"Patient" education: What's your technique?

Dr Gary
By Dr GaryCA Latest Reply 2011-05-24 11:53:45 -0500
Started 2011-04-24 21:25:36 -0500

Ever find yourself having to educate your family and friends about diabetes and what you need, and don’t need, from them? Maybe a better question is, how often do you have to educate them? Every day?

While you have taken the time to get educated on your condition and how to take good care of yourself, friends and family may not have put in the same effort, or may not know how. As a result, you may find yourself sometimes getting frustrated over their lack of understanding, the insensitive comments they make, or the times when you need a helping hand that they don’t offer, or the one that they do offer, but that you don’t need.

And then there is plain old denial. But even if you have loved ones who just want to pretend that if you don’t think about your condition it will go away, some education, over time, may help them to face up to what you’re facing, and be a better support.

So what it comes down to is that, on top of everything else you do to maintain your health, being an educator is part of the deal. And the best way to do that job, as you may already have experienced, is with a whole lot of patience. In other words, “patient” education.

Here are few ideas to help you in your efforts:

Be an example. You can show who your family members and friends that you are dealing with your diabetes by doing the best you can to live the best life possible. Being compliant with your treatment, reaching out for additional help from your treatment team as questions or crises arise, taking the best care of yourself that you can. This may help to reassure them that, while your condition is challenging, it is also manageable. Actions speak louder than words, as they say.

Be your authentic self. This means being the loving, caring person that you are, being there for them. But also letting them know when you are not at your best. Letting them know that you are okay but that you may need a little extra support from them, as well as some understanding. If you are having a bad day, don’t pressure yourself to pretend otherwise.

Answer questions. Encourage your loved ones to ask you questions. And when they do, answer these questions at their level. In other words, give them information that you think they can understand, that won't be alarming, but that will also provide enough information that they will have a sense of what you are facing. You might want to offer answers to the questions that you suspect your loved ones have but are afraid to ask, such as whether diabetes is hereditary. If you run into any questions you can’t answer, you might want to check in with your physician, or offer to help your friend or family member do some research.

Provide reassurance. Your loved ones may be feeling helpless, wanting to help you and worrying about what your condition may mean for them in the future. Remind them that you are doing everything you can to take care of yourself, and that you intend to do everything you can to take care of them, that you are all a team. Again, letting them know how they can help you to help yourself can make a difference in how they experience your condition.

Look for teachable moments. When an issue arises, address it in the moment rather than saving it up as material for your next lecture. If a loved one says or does something that shows lack of understanding, or offers to do something that you don’t need them to do, use that moment to gently let them know how you were affected, and what they could do instead.

Be compassionate. I am a big believer in compassion, being compassionate toward ourselves and directing that compassion outward toward others. I think that if you live a compassionate life, you have a firm foundation for weathering the day to day challenges that come your way, and that includes people in your life who just don’t seem to know any better.

Be optimistic, but don’t expect miracles. Expecting people to think or feel or behave the way we wish they would is often a losing proposition. People come around in their own way and in their own time, or, sadly, sometimes not at all.

And so, at the risk of repeating myself: Take care of yourself. Gather the people around you who can be supportive, who are willing to understand what’s going on with you, who are willing to be taught and to learn. There are a lot of them out there, including right here on Diabetic Connect.

How is your “patient” education going? Any ideas to share? Any way we can offer you support?


