Caring for the Elderly Adult with Diabetes - Research Paper Example

?Caring for the Elderly Adult with Diabetes Diabetes mellitus is one of the most common chronic diseases, with almost 2.4 million Canadians living with the disease, and Ontario has amongst the highest age-standardized rates of diabetes in the country (Government of Canada, 2011). Evidently, a disease with such a high prevalence rate will be important in nursing care, especially with a disease such as diabetes which can lead to a huge number of complications when strict guidelines are not followed. There are a number of guidelines for best nursing practise when dealing with patients with diabetes, and special care needs to be taken for the elderly who may be more at risk of complications such as eyesight loss and foot ulceration. There are a number of important nursing practise points that are important in providing good care for elderly adults with diabetes and their families. There are a number of reasons for choosing this topic. Firstly, diabetes affects almost 2.4 million Canadians (Government of Canada, 2011) and many more are thought to be undiagnosed. Not only that, but patients with diabetes are three times more likely to be hospitalized due to cardiac disease and twenty times more likely to need a non-trauma lower limb amputation (Government of Canada, 2011). Although these are just statistics, they do give a real feel for the potentially devastating impact that diabetes can have on the elderly adult and their families, and I think it’s increasingly important (as chronic disease becomes more common) to understand the best nursing practise guidelines to help prevent the complications of diabetes. Not only that, but many family members are not aware of the problems that diabetes can cause, and therefore it’s important that a nurse is well-informed to answer questions about diabetes to allow best care in the home. The Registered Nurses’ Association of Ontario (RNAO) have issued a number of guidelines with respect to practical nursing and adults with diabetes mellitus. One of these concerns the best practise in reducing foot complications, which includes foot care education for the patient as well as frequent check-ups. Another guideline concerns best management of foot ulcers in diabetes patient. The final guideline concerns the subcutaneous administration of insulin in adults with type 2 diabetes, which is particularly important in that patients and families may need to be educated on this as maintenance of insulin levels is vital (RNAO, 2011). The College of Nurses of Ontario (CNO) also publish guidelines for the utilization of nurses working with adults with diabetes, and suggest that nurses may play an important role in directing diabetes management programs for the patient as well as advising patients on other matters (CNO, 2011). Evidently, practical nursing care needs to incorporate aspects of diabetes management, in part because it is so common and in part because the nurse can play such a vital role in preventing complications Evidently, the topic of diabetes is important to the sufferer and their family, as they will wish to know as much about the condition as they can to help prevent complications and to ensure that they stay as healthy as possible (Rother, 2007). In understanding diabetes management and care, the patient can ensure that they follow medication protocol, have a healthy diet and watch closely for signs of foot ulcers, vision loss and other complications (Rother, 2007). By doing this, the patient can inevitably prolong their life, and perhaps even reduce the severity of their diabetes (Ceriello, Ihnat & Thorpe, 2009). Both the patient and the relevant family members may need to be guided on how to intravenously inject insulin if it is needed for their care, as this can be a complex procedure and is important in management of some cases (Rother, 2007). All of these issues have been highlighted by the RNAO Best Practice Guideline mentioned above, and therefore all nurses should be aware of how important it is for the patient and their family to fully understand the condition and best management. Evidently, it is important that individuals with diabetes are familiar with some of the things that nurses can tell them. As mentioned before, the RNAO Best Practise Guideline mentions that nurses educate diabetes patients how best to look after their feet to prevent ulcers and other diabetes-related ailments. This is important. If an elderly patient is not able to do this themselves, it is vital that family members and carers are also familiar with this process so that the risk of side-effects is lowered. Additionally, family members should be aware of how to deal with worries that diabetes patients may have about their lifestyle ad their health, and should have the full support of nurses in this matter. Families can often be the best people to relay information to the patient, as they are in a position of trust (Rosenstock, 1985), and this is no different for diabetes patients. There is a lot of education needed for nurses in assisting the patients and family. Firstly, nurses need to be aware of the complications of diabetes and how they are treated. Nurses should also be aware of nutrition plans that are suitable for the patient, so that they can relay this information correctly. This is perhaps more important in diabetes than a number of other conditions, as control of insulin levels can be done to a satisfactory standard by diet alone in a number of patients, particularly those with type 2. Nurses, therefore, need to be educated in both the management of diabetes, and how to deal with patients who need to know the information. Nurses should also be aware that a number of patients may have a lot of questions and need help administering their medication, and should be prepared for this also. These facts are included in the RNAO Best Practice Guidelines, although these put a particular focus on complications of diabetes concerning the foot that may lead to lower limb amputation. Although this is important, education is needed to deal with the other complications of diabetes such as heart disease, retinopathy (leading to blindness) and nephropathy (Rother, 2007). There are a number of important signs that these changes may be occurring, and nurses should be able to help patients identify these as early detection may prevent further catastrophic changes. In conclusion, there are a number of important reasons why diabetes care should be carefully administered by nurses. Diabetes is a chronic condition that relies on medication, diet changes or both, mainly with the aim of preventing the complications of diabetes mellitus. Nurses should be aware of the signs and symptoms of these conditions, and be prepared to relay this information onto their patients and the families of patients where applicable. This is particularly important in the elderly adult, who may need help from family members in trying to control their diabetes, and may not be able to check their own feet for ulcers or administer their own insulin. Although the RNAO does offer Best Practice Guidelines, it is important for nurses to go above and beyond these, particularly in the case of diabetes where the guidelines focus mainly on preventing damage to the extremities. Diet is also extremely important for patients with diabetes, as dietary changes can have a significant impact on the disease and the resultant complications. Nurses should be aware of these dietary changes and how best to inform the patient on their needs in this area, as some patients may be unwilling to make these changes without medical assistance. As diabetes is becoming one of the most influential chronic diseases of our time, these points become increasingly important and therefore nurses should be prepared. References Ceriello, A., Ihnat, M. A., & Thorpe, J. E. (2009). The ‘Metabolic Memory’: Is More Than Just Tight Glucose Control Necessary to Prevent Diabetic Complications? Journal of Clinical Endocrinology & Metabolism, 94(2), 410. CNO. (2011). Nursing Standards. CNO. Retrieved from www.cno.org Government of Canada, P. H. A. of C. (2011, December 15). Diabetes in Canada: Facts and figures from a public health perspective - Public Health Agency of Canada. Retrieved March 12, 2012, from http://www.phac-aspc.gc.ca/cd-mc/publications/diabetes-diabete/facts-figures-faits-chiffres-2011/highlights-saillants-eng.php#chp1 RNAO. (2011). Best Practice Guidline - Diabetes mellitis. RNAO. Retrieved from http://www.rnao.org/Page.asp?PageID=861&SiteNodeID=133 Rosenstock, I. M. (1985). Understanding and enhancing patient compliance with diabetic regimens. Diabetes care, 8(6), 610–616. Rother KI. (2007). Diabetes treatment—bridging the divide. The New England Journal of Medicine, 356(15), 1499–501. doi:10.1056/NEJMp078030 Read More