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She has been diabetic for years, has survived 2 bouts with breast cancer, has osteoporosis, and refuses to take insulin shots even though the pills and her diet are not working the best for controlling her A1C. She does not drive and I get her groceries, which I am partially to blame for her not eating well when I get her ice cream now and then. She is not very mobile, uses walker most times, and it seems like I am working my best to keep her going when she seems like that "when the good Lord is ready he will take me no matter if I take shots or not". Now that she has some mild retinopothy starting, she now has to see a specialist. who knows what he going to suggest and to top it off, I have a brother 1/2 hour away, retired and seems more interested in his 2 day volunteer work than coming up and helping with relieving some of my (and hubby) stress. Not to mention that our dad is in nursing home with dementia for the last 5 years and brother has only seen him 2 times, but I take mom in every week. I feel like I am getting burned out some days that I could scream, but have cried several times. just need to vent.

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In the case of my Uncle who would never admit to diabetes, he wound up being dismembered because of the infections in his legs. Toes first, then foot and legs and still he would not comply. Ate everything that was wrong, biscuits and gravy, pringles by the can daily, sweet rolls, you name it. and he died a miserable death.
reducing the intake of carbs helps a lot.
I am a type two diabetic have lived a low carb life for several years now and so far I am doing great. A1c less than 6.
The ADA is now recommending lowering the carbs intake to help control BG levels.
I have reduced my intake of all grains and root vegetables. I feel pretty good for a 72 year old Old Sailor.
Moderate intake of certain fats helped also.
Best of luck.
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Could it be possible for you to ask the Elder attorney or paralegal to write up a POA for mom and dad, and perhaps a living trust? Moving 2 people into the same facility helped me a lot. The stress went down. my friend moved her mom &step dad into the same facility that he FIL lives in. one stop shop for all 3. Sounds very nice. But is this facility closer to you? I hope so. That's my main concern: I want everyone t be within a 4 mile radius. NOpe, my kid won't.. Off to college, but close enough where I think I can get here to come back a couple weekends.. naa, she's happy there. Keep Venting. Any fun stories about mom and dad visiting? I brother was diagnosed with a strange brain disease, early onset Alz disease.. The first time I saw him, they were starting lunch, my plate had chips on it. His eyes go wide, and he got excited, and told me to turn around, LOOK points into a direction away from my plate. I played into it, I turned around and heard the biggest laugh, smiling from ear to ear. Yup, he alwys did that when we were younger. We just laughed...God I miss him.I tried sneaking up on him one day, he flew when I yelled/screamed at him. I was his kid sister. How many brothers do yo know who would let their lil sister hang out with him and his friends? I was part of the pack, most of the time.
One summer, we went cliff climbing with our friends. brother found a "path" if you can call it that... and we started climbing. Half way up, and I looked down.. Not a good thing to do. I froze. started at a large rock, and it looked like somone gutted a fish or something. When he go to the top and looked at me, he knew I was frozen..I couldn't back track either... He actually came down another way, grabbed my hand all the up the cliffs. Then the news: I was not allowed to go cliff climbing with him any more... I agreed.

anyway, about your problem,,, Give them what they want make them happy,go to the library and look for cookbooks for diabetes.

take he to adult day care once a week. wheelchair dancc, play ball, just tossing the ball around, and may hav them say a list of flowers as they are tossing, or the days of the week, etc. Keep her thinking.
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wolflover451 Feb 16, 2020
actually both my brother and I are POA for both parents. and the NH where my father is, is only about 12 minutes away so that is not the problem.  My mother does not cook anymore, other than just heating stuff up in microwave and at this point I am not investing in cooking diabetic meals separately for her and then a whole different meal for us.  I already watch what I give her as extra meals for her.  Its just that I think at this point she has had diabetes for so long that the pills are no longer working as well as they should be.  She has no desire to go to a senior center, and again........I am the one doing all the running.  I am trying not to sound selfish but after awhile its get tiring to run here, run there, get this, get that. I send for stuff she thinks will help her with the pain in her knee, (which it didn't), I got her some diabetic socks thru an online diabetic place (has no seams), she looked at them at first and just sighed. but she has been wearing them.  I got her something special to sit on because she started developing a "pressure sore", which the lady that washes her says looks good and NOT getting worse, but she didn't like the think I bought.  So without spending tons of more money on stuff that I know she isn't going to like or use, no sense in wasting it.  She likes to put puzzles together which I have just bought 10 more (not counting the 6 she got for Christmas, and an extra 4 that I had on hand)............, she like to work on crossword puzzles.  other than that not much of a hobby person.  So with her eyesight now getting questionable, time will tell after her doctors appt on this Monday to see what is happening and what needs to be done.  thanks for the stories, but we didn't do much when I was growing up. dad was always working and we never went on vacations. I only remember one and that is when I was 14.  we never played games as such.
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At that age, I would not worry about insulin.

