Caring for Diabetes and Dementia: A Unique Challenge

A staggering 100 million Americans – nearly one in three of us have diabetes or prediabetes. It’s a complicated disease that further complicates the lives of many. And if a loved one is also living with dementia, the health needs and responsibilities of the caregiver can multiply. But there is hope and support at AdventHealth.

This article will outline some important things that can support you and your loved one as you navigate life with diabetes and dementia.

Diabetes Affects the Brain

The brain is especially sensitive to the effects of diabetes. People with diabetes are at risk of high blood pressure, and in turn, high blood pressure can lead to strokes. Like a heart attack, where blood flow is blocked to heart tissue, strokes occur when the blood carrying nutrients and oxygen is interrupted.

In some cases, these brain attacks lead to permanent loss of strength or inability to speak. In other cases, strokes can lead to damage in the thinking parts of the brain. When this happens, it is called vascular dementia. It is this combination of dementia and diabetes that is particularly difficult.

How Dementia Affects Those Living With Diabetes

When someone has dementia, their normal intellectual abilities decline over time. Having diabetes requires an individual to be careful with what they eat and drink, and monitor their exercise all while eating and taking medications on a regular schedule. If dementia has set in, and the ability to remember to take medications, follow instructions, and keep track of what and when to eat is affected, the caregiver’s role becomes even more important.

At the AdventHealth Centre for Senior Health, specialists partner with colleagues at the AdventHealth Diabetes Institute to provide patients and their caregivers with coordinated treatment that spans all aspects of diabetes and dementia treatment. Here, professionals help patients and their caregivers adapt to the range of diabetic and dementia-specific needs, such as specific dietary advice that can help patients and their family caregivers manage diabetes well, with special emphasis on strategies to follow as dementia progresses.

Making a Diabetes Diet Plan

Here are some basic dietary guidelines to help your loved one manage their diabetes.

1. Follow an eating plan that cuts down on carbs, focuses on lean proteins like fish and turkey and incorporates plenty of vegetables, especially leafy greens.
2. Follow an exercise plan that includes aerobic exercise and strength conditioning.
3. Take appropriate diabetes management medications.
4. Reduce stress, which can increase blood sugar.
5. Check with your loved one’s specialists to see if any dietary changes need to be made after starting a new medication or dose.

Adjusting Health Goals with Dementia

In the early stage of dementia, patients will usually be able to follow usual diabetic diet guidelines. As the dementia progresses, problems with thinking and memory may limit the foods they can or will eat regularly. This can greatly complicate a caregivers efforts at helping their loved one eat enough food, let alone maintain a healthy diet. As the course of dementia progresses towards its later stages, caregivers will benefit from being fully engaged with the medical team so the goals of diabetic care management are appropriately adjusted.

Here are some tips to help caregivers manage their loved one's nutrition in later stages of dementia:

• Offer a balanced plate with nutrient-dense healthy fats such as nut butters and avocados. They are also packed with calories, so your loved one doesn't need to eat a lot. Other good choices include:
  • Smoothies with protein. Smoothies are a great way to incorporate high-fiber foods, like vegetables and many fruits, into a diet. Ideas for the protein source include protein powder, peanut butter or nut butter.
  • Oatmeal with nut butter
  • Omelets or egg scrambles
  • Tuna Casserole with noodles, cheese and garbanzos
  • Greek yogurt parfait

• Cut back on empty-calorie refined sugars like cake and cookies, and consider replacing them with fruit.
• Ill-fitting dentures often raise problems with chewing. Consider food that is soft, in small chunks and easier to swallow.
• Adaptive eating devices can allow a person with dementia to eat on their own, which will help them maintain their independence and eat more. Examples include large-handled spoons, bowls and plates with higher rims and plates with suction cups on the bottom. In later stages of dementia, finger foods and using straws can be helpful.

Caring for the Caregiver’s Whole Health

It's easy to see how managing diabetes and dementia can lead to burnout among caregivers.

Caregivers report very high levels of stress because of the time and energy to take care of their loved one because of the degree of time and attention that's involved. We encourage caregivers to step back, recognize the symptoms of stress and take time to assess their whole health.

Here are some helpful tips for caregivers to maintain their own health:

• Prioritize self are. If you don't take time for self-care, schedule regular breaks and ask family members for help you will be less able to care for those who rely on you.
• Keep up with your own medical appointments; consider including a therapist to talk

about your feelings as a caregiver.

• Incorporate exercise into your routine. This releases stress-reducing chemicals and helps you manage your weight.
• Consider joining a local support group for caregivers with dementia. Ask your caregivers provider about support near you, or consider visiting the Alzheimer's Association for additional resources.
• Remember that changes in your loved one's condition are a natural part of their illness and aren't your fault.

Help is Here

If you are the caregiver of someone living with diabetes and dementia, know that you’re not alone. We are always here to help support you both in body, mind and spirit. Learn more about our comprehensive diabetes education programs today.