Building Competency in Diabetes Education THE ESSENTIALS

4-36 | CHAPTER 4

• May be experiencing depression. • Having to make the decision to stay or move from their home. • Having to start dealing with the loss of friends and relatives. • Having to strive to make ends meet on a fixed income.

Being aware of these challenges faced by older adults is the important first step in helping them cope. You may need to take more time or use simpler terms to explain concepts and alleviate fears. With their multiple health problems, an empathetic ear can result in constructive problem-solving. Challenges for the health-care professional (HCP) working with the older person with diabetes (70,78,79): • Heterogeneous group: Healthy to frail requiring different approach in terms of physical, cognitive and social issues. • Multiple co-morbidities to be considered in all treatment decisions. • Assessment of cognitive function needs to be done frequently due to slow decline. • Dealing with loss and depression. • Helping patient maintain maximum independence. • Nutrition concerns. • Management of diabetes in nursing homes. • Few randomized controlled studies used to inform practice include elderly participants.

The goal for this stage of life is to: Ensure the best quality of life possible by maintaining the highest level of functionality in terms of physical, emotional and cognitive status (37).