Very worried son

[Adamgross80]

The title is me. I am not a diabetic. My dad is. He has type 2 diabetes. He is 72 years old and lives on his own. He has a relatively inactive lifestyle and is very set in his ways. Over the last year, his diabetes management has become out of control. His HbA1C was 106 in October 2017. Over the year, perhaps because of his diabetes, we have seen a rapid decline of his well being. He struggles to walk (gait apraxia), suffers from memory loss, and is despondent and depressed. He has no motivation or interest, it seems, to improve.

Shortly after hearing about the 106 reading, we purchased Dexcom. Initially this helped, and after making a few changes we think he may be at optimal insulin dose for him which is:

HUMULIN M3

30 UNITS morning
20 UNITS evening.

About 3 weeks ago, the Dexcom gave an estimated HbA1C of around 76 which is a vast improvement. He is also on Trulicity and Metformin in addition to insulin.

However 1.5 weeks ago, Dexcom stopped working. My dad said last night that he has no intention of using it again. He is slowly slipping to his former self from October 2017; and I have no way of checking whether he is doing what he should be doing or at the right times. E.g. on a random visit to his flat we discovered he had enough insulin for the day but did not remember (or think to remember) to place a new order on his repeat prescription. We managed to get another pen at very short notice. Otherwise it would have meant 4 days without any insulin.

Moving forward, I know I need to get Dexcom back up and running, despite my dad's protest. Thereafter, I believe our options are as follows:

1. Obtain psychological support as his management has been a huge strain for me and other family members and he gets very despondent a lot of the time (with difficulty is getting him to engage).

2. His diet needs massively improving to reduce the glucose peaks on Humulin regime. He almost certainly doesn't have the intelligence/willpower/motivation to go onto a Lantus/3x daily Actrapid regime. And even with the various excellent diet plans available, what my dad should eat and what he does are 2 different things. The latter may be a struggle (which is where psychologist might come in handy?).

3. Finger prick testing - he still needs to do this twice daily (to calibrate Dexcom) but he is still having difficulty doing this meaning multiple attempts each time and disengagement as his fingers are so sore.

If anyone has any thoughts/recommendations on the above or even alternative suggestions, it would be enormously appreciated. Whilst I feel we have made a vast improvement, my dad seems very unwilling or unable to improve. It is a huge battle and I feel we are still too far away from sound diabetes control. If things do not improve quickly, I fear something critical will happen soon.

Many thanks for taking the time to read this and for any recommendations you might be able to make.

Adam

 

[wiflib]

Don't battle with your Dad, it does no good at all. My siblings and I tried our very hardest to help my Dad but he just didn't want it, all he wanted was to do his thing, listen to our inane chatter and cuddle grandchildren. It took 30 years of diabetes to kill him and along the way he accepted ONLY the things he could not do himself. Just be there, enjoy his company and nudge him along when he needs it.
My Dad tried to die several times (not of his own hand I hasten to add) but was resuscitated at least three times, he was bloody tough! But he wanted to die, he told me that several times and made me promise not to try to resuscitate him if he was with me when it happened.

All of my peer group with elderly parents have said exactly the same thing; they resent people interfering and just want to get on with their lives.

 

[Kittycat_7_]

Hi Adam,
Your dad might be depressed, in which case he needs to see his dr.
Please don't give up, you could get his local pharmacy to deliver his meds every two months.
It's hard having diabetes, however it can be managed. He is young still really at 72.
I know your not battling with him and care for him.
Counselling might help the family.
Great ideas you have about caring for him.
The forum can support you.
Ask any questions you like.
Finger prick testing, what depth is he using on his device? Does he change the lancet regularly?
Take care

 

[EllieM]

He almost certainly doesn't have the intelligence/willpower/motivation to go onto a Lantus/3x daily Actrapid regime.

It could well be depression, it could also be the beginnings of dementia. If the latter it's not going to get any easier for him unfortunately and you won't be able to ask or expect him to change his ways.
Have you considered a freestyle libre? If he's one of those for whom it works well then it might be easier....
Good luck.

 

[Adamgross80]

Thank you all for your comments - the support on this network is amazing.

I have no doubt he is depressed. We're going to ask to be referred for a psychological assessment. Additionally, I think working in a local charity shop could help, if he's willing to do this. He used to love the interaction with customers as a retail sales agent before he retired; and it will make him more active again.

I had been looking into Freestyle Libre. Great idea. I need to check with my dad if he wants this and also whether having 2 sensors (i.e. Dexcom and Freestyle Libre) would work.

Thank you again for the comments. I am new to this site and so comforted at how willing people are to help.

Adam

 

[NewTD2]

Thank you all for your comments - the support on this network is amazing.