high glucose in the blood will not kill quickly, Over the years it causes damage to all the organs, but then, so does insulin resistance. Honestly, it is a toss up which is worse at this point....more insulin to compound the resistance or more blood glucose. I would be willing bet that at 92 with A1C above 9 there is serious levels of calcium built up in the heart and arteries... this can only get worse no matter what you do short of removing all the sugar (carbohydrates) from the diet.

so, I am saying. Don’t worry about it. 92 is a ripe old age.
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Wolf - thank for your update post.
Regarding your brother “being in for a surprise”, please realize he does not have to do squat. If your somehow thinking he will himself do what you’ve been doing on-site daily in moms nearby house & errand runs for years for your mom, well, I bet there’s a better chance I’ll fit back into my size 4 slacks. He likely does not share your perspective on what is best for mom’s situation. Family is not required to do for their parents. If they want to take on the responsibility, that’s their choice, they don’t have to. Even if their named as DPOA, they can ignore it, or formally resign it.

So your brother lives nearby and has committed some of his free time to a volunteer organization, right? he’s sounds socially aware & part of y’all’s community. He’s decided to go with you two to the eye specialist next week, and this is great, he is concerned for his mom. After the visit will be an ideal time to make a informed decision as to what is best for her health safety & security and put a plan in place. If it means mom moves into the same NH dad is already in, move ahead with doing this. Perhaps Bro will take on getting your folks house cleared, made market ready & deal with Realtors. Your 1 house away, you’ll know what’s going on but let him take on that responsibility.

Perhaps I missed this, but how is dads NH stay being paid? private pay? Medicaid? LTC insurance? VA $?. This will make a difference as to house situation, but that’s imo a whole other question.

As an aside, if retinal guy wants a flouresein angiogram done, it is an invasive procedure & can be scary as you get major dilation, you’re fixed into a tight head set, then a set of images done on back of eye, then an IV run with a dye in it and as the dye filters thru there is 2nd set of images which capture where leaks and damages are in the back of your eye & optic nerve from the retinopathy. My dad, who was quite the wag, called it the annual Clockwork Orange. Images are quite astounding & in a way beautiful. I mention this as you might want to consider to use this as a “cudgel” that if you insist on staying in your home that you are going to have procedures like this regularly (and maybe work in daily insulin shots too) but if you move over where dad is things will stay status quo.

I've got to say, you seem warmly open to what folks have suggested you on this site. I’ve been on AC quite a while, and that’s not often the case.... like folks posting are often flat hostile to suggestions. Kudos to you! & good luck with brother & mom. Let us know how eye visit goes.
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wolflover451 Feb 14, 2020
actually my brother lives only 1/2 hour away and volunteer 15 min from his house.  Dad has been in NH  since 2014 with dementia. it is being paid by Medicaid.  The house is in mom's name and the paralegal said they can help with a one time savings of her money. I don't know all the legal stuff but they are very good.  Yes I told my brother that we will have to sit down after the eye appt and discuss what options for the future we want to do.  I will keep posted probably on Monday sometime as how things go. I am sure that a lot of the cleaning of "junk" will be done by me/hubby, but the major stuff by both brother/myself.  And being that I am in this state and my brother in another, I already know a good realtor that I would select to sell my mothers house.  thanks for listening and everyone's suggestions, etc.
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Wolf - regarding “retinopathy just showed up... being caught early”, that is not accurate.

Diabetes as affects your eyes is asymptomatic; there’s no pain.
If retinopathy obvious, it has taken 20-25 years to be at this point.
It did NOT just start. Your mom at 92 has had diabetes couple of decades; her retinopathy is a side effect of diabetes.

How it gets detected as to type & extent is by a fundus examination of a dialated eye by an ENT or ophthalmologist. Often even with dialation the degree of retinopathy damage isn’t obvious; & that’s why her doc is wanting her to see a specialist. It will likely be a ophthalmologist who is retinal specialist. The usual is eye dialation fundus exam, fundus photography and flourescein angiogram. This lets doc determine if NPDR or PDR type of retinopathy.