41 replies

June Tademy
June Tademy 2011-05-19 22:01:19 -0500 Report

Hi Dr. Gary and friends, before I had my BS in control (still working on keeping it in control) my Doctor(s) sent me to every class there was on "diabetes"and if you need to go back at anytime to take the classes you can, it is all free. You receive booklets with soo much information, I could also see a nutritionist, which did not really help me, one would say one thing and another would say another. The best class I attended was for Kidneys, they had a grief specialist, nutritionist(again not the best), pharmacist, just everyone that you would have to deal with and I truly enjoyed it. It took awhile for me to really read and follow the suggestions but I did. My family is supportive now because I had to educate them every single day. They were always telling me how a person they knew who had diabetes ,how they were doing and what they do and so on and so on. Also comparing me with our Mom who had diabetes but was in denial and I am not. I finally told them that I am June and not them and I am different from them and I am not eating everything in the house, etc., just treat me as your sister and give me respect for my efforts and be kind to me. I told them I do not need anyone to be angry with me or blame me for my condition anymore. Now they understand and they are in my corner, I do not have to hear the"why didn't you do this", etc. I educate everyday to anyone that will listen, especially the young ones, I also took a few of my neighbors to my classes just so they would know about diabetes and help themselves and their kids. My "patient" education is going fine, but I always need more ideas, and will always need help. Dr. Gary you are the best.

P.S What about drinking wine, the nutritionist said we could have four fingers with food and never alone but with food. I know if your meds say not to drink you should not. What say you DR. Gary?

Dr Gary
Dr GaryCA 2011-05-20 16:52:11 -0500 Report

Hi June,

Thanks very much for the really interesting reply. This is an extremely important issue that you bring up.

The theme here is "generalization" and I see patients and family members doing this. Sometimes newly diagnosed patients will fear the worst because they are generalizing -- assuming that other peoples experience will be theire own. So if they are diagnosed with the same conditon as someone else in their family, and that person had a difficult time, they assume the same thing will happen to them. The result is unreasonable fear that isn't necessarily rational.

Sounds like you got yourself educated right away. Real information is the best antidote for fear. You didn't need to fall into generalization because you got facts. You are your own person, and didn't need to assume that you were going to have someone else's experiences.

So congratulations!

You family, unfortunately, has been generalizing. So they are falling into the fear factor, imagining worst case scenarios that are not real.

Again, educaton is the best antidote to fear. Telling them that you are you, and not your mom, is a good start. Inviting them to accompany you to your classes is a great idea. That third party expert is a great way to support your case.

So congratulations again.

Unfortunately, I am not a physician so I can't advise you on whether you can celebrate with a glass of wine. So sorry.

Great to hear from you. Thanks again. And have an excellent weekend!

Gary

EmiliaK
EmiliaK 2011-05-19 18:20:50 -0500 Report

I educate clients in my consulting business, but this is a drop in the bucket. What we need to do is educate children and parents at a large scale if we really want to take care of all rhe health issues that are plagging us now.

Dr Gary
Dr GaryCA 2011-05-20 16:41:00 -0500 Report

Absolutely! As a country, we really need to address health education, prevention, healthcare empowerment. This would save money in the long run. But it just doesn't seem to be a priority.

EmiliaK
EmiliaK 2011-05-22 10:37:45 -0500 Report

Hello Dr. Gary,

Why do you think this doesn't seem to be a priority, in view of what is happening around us and the not so long health consequences? Do you have any suggestion to move people in the right positions to start taking action?

Have a great day,

Emilia Klapp, R.D.,B.S.
http://www.TheDiabetesClub.com

Dr Gary
Dr GaryCA 2011-05-22 22:30:26 -0500 Report

Hi Emilia,

That is a very goood question! Health insurance companies pay incredible amounts of money for treatment but they seem hesitant to spend on prevention. And the country seems to be in reactive mode, unwilling to spend on education and prevention. The case doesn't seem to have been made, or the evidence is being ignored. It is really frustrating.

Great to be in touch with you! I really like your Website.

Gary

EmiliaK
EmiliaK 2011-05-23 09:13:32 -0500 Report

Thank you Dr. Gary,

It has also been my experience that at an individual level, people are not interested in nutrition or being physically active unless the doctor orders it. It is also very frustrating for me, since I know the implications of not preventing. But somehow people think "that will never happen to me and if it happens, I'll take a pill".

As for the insurance companies, they will save a lot of money by making mandatory attendance to some kind of nutrition and exercise classes when people enroll in the insurance. Somehow they have not seen the light yet.