I have no doubt he is depressed. We're going to ask to be referred for a psychological assessment. Additionally, I think working in a local charity shop could help, if he's willing to do this. He used to love the interaction with customers as a retail sales agent before he retired; and it will make him more active again.

I had been looking into Freestyle Libre. Great idea. I need to check with my dad if he wants this and also whether having 2 sensors (i.e. Dexcom and Freestyle Libre) would work.

Thank you again for the comments. I am new to this site and so comforted at how willing people are to help.

Adam

I would take him in if you can so that you can properly look after and take care of him

 

[Adamgross80]

I would take him in if you can so that you can properly look after and take care of him

If I could, I would!

 

[NewTD2]

If I could, I would!

Or get someone else to look after him full time?

 

[DCUKMod]

Thank you all for your comments - the support on this network is amazing.

I have no doubt he is depressed. We're going to ask to be referred for a psychological assessment. Additionally, I think working in a local charity shop could help, if he's willing to do this. He used to love the interaction with customers as a retail sales agent before he retired; and it will make him more active again.

I had been looking into Freestyle Libre. Great idea. I need to check with my dad if he wants this and also whether having 2 sensors (i.e. Dexcom and Freestyle Libre) would work.

Thank you again for the comments. I am new to this site and so comforted at how willing people are to help.

Adam

Adam - Well done on having a deeply caring relationship with your father, and trying to help him improve his lot. May I ask though, why you would want him to have both Dexcom and the Libre? I do understand their differences.

 

[donnellysdogs]

Seriously, I would be asking GP to look at dementia.....
A lot of what you are describing is similar to my mum with her dementia diagnosis.
She wasnt Diabetic but has now recently been given a diagnosis of pre diabetic (which I'm not suprised at, I've asked stepdad for years to get her GP to test her).......

Being older it is going to be difficult to get minds to change....

I would ask GP to test for ddmentia and a minimum of a Mri scan as well. And do before buying any more dexcom etc... if it is dementia then you will need to re evaluate what steps to take to care for your dad..

 

[ixi1429]

@Adamgross80
Hi,

I have the same issue with my Dad. He's a typical northern bloke of a certain age(77) and has a lot of medical issues - high BP, joints, heart attack last year and Type 2. He lives on his own but a lot of his brothers, sisters , nephews nieces etc. live very close so has a support network which he won't use ! (arrghh)

He h as a pretty good diet but not for a T2 - everything is fresh -, fish 2/3 times a week, meat and vegetables including the potatoes and he eats 2 Weetabix with Bananas. He has sandwiches and biscuits, has sugar in his tea and so on. Since being diagnosed I have a greater understanding and I have tried to help him but my dad thinks he is doing the right thing. I am trying to be sneaky by using my son (12yrs old) who my dad loves to bits to convert him away form Weetabix.

I unfortunately don't have an answer for you but I thought it would be good to let you know you are not the only one and I have the same issue. Undoubtedly there are many others - Bloody Old Folk

 

[Adamgross80]

Adam - Well done on having a deeply caring relationship with your father, and trying to help him improve his lot. May I ask though, why you would want him to have both Dexcom and the Libre? I do understand their differences.

Thanks for the message. Good question. Dexcom enables me and other family members to monitor his glucose levels. Libre is not, as I understand it, compatible with an iphone (which my dad and other family members have), but has a lesser need to do a finger prick test.

 

[Adamgross80]

Seriously, I would be asking GP to look at dementia.....
A lot of what you are describing is similar to my mum with her dementia diagnosis.
She wasnt Diabetic but has now recently been given a diagnosis of pre diabetic (which I'm not suprised at, I've asked stepdad for years to get her GP to test her).......

Being older it is going to be difficult to get minds to change....

I would ask GP to test for ddmentia and a minimum of a Mri scan as well. And do before buying any more dexcom etc... if it is dementia then you will need to re evaluate what steps to take to care for your dad..

Thanks for the recommendation. We'll ask.

 

[Adamgross80]

@Adamgross80
Hi,

I have the same issue with my Dad. He's a typical northern bloke of a certain age(77) and has a lot of medical issues - high BP, joints, heart attack last year and Type 2. He lives on his own but a lot of his brothers, sisters , nephews nieces etc. live very close so has a support network which he won't use ! (arrghh)

He h as a pretty good diet but not for a T2 - everything is fresh -, fish 2/3 times a week, meat and vegetables including the potatoes and he eats 2 Weetabix with Bananas. He has sandwiches and biscuits, has sugar in his tea and so on. Since being diagnosed I have a greater understanding and I have tried to help him but my dad thinks he is doing the right thing. I am trying to be sneaky by using my son (12yrs old) who my dad loves to bits to convert him away form Weetabix.

