is as important as providing good care to a loved one who needs your assistance.

Diabetes and other chronic endocrine diseases, particularly in the elderly population are particularly challenging to caregivers, says Anis Rehman, MD, an endocrinologist at the University of Cincinnati Medical Center in Ohio. “Stress can affect the health of these caregivers since, in many instances, people under stress do not take care of themselves, do not exercise, choose unhealthy food options, and drink excessive alcohol,” he says.

What Is It About Caregiving That Is So Stressful?

The research into caregivers’ stress focused on the differences between male and female caregivers and the effect of social support on their health-related quality of life.2 The authors reported that women caregivers were much more likely than men to report physically unhealthy days (12.7% vs 11.1% women and men, respectively) and mentally unhealthy days (16.1% vs. 11.9% women versus men, respectively). Men were much more likely to report rarely or never receiving social or emotional support.

Its evident to anyone who has been a caretaker, caring for someone with a chronic disease increases the stress placed on a caregiver, Dr. Rehman says, “Usually, elderly patients have multiple comorbid conditions. In addition to the medical care, the caregiver may also be in charge of grooming, dressing, bathing, toileting, and feeding the care-recipient.”

 If you are caring for someone with diabetes, particularly when they are in their senior years, then you know, the demands on you can be intense. The patient typically must test her blood sugars, remember to take multiple medications, and even inject insulin, according to Dr. Rehman. “These blood glucose checks and injections can occur three or four times a day, which is very challenging to a caregiver,” he tells EndocrineWeb.

From a medical point of view, caring for someone with a chronic disease like diabetes is especially demanding because the caregiver may have high expectations and think she can “fix” the problem, says Robert Courgi, MD, an endocrinologist at Northwell Health’s Southside Hospital in Bayside, New York.

“It’s stressful to deal with a situation you can’t solve,” he says, “Even when you do everything right, the person you are caring for can still experience high blood sugars and develop complications like foot ulcers, vision changes, and renal complications.”

Having Diabetes As a Caregiver Is Especially Hard

If you have diabetes, or even prediabetes, yourself and are caring for someone else with a chronic illness, this could cause your own illness to become worse.

“These caregivers may not be going to the doctor because they are caring for someone else and don’t have time,” Dr. Courgi tells EndocrineWeb. “The caregiver very often experiences increased body weight and elevated blood pressure.”

 Individuals who have a thyroid disorder and are caring for someone else also can face adverse health consequences, says Dr. Courgi. “Diet and exercise are not as big a factor for those with hypothyroidism as they are in diabetes, but you must still remember to take your medication and follow up with the doctor, which can be difficult for caregivers,” he says. “And with hyperthyroidism, the response to the medication is much more erratic and not as straightforward as it is for hypothyroidism.”

Recognizing the many responsibilities that fall on caregivers, and how hard it is to remember everything that is needed to make the most of a visit to the doctor, the National Center for Chronic Disease Prevention and Health Promotion, part of the Centers for Disease Control and Prevention, created a tip sheet as a guide.3

Suggestions to help guide you before, during and after a visit to the doctor:

  • Be sure to write down any questions or concerns you have about the care plan.
  • Bring a list of current medications the patient is taking, even if prescribed by other doctors.
  • Keep a journal of any changes in their routine, behavior, and health since the last visit.
  • Remember to invite the recipient to discuss any concerns about the current care—what’s working and what’s not—before you raise any questions.
  • Take notes about any updates in care that the doctor suggests or prescribes.
  • Ask questions about anything you do not understand so you can refer to your notes later.
  • Voice any concerns about your ability to provide the needed care if it becomes too difficult.
  • Review and update the existing care plan to include any change in the medications, timing, and need to take with food or not as well as when the next follow-up visit is scheduled.
  • Do not hesitate to call the doctor to ask any questions that your care recipient might ask that you can’t answer, or that may occur to you once you begin to implement the changes.

Taking Care of Yourself Is Just as Important   

The study authors suggest some strategies that could be helpful to caregivers. “Interventions for caregivers may include social and emotional support, skills training, education, activity planning, environmental redesign, and may be tested either singly or in combination,” they wrote.

The most important step a caregiver can take is to reduce your own stress. The best way to do this is to recognize that you need help, says Dr. Rehman. It’s especially important that you “set realistic goals and seek help when you can’t take care of another person,” he says.  “And consider joining a support group.” It’s also necessary that you are prepared to accept help if you need it; this better for both you and the person you are caring for.

 If you feel like you’re losing control or can’t manage, take a few deep breaths. “Try to do the best you can,” Dr. Courgi advises, the best is all you can expect of yourself and all your care recipient expects of you, too.

 

Finally, maintain a healthy life in terms of eating, managing your stress, and sleeping. If needed, do not hesitate to see a physician for yourself, Dr. Rehman says.  

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