Have a great day,

Emilia

elaine52
elaine52 2011-05-19 17:33:28 -0500 Report

Seems like I am 'trying' to educate my family ALOT. Either they just aren't listening…or don't care. All except my youngest daughter and my second to the oldest daughter, they are the only ones who seem to understand or care that my diet is different because of my diabetes…:(

Dr Gary
Dr GaryCA 2011-05-20 16:39:28 -0500 Report

Hey Elaine,

Some family members are able to jump in and be supportive. Others just can't or won't deal with what's going on and, at least temporarily, hide out or run in the other direction. We find support where we can.

Glad you are here with us!

Gary

Gimpalong
Gimpalong 2011-05-23 11:51:16 -0500 Report

Hey Gary,

My youngest son who lives in town has been in complete denial about diabetes. He thinks if you wish it away, it will just go. I had him take me to my doctor visit, and I had him go back with me. The doctor talked with me about some issues, then he turned to my son, and asked if he had questions. They began to have a discussion and the doctor looked at my son said that he should be listening and trying to find out what he can about diabetes because he had a very good chance of getting it himself or his children could. That was a big eye opener for him. Sometimes we have to find an "attention getter" along with the "patient" education.

I'm glad you're still giving us thought provoking ideas. Have a great week.

Nancy

nanaellen
nanaellen 2011-05-23 12:32:27 -0500 Report

Nancy,
PLEASE tell your son that if he doesn't learn about it now he will suffer in the end like me!! I started this battle 6 years ago with having to take 3 shots a day and 1 at night. I struggled for the first few months and got my #'s somewhat under control so I got off the 3 shots a day and just had to have my lantus shot at night. So I got very laxed about testing and such and ignored my diabetes! Then last Nov. I had to go to the hospital cause I couldn't hold anything down for 3 days, not even water!! I ended up with pancreatitus. Nothing to eat or drink for 4 more days just IV fluids! Than had to have my gall bladder out. Can't get my #'s down since then!!! Now they say there's something wrong with my pancreas and I have no Insurance so no more tests for me, the hospital said it's too expensive!! I've had pancreatitus 5 times since Nov.!!! And don't know where it's gonna go from here! I wouldn't wish this on my worst enemy (not that I have any lol) Please tell him to learn about it NOW while he still has a chance!!! Much love goin' your way! Ellen :)

Dr Gary
Dr GaryCA 2011-05-24 11:53:45 -0500 Report

Hi Ellen,

I really appreciate that you jumped in here. I am concerned about you, and very sorry to hear that you are going through this right now. I hope that you are staying in close contact with your healthcare team and advocating for yourself as much as possible.

Stay iin touch with your friends here on Diabetes Connect. My thoughts are with you.

Gary

Dr Gary
Dr GaryCA 2011-05-23 12:25:18 -0500 Report

HI!

Thanks for checking in and for your kind words. It is always a great pleasure to be connected here on DC.

Sounds like your doctor gave your son some tough love, and it worked. As human beings, it is normal to want to avoid the things we dont' want to think about. We feel like we have a choice, and we choose not to deal. But sometimes it takes a wake-up call, like your doctor provided, to bring home the fact that denial and ignorance are not among the choices. Diabetes is not going away.

I really appreciate your perspetive. Have a great day!