My understanding is there is NO CURE for retinopathy. It’s not like glaucoma which has very good eye drops drugs which regulate the pressure causing the glaucoma, so keeps glaucoma totally manageable if caught early & drops done exactly as prescribed.
For retinopathy, treatment is laser surgery (to weld burst vessels), corticosteroid or A-VEGF shots to the eye, or vitrectomy (they remove some of the liquid that has the blood or “cotton” floaters).
Treatment does not stop it, just manage it better. If I had to guess, the issue will be that at age 92 with no diabetes lifestyle & A1C stability already in place (so she noncompliant for care), your mom won’t be a good candidate for having any of these done.

My dad was type 2 diabetic & saw a retinal specialist annually last 20 years of his life. He even brought home photos pulled from the angiogram that showed burst pattern on leak he had. He had a vitrectomy to get the blood balls out. Home for like 3 weeks, with no bending, no looking for stuff under the bed, on stool softeners. Then went back to work but my mom had to drive him to the lab for weeks. Dad was strict on his diet & meds, so his was mild. Diabetes over time leads to retinopathy for like 80% of diabetics. I think it’s the main cause of blindness for those under 65 in the US.
My hubs had retinal tear 5 years ago and had 2 laser surgeries abt 4 mos apart to basically spot weld the tear. He had sudden flashes of light & curtain in his vision, just lucky only a tear & not detachment. Saw retinal guy within couple of days of flash & surgery like day later. Post surgery hubs home a week, upright 24/7 & no screen time, then nothing strenuous for a month but back at his office. Hubs has had no issues since but sees regular ophthalmologist annually & retinal guy every 2 years & will till forever. Retinal work is not like out patient cataract day surgery, where your pretty ok in a day or so as it’s done now.
My point in all this is anything retina is going to require lots of compliance on your moms part and someone there for 24/7 oversight on her perhaps for weeks. Weeks....
If your kinda at burn out stage, really have a clear talk with the MD as to what aftercare needed for her & then have a reality check talk with your hubs on all this. Are you totally on your own, up for all this? It sounds like your really on 24/7 call for your mom; can you do this another 1, 2 or more years? She’s just beyond fortunate your like 1 house away. If you didn’t take over meals, take her to appointments, just “do” for her, she could not truly function independently on her own beyond a couple of days.... is that accurate? If so, she’s imo 1 incident away from going back into the NH; not AL as she’s 92, diabetic, actually lots of medication management needed as well as dietary restrictions, plus diabetic retinopathy which means she’s going blind. I know it sounds harsh, but you have to make a decision as to what’s best for her safety, security and health and ditto on yours as well.

Really, if you got hit by a bus manana, what then?
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wolflover451 Feb 13, 2020
my mother has seen a regular eye doctor for years and this is the first time anything showed up.  I know IF I didn't get her meals she would starve over time cause she hasn't driven in 2 years so no way for her to get food, and when I did get her "meals on wheels" that was fine for 3 months, then she said it was too much food.  which I know was a bunch of bologna cause when we go out for meals, she eats more than what they gave her. I think she just didn't want them coming to the house anymore, so I cancelled that.  I know and I have told her today that  the problem is that what she has is not going to get better and eventually if not handled properly she will go blind.  then she gets frustrated (so to speak) and says, well, I only watch the cats across the road anyhow. I said well better to see that than to be blind 24/7 365.  I know she gets frustrated with not being able to do a lot of things without having aches/pains due to the osteoporosis and just being old I guess.    I guess if I got hit by a bus, my brother would be in for a big surprise.  I don't try to burden my children with my venting cause I don't feel its their responsibility either, but glad that I have this site to ask questions and see other peoples issues.  In fact it was on this site that I found out about an Elder Attorney.  thanks for your input.
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If she is competent, it may be that she just gets to make her own decision on diabetes care. I suppose it depends on just how aggressive you want to be with blood sugar control. It's all about the risk vs. benefits.

