Building Competency in Diabetes Education THE ESSENTIALS

4-50 | CHAPTER 4

The phases of the grief cycle as outlined by Kubler Ross are: • Shock and disbelief • Anger • Bargaining • Depression and sadness • Acceptance

It is important to realize that these phases are fluid; people pass back and forth through them, and they may recur. Losses for family members and significant others may be similar to or different from those experienced by the family member with diabetes, and they too may experience the phases of the grief cycle. Difficulties may arise either from family members being at different stages at the same time, or from family members being stuck and unable to move forward. The Diabetes Attitudes Wishes and Needs (DAWN) 2 study highlights the ripple effect the diagnosis of diabetes in a loved one can have on other family members. In this study, conducted in 17 countries, people with diabetes, HCP (nurses, dietitians, physicians), and family members living with someone with diabetes were surveyed to determine their attitudes, wishes and needs regarding the psychosocial aspects of diabetes management. The study confirms that the physical, financial and emotional burden of diabetes across cultures and countries is experienced throughout the entire family (5,116-118): • 20.5 % of the patients reported a negative impact of diabetes on their relationship with family/friends. • 35% of the patients reported that their family members argue with them about how they manage their diabetes. • 63% of the family members reported feelings of anxiety related to the possibility that the person they live with will develop serious complications.

• 44.6% of family members reported a negative emotional effect. • 37.1% did not know how to help the person with diabetes. • 62.7% of the HCP felt there is an increased need for psychosocial support.

The educator’s role is to help patients and their supporters understand that these feelings and responses are normal and to help them explore their attitudes, emotions and behaviours