Gary

crazygirl777
crazygirl777 2011-05-19 16:51:53 -0500 Report

It seems like I have to "educate" my family every day. It can be very irritating at times. Like when my mother is convinced that I am not really a diabetic and can just stop taking my insulin and the doctors are wrong and stuff like that. She doesn't understand how hard it is for me every time they invite us over for dinner and I have to sit there and look up foods and amounts and add numbers and they are always trying to just dump food on my plate and rush me as if this is all just a game or something. My husband seems to be the only one who gets it in my family. My kids are always trying to get me to "taste this" or "try" this, or "finish" this and it gets really annoying to keep explaining that i can't just eat whatever I want whenever I want. I do take my insulin in front of everyone and they all have seen me take it. I have tried over and over again to tell them what to do in an emergency situation, how to give me my emergency shot, tried to get them to watch the video…they just blow it off. So, I hope that I truly never need it and if I do, I hope that my husband is around because he's the only one who ever paid any attention to anything that I said. I just joined this site a couple days ago and I think it's going to be the best thing that ever happened to me. I haven't had a support system before this or any other diabetics to talk to so it's great! When I find myself feeling down I try to remember that though this will be a part of me for the rest of my life now, I can't let it rule my life. I have to rule IT! (and I have to learn to enjoy food again someday and stop looking at it as the enemy) I have only been a type 1 diabetic for about 18 months so I am new to the whole thing and still have a ton to learn. This site has already shown me a lot!

Dr Gary
Dr GaryCA 2011-05-20 16:37:14 -0500 Report

Hi Crazygirl,

First, no way do I believe you are crazy. Welcome to Diabetic Connect. And thanks so much for chiming in on my discussion. I hope a lot of people read you post because you shared such a compelling message with us.

What I have experienced in my work, and in my life, is that the average human being would like to walk around hoping that if they don't think about bad things, and don't acknowledge bad things, then bad things won't happen. Ignore it and it will disappear. Sounds like most of your family is in denial. about their own potential for health problems, and want you to participate in this denial.

If any of them have to face their health issues at some point in life, they will be emotionally unprepared.

I am glad that you have such a great support in your husband. You are fortunate to have him.

I don't know how old your children are but some of their denial may be related to fear. They want Mom to be healthy, and to be there for them, and they don't want to believe that she might need help or have an emergency. You might want to sit down and talk to them about any fears they might have, and to reassure them that you doing everything possible and more to stay healthy. Just a suggestion.

I always encourage people facing medical conditions to get as much support as possible, to reach out to people who can be good listeners, and to caring and concerned, and build a strong network. Sometimes, unfortunately, family members can't or won't be part of that network. But we find support where we can, kind of like creating new families for ourselves.

Again, really glad that you are with us on here on DC. IT is great to meet you and I am looking forward to staying in touch.

Take care!

Gary

crazygirl777
crazygirl777 2011-05-20 17:04:35 -0500 Report

Thanks Gary. I sure do appreciate your words of wisdom & suggestions. Being new to this, I need all the help I can get. It's been a huge struggle for me & my sugars just refuse to get under control. But today I got great news finally. My doc is fighting my insurance company to get them to cover an insulin pump for me. We don't have the $ to get it without coverage but I've been such a roller coaster going from as low as the 20's to as high as 300 & I don't feel my highs or lows at all. So if this works & I get the pump, I know my family will realize much more how "real" this is. So maybe that will help. I plan on my kids being there when I get the pump & monitor put in. (my kids are 16,13,9 & 14 months) i'm sure that will help some. I feel I have already gotten a lot of support here already & feel so much better about things than I did before. This is a great place with great people!! I will keep you posted. For now..i'm hoping, praying & crossing my fingers for the good word!

Dr Gary
Dr GaryCA 2011-05-22 22:34:29 -0500 Report

Hi, I am glad to hear that your doc is fighting for you. That is great news. Wow, you have really had some highs and lows, haven't you? I hope you get approval soon! And it's a really good idea to get your kids involved, they can feel like they are part of the process, and it will help them to understand what's going on, that this is real and that you are doing everything you can to be be healthy. I will hold you in my thoughts. And definitely please keep me in the loop. Gary

June Tademy
June Tademy 2011-05-21 13:30:38 -0500 Report

All will be well simply because you are leaving yourself open to suggestions and most of all help, this site is the reason my BS is in control it took a long long time before I could get a handle of it and get support but I did and I am with you in your prayers that you will and YOU will.

spitfirelady
spitfirelady 2011-05-19 17:06:19 -0500 Report

Wow, I am frustrated for you just reading this! How about bundling the kids up (no matter the age) and taking them with you to your next doctors office visit or to visit your diabetes educator soon. It sounds like you have pin pointed the problems with your family members and I certainly am impressed! Now, they need to get on the same page as you and be supportive! Good for you! kudo's for not letting them get you down and you must have a wonderful relationship with your husband. Kudo's to him, Too! Hang in there!