Those may vary depending on the patient, age, health status and lifestyle. I'd meet with an endocrinologist and certified diabetes educator before making a decision on insulin. It makes a huge impact on potential lows. With insulin on board, you really do need someone around to monitor drops. Even though I am very experienced with using insulin, now by pump, it's still a risky thing and you need all kinds of training and backup plans. I know a lot of experienced insulin users family members who have to call 911 because they went too low and passed out. Once, again, it's a risk benefit analysis.
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She is still competent. A social worker once told me that every person is free to screw up their own lives as they see fit. To add one more...no one can take advantage of you without your permission.
I doubt that you can get guardianship at this point. One day she will become blind and then will need to hire someone or go into a nursing home. She may have to skip the assisted living part.
Please do not enable her. Groceries are fine if you are OK with it. Just remember that things wil get worse. Step back so that she hits her own rock bottom. Your interference will just waste your time and prolong reaching that bottom. Speak to your brother and decide what are your end points to help. Also accept if one or the other wants to stop this craziness.
Sure you care for her but she already has shut out your nagging and pleading plus her doctors recommendations
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wolflover451 Feb 13, 2020
well my brother decided to go along when we see this specialist on the 17th, so I guess we will see what the outcome is and what is going to happen.  I would say that she could go into the NH (and if they have the room they said they would take her), and she would want to go to the one where my father is.  she has already said that.  So I guess my brother, myself and mom will have to have a discussion about the future plans for this coming year.  I already figured she would be in a NH by next year just because of moving slower (with the osteo), and other things.  I know its hard for people to give up their independence (even though she had no problem giving up driving).  its just the fact that you (in general) don't want to leave your home that you worked hard for.
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I don't know if this is a good idea or not, but could you tell her that if she does not get the shots then she will need to go into assisted living? I am also assuming that she will have to have someone give her the shots. Stress to her that she can decide between the 2 scenarios. Let her know that if she is not getting the shots, her decline is not something that you can manage, so she would have to go into AL. I don't know if it is an option financially for you.
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JoAnn29 Feb 12, 2020
She can refuse the shots in the AL and LTC. By law, they can't force a resident even those suffering from a Dementia.
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My father didn't want to do the shots, he said No for years, finally he conceded, I was against this from the get go. His body started breaking down and in died six months after starting the shots. He was old, there was no reason for this,

I agree with your mother, she is old, leave her be, if she says no, accept her decision, it is her life.
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wolflover451 Feb 13, 2020
sorry to hear about your dad and yes, we are all responsible for our own decisions and I know my mother will probably still refuse the shots and honestly I don't know IF I can do the shots and monitor her several times a day.  At that point she would have to either have someone come in every day to give shots (which she won't want to happen) or go into the NH where she will have the 24/7 care (if that's what it turns out to be).  She knows quite a few of the people in there, both patients and the nursing staff so she would have more people to talk to other than ME.
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Who's going to do the shots?

The reason I ask is that if it's a visiting nurse, that person will probably be the best person to talk your mother round and explain the routine for her. Specialist diabetes nurses know the subject inside-out and upside-down and have seen it all, from schoolkids who are already expert self-care managers to older men who are facing amputation and yet still chow down six donuts for breakfast. Does your mother have a needle phobia or anything like that? - same again, an experienced nurse will be able to help overcome it.

The Lord will indeed take every one of us in His own good time, but that's no reason to hurry Him along.
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wolflover451 Feb 11, 2020
My mother does not have a needle phobia, she just says she doesn't want to do shots.  She does live alone and we are only 1 house away from her.  I take food up to her when we have our dinners but she also has tv dinners as a "back up" if needed, but I try to get ones that are low carbs and low sodium (which is hard to do sometimes).  She gets around okay and she does take her pills.  I told her that yes when her time comes it will be but don't make yourself miserable in the meantime.  I guess my heart is on my sleeve (like people say), cause I care too much but it seems that no one else does.
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It sounds like you're doing a lot of work for her. Is she mentally competent? How do you know that she's taking her pills? Some people don't make taking their medication a priority. Who would give her shots if she is prescribed them? It may be that she's just not able to live alone anymore. This is especially true if she starts with insulin.

I am a Type I diabetic and I know the complete diligence that is involved when taking insulin. When you take insulin, you really do need to do regular daily finger sticks to monitor blood sugar. Also, it may be that she is just needing more help with her insulin due to time. I've heard doctors say that people with Type 2 diabetes, often need more help, like shots, over the years. They don't know why, but, you can be doing everything right and still need to go to shots years into the diabetes.

If she's mentally competent, I'd just provide her with the information and options. It's really her choice. And, if she's not competent, I'd discuss it with her doctor and seek legal advice on the options. Could they increase her pills and/or add another pill hire a medication aid? I'd ask about the ONCE weekly injections.
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Serenity61 Feb 11, 2020
I second everything said here!
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Wolf, what is the plan for moms future???

so right now her hubs is in a NH but she’s 92 & living in her home / apt on her own & kinda semi-independently as you do oodles of stuff for her? And her diabetes meds are just pills? That’s it, right?

if so I’d be somewhat cautious about having her move to shots & for a couple of reasons:
- just who is going to do this? and monitor her diabetes on clockwork like schedule for first couple of months after injections start?
BUT more importantly what it means for her future...
Why? Is cause eventually she will get beyond being able to live at home & needing to go into a facility; and facilities could view a resident requiring daily injections to be speciality care and will NOT take them in. Injections may not be standard medication management.

