How can family members or loved ones help patients with diabetes reduce his/her risk of developing a diabetic foot ulcer?

How can family members or loved ones help patients with diabetes reduce his/her risk of developing a diabetic foot ulcer?

Diabetes is diagnosed in individuals; however, the disease affects an entire family and in many cases, friends.  The availability of a strong social support can directly affect a patient’s ability to manage chronic illnesses, including diabetes (Chlebowy & Garvin, 2006).  Stopford, Winkley, and Ismail (2013) performed a systematic review of studies examining the influence of social support on diabetes control and found naturally occurring relationships, including family and friends, may exert greater influence on health than healthcare professionals.  Family members and caregivers can serve many roles for patients with chronic illness.  Scarton, Bakas, Miller, Poe, and Huber (2014) examined the roles of family caregivers and found tasks, such as medication management, meal preparation, and assistance with basic and instrumental activities of daily living were frequently needed.

Figure 1: Home Instead. (2015). Retrieved from https://www.homeinstead.com/994/home-care-services/senior-conditions/diabetes-care.

            Patients with diabetes should be given a diabetes self-care plan covering  educational resources, eating plans, activity guidelines, instructions for glucose monitoring, medication instructions, and risk reduction behaviors (American Association of Diabetes Educators, 2010).  Risk reduction behaviors are behaviors to minimize risk of diabetic complications.  These behaviors include smoking cessation and regular eye, foot, and dental care.  An important risk reduction behavior is daily foot examination to reduce risk of a diabetic foot ulcer.  Some patients are unable to comply with this recommendation due to a variety of reasons, including the presence of cognitive impairment, visual loss, or limited movement (Miller, Salloum, Button, Giovinco, & Armstrong, 2014).  Family members or friends are frequently called upon to assist with tasks such as this; however, they may be ill equipped to perform this duty.  Family members commonly report the need for additional resources to properly provide diabetic care (Scarton et al., 2014).   It is critical family members and loved ones be adequately supported in these tasks, as increased social support is associated with improved compliance with diabetes self-management (Stopford et al., 2013).

Another way to support caregivers is to refer them to support groups.  Diabetes support groups can be beneficial for both patients with diabetes as well as caretakers and can be an effective way to provide information and support (Fitzgerald, 2012).  

Figure 2: Kentucky Cabinet for Health and Family Services. (2007).  Kentucky Diabetes Resource Directory.  Retrieved from https://prd.chfs.ky.gov/KYDiabetesResources/

Printed and electronic resources are available to support family members and caregivers of patients with diabetes.  The American Diabetes Association maintains a website with educational information, including helpful tips for caregivers (see Link 1 below).  Many healthcare organizations provide specific information for their members (see Link 2 below).

When clinicians treat patients with diabetes, it is critical social support be part of the treatment plan.  Clinicians should support caregivers by providing necessary resources to assist them. 

Figure 3: National Diabetes Education Program. (2013).  National Diabetes Month 2013.  Retrieved from http://ndep.nih.gov/partners-community-organization/national-diabetes-month/2013.aspx.

Additional Resources

Link 1: American Diabetes Association: 8 Tips for Caregivers http://www.diabetes.org/living-with-diabetes/recently-diagnosed/8-tips-for-caregivers.html?loc=lwd-slabnav

Link 2: Group Health: Tips for Family and Friends http://www.ghc.org/healthAndWellness/?item=/common/healthAndWellness/conditions/diabetes/familyAndSupport.html

References

American Association of Diabetes Educators (2010).  American Association of Diabetes

Educators guidelines for the practice of diabetes self-management education and training [PDF]. Retrieved from http://www.diabeteseducator.org/export/sites/aade /_resources/pdf/research/Guidelines_Final_2_1_11.pdf.

Chlebowy, D. & Garvin, B. (2006).  Social support, self-efficacy, and outcome

expectations: Impact on self-care behaviors and glycemic control in Caucasians and African American adults with type 2 diabetes.  The Diabetes Educator, 32(5), 777-786.  http://dx.doi.org/10.1177/0145721706291760.

Fitzgerald, R. (2012). Lower extremity amputation prevention. Podiatry Management,

31(5), 187-191.

Miller, J., Salloum, M., Button, A., Giovinco, N., & Armstrong, D. (2014).  How can I

maintain my patient with diabetes and history of foot ulcer in remission?  The International Journal of Lower Extremity Wounds, 13(4), 371-377. http://dx.doi.org/10.1177/1534734614545874.

Scarton, L., Bakas, T., Miller, W., Poe, G., & Huber, L. (2014).  Needs and concerns of

family caregivers of persons with type 2 diabetes: An integrated review of cross-cultural literature with implications for the American Indian population.  The Diabetes Educator, 40(4), 444-452.  http://dx.doi.org/10.117/0145721714529831.

Stopford, R., Winkley, K., & Ismail, K. (2013).  Social support and glycemic control in

type 2 diabetes: A systematic review of observational studies.  Patient Education and Counseling, 93(3), 549-558.  http://dx.doi.org/10.1016/j.pec.2013.08.016.