Dr Gary
Dr GaryCA 2011-05-20 16:38:08 -0500 Report

Great idea! Sometimes it takes an objective third party to help with the education.

spitfirelady
spitfirelady 2011-05-20 16:45:26 -0500 Report

Enjoyed your comments about this…since I was an patient educator, I always suggested bringing in the family to take the load off the family member already dealing with the new illness/diagnosis. Especially when the family was in denial as well… Thanks!

Gimpalong
Gimpalong 2011-05-04 15:03:37 -0500 Report

Hi Gary, thanks again for some more thought provoking information. Please keep informing us. I pray you are having a great week. Take care of youj.
Nancy

Dr Gary
Dr GaryCA 2011-05-04 16:08:59 -0500 Report

Nancy, thanks for your kindness and encouragement. You made my day! And you have a great week too. Always great to be in touch.

Cookie Roma
Cookie Roma 2011-05-01 01:43:53 -0500 Report

The day I was diagnosed (almost 2 years ago) each of my kids as well as my husband told me how sorry they were and that they love be. After that, their biggest concern quickly turned to concern that they might have to eat differently (I am the family cook). None of them have a clue what to do if I have a big drop in my bg.
I'm so glad I found DC as I have no support group!!!! Thank you DC.

Gimpalong
Gimpalong 2011-05-04 14:57:30 -0500 Report

Hi Cookie, it is difficult when you don't have a support group at home. When my sons were growing up, we had certain nights designated for each of them to plan the meal, cook it and serve it. It couldn't be a fast food meal, they had to actually cook the meal. Today they do a lot of the cooking. Since my husband died, I am living in the town where my younger son lives. He is close enough to come when I call. I have prepared a list about what to do if I am having a low BG crisis. I have a tube of glucose for if I am passed out. I have peanut butter/crackers, hard candy, etc…plus I have a glucometer and insulin to use as needed. I also carry these items in my purse just in case. When you have a low BG and pass-out at their feet, I guarantee that they will be more receptive to learning how to help you. It took my sons a while (they were in denial) to finally realize that they needed to know how best to help me. Also, they needed to know when you can be treated at home, and when it is time to get you to ER.
If you cook meals from the recipes on DC, they will find that they are very tasty. If you are the cook, that means to me that they will eat what you put in front of them. Sometimes while trying to be patient with our loved ones and friends, we have to also practice a bit of "tough love". Cookie, I pray that you will be able to find that support from your loved ones as I have. It takes time, plus a little bit of stubborness about meals from the cook. Taking care of you is #1. One thing I do with my family is that I take my insulin in front of them. That makes the diabetes real, and also, it can bring some questions to educate them. Have a wonderful week. I'm sorry to have written a book. I'm glad you are here at DC.
Hugs and prayers,
Nancy

Dr Gary
Dr GaryCA 2011-05-01 22:30:42 -0500 Report

Hi!

Great to hear from you. Familiy members want to be supportive, but food is such an ingrained habit, and change comes slow, changing to eating healthy comes even slower. Maybe they will pick up some of your good eating habits over time, but maybe not.

Glad you are taking care of yourself, even if it means not always, or hardly every, eating what they eat. What's important is to keep yourself healthy.

And glad you found us. We are here 24/7!

Stay in touch!

Gary

jayabee52
jayabee52 2011-05-01 01:53:30 -0500 Report

Cookie,
for your own health and safety, teach them what to look for when you go low and how to combat a low should one incompacitate you.