I’d suggest that you clearly ask at dads current NH, if they take new residents coming in & already on daily insulin injections. Not already being there and then get worse & have to transition to injections. But coming in on daily shots. If this NH won’t take in new residents on daily insulin injections, it’s probably going to be very difficult to find one that will. What then..... like dad in NH 1 & mom in a whole different one perhaps much farther away?

if she’s constantly having A1C yo-yo’s, there's gonna be a medical crisis. 92 with uncontrolled diabetes and diabetic retinopathy, things are not gonna get better. What’s her field of vision like? How close is she to being able to be considered legally blind? What are her extremities like? Numbness or foot issues? Has she had bad missteps or falls?

has any serious thought been given to having her move into the same NH that her hubs already is in? & doing this now while she’s still kinda ok visually & just on pills for her medication management. It kinda sounds like you are approaching burnout.
What’s the reasons why she’s not already where dad is?

My mil was legally blind & finding care was a challenge, my dad was adult onset diabetic that too was a challenge, he big timed changed his diet to avoid being injections dependent as it for him would have limited what he could do for work & his health... like even for something routine like getting dental work done.
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wolflover451 Feb 11, 2020
Well her plan is to stay at home as long as she can physically.  She does NOT use the stove/oven, only the microwave.  I provide her extra food from what hubby and I have, and we live only 1 house away from her.  I already talked to the NH where our dad is located and they said that IF they had a room available when her time came, they would take her.  She was there back in 2018 for 3 months because she had fallen and hit her head, then broke her arm, so she had to do rehab.  She likes the people there and they are good to my dad, so she said that is where she would want to go.   Personally I don't know if she would give herself the shot so that means it would fall back on me for that and with other things going on in our daily life I don't know if I could handle having to do yet another chore.  Her vision is good, only needing reading glasses. her eye doctor just wants the specialist to look at her since this retinopothy just showed up and being caught early.  I am hoping that the thought of maybe going blind IF she doesn't start eating better will wake her up.  She does NOT drive, that ended in 2018.  I have someone come bath her 2 times a week just because she doesn't feel safe getting in the shower by herself.  I pretty much take her to get her hair done and any other doctors appts.  I am just getting tired of having to make her appts, and making me/hubby appts, keeping calendars all updated, etc.  The one doctor was going to have her go on another diabetic pill but it would have cost $300 and that was after insurance paid the other part.  she said no way.  and all the pills they suggested were $300 or $400 and that was for just 30 pills.
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A social worker once told me “Let them live until they die”, which means to me, allow them to live their life as they choose.

However, this causes an additional burden on you. You will have to deal with the decline, more doctor’s appointments, more caregiving. Plus, the frustration.

One time I got my mom to do something because I lied. If you don’t get up, insurance won’t pay for any of this. She just had her knee replaced and refused PT. She got up right away.

Refusing to roll with the flow and medical suggestions could be an indication of hanging on to those last morsels or independence.

After YEARS of caregiving for my now deceased father and mother in a nursing home, I learned what I term as “Senior Anger Management”. In other words, dealing with you senior parents. Lashing out pushes them away. Being insistent does the same.

Know the psychology of your loved one and find a way to let them make their own decision. Consider a Plan B if this doesn’t work. My mom doesn’t listen to me but she does anything my husband says. Does your mom have a favorite family member?

I am not a medical person and this is all my opinion based on my own experiences.
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wolflover451 Feb 11, 2020
I have told her in the past that she has to keep an eye on her sugars because even if she doesn't feel any different from the high to the low, it is still doing damage inside her body.  So maybe this new upset with her eye (knowing she could go blind if not treated) will wake her up.  I know she is 92, she likes to sit and work on puzzles, watch tv so her amount of walking around is minimal cause she hurts with the arthritis.  which I also told her that the more she moves around the better it will feel (maybe not at first).  There is only my brother and myself.  And my husband is an "introvert" so he don't say much, comforting to me and I can't see him saying anything to my mom about doing things better.  He just says she is 92 and we have to realize that she is getting older.  duh........yeah like I don't know that.  He is a good man, does a lot of stuff up at her house, more than my brother.  So I guess I will have to go with the flow for now and see what comes out of her new eye doctor appt on the 17th.  time will tell.
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