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Nowadays, the spread of diabetes across the globe is on the march. Sitting lifestyle, obesity, and the aging of the population contribute to this health problem. While there is no cure for diabetes, methods to improve patients quality of life have been elaborated and implemented. However, in cases when a patient has diabetes and dementia simultaneously, it may be difficult for them to do all the necessary procedures. Healthcare services should provide additional care to such patients. This paper hypothesizes that a patient-centered strategy should be implemented to promote health in patients with diabetes and dementia.
First of all, it is necessary to determine the significance of health problems to health status. To do this, the implications of age, gender, and ethnicity should be thoroughly considered. Research shows that Afro-Americans and Latinos are most at risk of developing diabetes of the second type (Marseglia et al., 2019). The risk indicators are slightly lower for American Indians and Alaska natives though both these groups have a higher predisposition to diabetes than white people. Gender does not play a significant role in disease development: both men and women have an equal chance of getting the disease. With age, the predisposition to diabetes grows, and older people are more likely to suffer from diabetes.
It has been established that diabetes may provoke the development of dementia in older age groups. The incidence of dementia in diabetes-related groups is 50% higher than in people who do not suffer from the disease. Dementia is an age-related disease that is predominant in the women population. Studies show that ethnic factors do not play any role in dementia development. The mortality rate of patients with dementia and diabetes varies depending on their care. The cost of care is relatively high since these patients need day-to daycare provided by nurses and other health specialists. The population of focus for this study will be Afro-American women aged between sixty and ninety who have diabetes of the second type and dementia or are likely to develop dementia in the future. The geographical area where prevention strategies will be implemented will be Georgia since this state has a high percent of the Afro-American population.
Health teaching principles lie at the core of the successful implementation of any strategy. First of all, the readiness to learn should be measured. By asking questions about the patients view on the health problem and possible ways that they may take to improve their quality of life, one can assess the patients readiness to learn. There are several stages through which a patient changes his behavior, from ignorance of the problem to establishing healthy habits and changing their lifestyle (Marseglia et al., 2019). In adults, readiness to learn is closely associated with the developmental task of ones social role.
Subject prevalence is an essential factor in promoting adult learners motivation. Adults do not usually learn for the knowledges sake but want to see the practical results of their activity. It is especially true for patients with dementia whose ultimate goal is to take as much control of their life as they can. Initial simple tasks with practical application that allow patients to feel that they succeed can motivate further learning activity.
Reading level of patients with dementia is crucial in the learning process since it is essential to provide learning materials that people can understand. Dementia often leads to dissociation and memory gaps, so reading materials should be adapted to the understanding level of the patients. To access the reading level, healthcare workers may ask patients to read some article or brochure and then ask questions on the articles content. Learner engagement is another factor that influences the success of the teaching process. Patients with dementia get better learning results when they are interested and motivated. Irresponsive and passive learners are unlikely to significantly improve their quality of life.
The most effective approach to teaching patients with diabetes and dementia is a person-centered approach to care planning. Bunn et al. (2017) state that patient priorities [must be] at the forefront of therapy, while medical considerations should serve as a background. Indeed, independence and patient and carer priorities come to the fore, as they allow the patients to see the learning process results and improve their quality of life. Nevertheless, the minimum requirements of good diabetic control must be implemented (Bunn, 2017). The education content would be centered around life skills, such as taking care of ones needs or interests. For example, washing the dishes or watering the plants may be beneficial for dementia patients. In the cognitive sphere, doing simple arithmetic could be a good example.
The timeframe for such activities would necessitate several weekly visits by healthcare workers. Later, when the learning process transforms into habits, the number of visits could be reduced. The education will take place either at patients homes if they have difficulty getting to social centers or at social centers. The teaching would go in the form of practical skills education combined with mental training.
Learning success would largely depend on cultural variables such as culture, socio-economic circumstances, and family surroundings. Cultural variables should be taken into consideration when planning education processes as cultural implications may prevent people from doing certain things. Thus, women may refuse to wash the dishes or floor if they had a housekeeper who did it for them all their life. Poor socio-economic circumstances may prevent people from getting necessary medication. Healthcare workers must see to it that the insurance covers all medicines for this group of patients. Family support means a lot for patients with dementia and would broadly impact learning results.
References
Bunn, F., Goodman, C., Reece Jones, P., Russell, B., Trivedi, D., Sinclair, A., Bayer, A., Rait, G., Rycroft-Malone, J., & Burton, C. (2017). What works for whom in the management of diabetes in people living with dementia: a realist review. BMC Medicine, 15(1).
Marseglia, A., Wang, H. X., Rizzuto, D., Fratiglioni, L., & Xu, W. (2019). Participating in mental, social, and physical leisure activities and having a rich social network reduce the incidence of diabetes-related dementia in a cohort of Swedish older adults. Diabetes Care, 42(2), 232-239.
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