My husband has early stage dementia and diabetes-a tough combination. Any suggestions?

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Dear all, He has been an athlete all his life, never overweight, etc. and has trouble believing he has diabetes, to which he has just lost a toe. I am still working full-time. He is having trouble remembering to test his blood sugar and take his insulin. I have recently hired a part-time helper but if neither of us is here, he often neglects to check. I have tried all sorts of reminders, ie posting notes, setting cell phone alerts, etc. Have any of you out there had similar experiences? I welcome all your suggestions and thoughts.
Thank you.

Answers 1 to 10 of 13
Top Answer
Have you tried calling him whenever something needs to be done. Have you talked to his diabetes team and asked if he counld have an insulin pump or use a long acting Insulin and do all the finger sticks when you are around. Soon he won't be able to reliably give himself the correct dose of Insulin or interpret the rseults of the finger sticks.
Freestyle Libre is a new flash monitor on the market. A new sensor can be put in the arm every 10 days. The sensor is then scanned with the monitor, just like a store barcode, mostly eliminating finger sticks. Anyone can scan the sensor. Please read up on the Medtronic 670G insulin pump and continuous glucose monitoring system as well.
I agree with IASCG123456 above. Through no fault of his own, he can't be counted upon to perform the tests reliably and there will be a day when he just can't remember how. If you or another person can't be there to ensure he's tested and provide his own insulin regularly, if it's possible to automate the process the better for his health.
Would he at this point be a candidate for the Pump?
I think you can link that to your phone so you can check even if you are not at home.
I realize surgery for someone with dementia is risky but so is uncontrolled blood sugar.
Since he has dementia and doesn't believe that he also has diabetes (even though he could look down and see one digit missing on his foot), this is almost to be classified as a medical emergency. Thinking logically, if he doesn't know when to test his blood sugar, that could result in even more horrific dead skin tissue. His doctor should be made aware of this.
I agree that relying on him to be in charge of his blood sugar levels, insulin or medication, is very risky. Is he a Type I or II? Whether he's taking pills or insulin, you have to be alert and informed to know how to react in case of low blood sugar. It can happen with either type of treatment.

 I'm a Type I and it is very challenging to monitor blood sugars, adjust for lows or highs, etc. EVEN for an educated, alert person, it's a huge deal. I'd try to find a good Endocrinologist and/or Certified Diabetes Educator to consult with for advice on what is feasible. Keeping in mind that a person with dementia may not be relied upon to manage their care.

You can inquire about a Continuous Glucose Monitor, but, even though they are great, (I have one and love it) they are also a lot of work. You have to know how to monitor it, calibrate, interpret the information, check manually when there's a low, etc Plus, you wear it under the skin on your body. A person with dementia would have to keep up with the receiver and they could pull out the sensor. I can't imagine how a person with cognitive decline would manage it. But, you can discuss it with his doctor.

I would have someone personally supervise him until you get things straight though, for safety reasons. It's not just reminders that don't seem to work, based on my experience with my LO, but, they cannot process the information, even if they do read it.  
My mom is now in AL with staff that supervise her adminstration for proper dose. We played around with timing and found that before lunch or late in the day still worked for Lantus. Have you thought about trying to help him administer when you get home from work?
There really isn't a clear answer for you. It's a damned if you do, damned if you don't.

My Mother has dementia and is also diabetic. My older sister 'sleeps' at her house and convinces the people that need to know, that she is both Mom's and our step-father's 24/7 caregiver (hard to do if one is working a night shift, leaves at 12:00 in the afternoon and returns around 11:00 pm).

I went home to AZ because Mom had spent almost the entire month of December last year (caused by an extremely bad UTI which my sister would not recognize as the cause). Mom had been convinced that I was the reason for her lengthy stay by my sister (we live in TX). When I arrived unannounced (Mom knew I was coming, sister did not) Mom was in the hospital...again; reason: the UTI had returned and NOW my sister recognized it as a problem. Sister was also extremely peeved that I had shown up without anyone having told her...duh!!

I called our daughter (moved to TX from AZ to be near us) who is a registered nurse and told her about this surprise hospital stay for Mom. Daughter said, mom I told you that this was and will be a continuing issue for grandma and D***** won't accept it. Being that grandma has dementia and is diabetic, this will never ever go away but only make things worse. Her kidneys will start to shut down, then the liver until everything is gone.

Those of us with common sense and have the medical personnel talk in layman terms, are surprised that Mom is still alive this December, thrilled that she is, but surprised at the same time.

Calling your husband to make sure that he has checked his blood sugar or taken his insulin really isn't going to do any more than what is being done now. How does a phone call insure that your husband has done what he was asked to do? I know my sister calls during her 'breaks' at work to supposedly make sure that Mom tests/insulin. Where are the assurances here, especially since our step-father has Alzheimer's.

My sister was all for my paying for in-home care until she finally understood that it would only be 3 evenings a week after she left for work and just prior to her coming home; meaning that my sister would still need to take care of Mom including the weekends that she felt she deserved to enjoy with her kids/grandkids. The person would be certified in every area needed and also help with some house cleaning, take to the doctor if needed, EMT training etc. I got Mom agree to this, but my sister nixed it because of the above.

I don't know what my sister is doing other than trying to take advantage of Mom by having her sign legal documents without Mom understanding what she is signing. I know she isn't at home taking care of Mom because she and her daughters post EVERY THING on FaceBook (I check the family index periodically to see what they're doing and they won't know that I've seen it. Using for legally action).

It's hard, but you can't control what you can't see. I can't see how Mom looks medically or even my step-father; I can only read postings here and research every thing that I possibly can so I can hold my sister accountable for anything that happens to Mom or step-father that she should have been in control to stop from happening.

The condition your husband has is greater with women. Moms can be extremely stubborn as they were responsible for the family, including their husbands.

If you have neighbors who are willing to just checkup on him on the days that neither you or the in-care giver are there. This will also provide him with company which will help with the dementia issue. They will be able to tell you what has been going on with him i.e. attitude, memory etc.

Don't be afraid to ask for help from friends and family. If neighbors were willing to watch your home while you were on vacation, I am willing to bet that they will help you with this issue too.

Don't take all of this on your shoulders. Talk with your doctor too. It maybe time to consider an in-care facility or the doctor writing a letter so that Medicare will have to provide in-home care everyday. I wanted to do this, but again, the sister issue. Look into the Medicare benefits and what you would need to do to get help from the government on this. You're required to have Medicare at 65, you paid for it during your life working; use them as much as you can.

A pump is not the answer for someone with dementia. You may not be able to have tight blood glucose control at this point. I would check on Tresiba for his basal insulin. It is truly once a day and there is some flexibility in timing. You can decide the most convenient time of the day to take it and even then you have a few hours wiggle room around that time. If he has type 2 diabetes he may be able to control his after meal blood sugars with a glp 1 RA such as Victoza. There is not as great of a need to test blood glucose at mealtimes as with a fast acting mealtime insulin. You could give him both shots in the morning or evening and be doe with it. There is also a combo of these two meds, but not usually covered by Medicare. See an endocrinologist and a certifies diabetes educator
Thank you all so much for your replies to my question-so helpful.

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