You don’t mean to be part of the “diabetes police,” of course—you just want to help. But assisting others in taking good care of their health can cause distress in even the most loving relationships.
Policing someone else’s health often causes relationship problems, although love and concern may be at the heart of the matter. It’s a recurring theme in the diabetes community’s websites, blogs, message boards, and support groups. The Behavioral Diabetes Institute (BDI) is a nonprofit organization that works to address the emotional needs of people with diabetes to help them maintain good physical health. It has a fact sheet, “Diabetes Etiquette for People Who DON’T Have Diabetes,” addressing this topic.
William Polonsky, PhD, CDE, chief executive officer of BDI, says the institute gets many e-mails concerning caregiving, from both people with diabetes and others who want to help them. There are a few steps you can take to make sure you’re providing a support system, even when your loved one seems to be ignoring his or her self-care.
Make sure the person really needs help. You might think your loved one with diabetes could use a reminder to check blood glucose, for example, or should think twice about eating a particular food. But you don’t necessarily live with diabetes; he or she does. “Oftentimes, caregivers . . . want to take care and take action when it actually may not be needed,” Polonsky says. “There are way too many caregivers who get upset with their spouses or their teenagers: ‘Johnny won’t check his blood sugar!’ But if his A1C is in a good place, then you’re fine.”
• Action item: Consider, with your loved one’s permission, attending a doctor’s appointment together. Hear from the professional whether or not your loved one is on target with health measures. Maybe you don’t have such a cause for concern.
If help is needed, pitch it correctly. Your person with diabetes might be in a “no big deal” mind-set, even if your concerns are legitimate. That’s a rough spot for both of you. Polonsky suggests that you tread delicately and “extend your love.”
• Action item: Mention that you want to refrain from telling your loved one what to do. State your love, your willingness to be a steady presence and source of support, and your desire to enjoy a life together.
Know when to step back. “The problem is, you’re dealing with a functional adult. There’s really nothing you can do [without his or her consent],” Polonsky says. So even with the best intentions, you might not be able to help. “As a caregiver, you may have to get to the point that all you can do is nothing,” he adds. “It doesn’t mean that [you’ll stop worrying]. You have to just wish them well.”
• Action items: Be ready to be a safety net. Know the signs of severe hypoglycemia in case your loved one is prone to incapacitating lows. Have a plan for treating that situation, including injecting glucagon (a diabetes educator can teach you how) and calling 911.
Ask what you can do to help. You can’t be a mind reader, and you’re probably not a doctor. So ask questions, listen carefully, and try to come up with ideas together. Polonsky suggests using phrases such as “How can we do this as a team so I’m not on your case?”
• Action item: Work together to make healthful changes and to simplify care. People have greater success sticking to a meal or exercise plan when they do it in a group. Make that work for you and your loved one by eating the same healthful food and exercising together.