And you can cook meals which are Diabetic friendly and still keep the family happy. Use the Recipe section for recipes and pointers on how to do that.

Blessings to you and yours!

Dr Gary
Dr GaryCA 2011-05-01 22:32:02 -0500 Report

You are right, James, it's important to keep the family educated so they know what to do in case of an emergency. And eating healthy doesn't have to mean boring.

Cookie Roma
Cookie Roma 2011-05-01 02:53:39 -0500 Report

I get what you're saying but it's not going to happen. If I express concern or talk aboutcit much af all it's made clear that I'm either annoying or even being selfish.

jayabee52
jayabee52 2011-05-01 03:12:20 -0500 Report

That makes me sad for you, Cookie. It's one thing to be all alone like I am (but I can call my son who lives in the same town, and he'll come ASAP should I need) but to live with people who ought to love you and care about your well-being but doesn't seem to, is so sad. I am thinking about suggesting "defecting in place". Where you take care of yourself, but let them fend for themselves re cooking, clothes, cleaning. Let them know what it might be like if something bad should happen to you. Perhaps they would appreciate you more, and might be more teachable.

It would be ideal if you would go to the hospital for 2 wks to 1 month and they would learn what it is like.

Do you have a counselor you could trust to talk things over?

Cookie Roma
Cookie Roma 2011-05-01 13:30:22 -0500 Report

I've actually thought about doing that but then I just know it wound be me just being so dramatic.
Thanhs for the concern!

Dr Gary
Dr GaryCA 2011-05-04 16:06:58 -0500 Report

Hey Cookie, you are certainly not being dramatic for wanting to get more support to help you deal with the lack of support you have at home. It could be really helpful to gt some additonal perspective and to work on developing a strategy to help you to manage what's going on with your family around your diabetes. You might also want to look into talking to a CDE or joining a local support group.

tj101
tj101 2011-05-05 10:46:11 -0500 Report

hi gary i agree people that are doing all they can do to mannage there diabetes would benifit from some type of group but the question is how can we find one near us? any ideas hope you have a great day.

June Tademy
June Tademy 2011-05-19 22:07:07 -0500 Report

TJ101, if you can go online and/or if you are a member of AARP they have phone numbers and names of any group you can imagine for support. Also maybe your doctors can provide you with the information. I am fortunate to have had classes and met a couple of people and we walk together sometimes and I also give them information that I receive from this site, they do not want to just talk online, they like to talk face to face so they prefer group meetings which is nice. Try that and also try your local church, they always provide you with great information. Good luck and Bless You

jayabee52
jayabee52 2011-04-25 00:11:18 -0500 Report

*Whew!* Makes me tired, just reading this Dr Gary! It seems like a PWD's work is never done! (tongue firmly planted in cheek!)

EDIT: seriously, Dr G, a good and timely topic. My biggest 2 concerns right now are:

# 1, to convince people around me in the apt bldg who have DM to come to DC and become better educated on DM, and get some support. — some folks who use the computers here on which I am posting, also have DM.

One recently has had his big toe amputated and is lugging around a wound vac. He spends his time making snarky comments on FB rather than making them here (LoL!)

# 2. to wake my sons up to the dangers they might face from DM, having a maternal G-ma who had DM t2, a mother who had gestational DM with each of the 3 pregnancies, and a dad and their dad's bro. who have DM t2.

Dr Gary
Dr GaryCA 2011-04-25 16:58:38 -0500 Report

Hi James,

Nice to hear from you. I like your new pic!

Getting people to wake up and smelll the coffiee is a hard task, isn't it? This is where just being a positive role model, taking care of yourself, and then then using teachable moments, reminding them to take care of themselves when the opportunity arises, trumps the lecture approach.

You are always a caring and concerned person!

Gary

jayabee52
jayabee52 2011-04-25 17:52:34 -0500 Report

I have my good moments . . . . and then some not-so-good moments. I do try to have the "goods" out number the "not so goods" for anything.

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