I unfortunately don't have an answer for you but I thought it would be good to let you know you are not the only one and I have the same issue. Undoubtedly there are many others - Bloody Old Folk

Thank you for sharing - sorry to hear though. It's not easy.

@Adamgross80
Hi,

I have the same issue with my Dad. He's a typical northern bloke of a certain age(77) and has a lot of medical issues - high BP, joints, heart attack last year and Type 2. He lives on his own but a lot of his brothers, sisters , nephews nieces etc. live very close so has a support network which he won't use ! (arrghh)

He h as a pretty good diet but not for a T2 - everything is fresh -, fish 2/3 times a week, meat and vegetables including the potatoes and he eats 2 Weetabix with Bananas. He has sandwiches and biscuits, has sugar in his tea and so on. Since being diagnosed I have a greater understanding and I have tried to help him but my dad thinks he is doing the right thing. I am trying to be sneaky by using my son (12yrs old) who my dad loves to bits to convert him away form Weetabix.

I unfortunately don't have an answer for you but I thought it would be good to let you know you are not the only one and I have the same issue. Undoubtedly there are many others - Bloody Old Folk

 

[ixi1429]

Hi,

Not a problem. As I said, I don't have a solution but I thought shairng that I have similar issues with "old folks" may help.

david

 

[Grateful]

A couple of times in the past few years I have gone through a similar process with a close, elderly relative: trying to help out someone who is mentally confused and not receptive to being helped with medical issues, and practical ones.

After a lot of angst, I eventually concluded that I am accepting that person's wishes and have ceased any efforts to assist. I may think I know what is "best for them" but have reluctantly concluded that, as long as they are legally compos mentis, elderly family members should be left to their own devices if that is what they wish.

Sorry to say it, but there is also a selfish motivation. The situation was literally driving me crazy (I had to see a shrink for a while, to discuss the immense anger that these situations tend to foment). You have to look after yourself too!

I am sure this is very different from what might have happened in the "old days" of multigenerational families living under the same roof, and different from what happens in other cultures today, but nowadays us Westerners prize "freedom" and "independence" above almost all else.

 

[Jo123]

It is really hard isn't it.
The trouble is when you have someone who does things against medical and your advice and then expects you to pick up the pieces, as is specifically happening with my husband and his mother now. Guilt and duty make him do so, but I have to say at times it's hard.
You've received some great advice here, good luck with your dad.

 

[RosieLKH]

My dad sounds very similar to yours, and the others described on here. He still lives with my mum, who has COPD, so is not well herself, but while she tries her best to manage her health issues, my dad totally ignores his. He rarely modified his eating, except to say he needs a chocolate bar as he is feeling dizzy and suspects a hypo. Honestly, my dad doesn't go 2 hrs without food. I seriously think he couldn't have a hypo.

Dad secretly buys food and eats it (he does all the shopping & cooking), and he can't eat one of something - it has to be 2 giant sausage roll, 3 or 4 crumpets, 2 large scones and jam - and it's always the large portion.

Mum was hospitalised again on Friday with another chest infection. Dad didn't engage at all with the paramedics who came to collect her. He didn't go with the ambulance to the hospital. He did say, "Ooo, I think I'll order a takaway now, because Mum didn't want anything much for tea the way she was feeling".

He has complications with his type 2 diabetes, for which he now has insulin. His feet and legs are almost black, he can hardly walk, he has macular degeneration. We three sisters suspect he has the start of dementia - he never thought to ring an ambulance for my mum, my sister did that when she went round and saw how poorly she was.

However, there's little we can do about any of it. Dad has said he would rather die than stop eating the things he likes. All he want to do is eat, read and watch TV.

I refuse to beat myself up about his choices. You cannot make people do things to change. We've discussed it with him endlessly.

One positive though, he makes me determined not to go down the same route, which I so easily could as I know I have similar personality and physical traits.

Sorry for the length diatribe. I suppose what I want to say to you is - do what's best for you. Don't let worry about your dad's choices take over your life. All the best.

 

[Scott-C]

People reach a certain age and come to terms with their own mortality.

I don't think it is for anyone to dictate the terms of their last few years. If they want a Greggs steak bake, or, dare I say it, a yum-yum, let them have it.

My folks are both approaching 80, are both reasonably healthy, compos mentis, but I get the sense from recent lunches with them that they are both acutely aware their remaining time could be a year or ten years - they simply don't know.

But I know that it gives them comfort to know that their offspring, me, my sis and the grandkids are doing ok.

Although, I will have to put some thought into my mum's 80th. She's a petrol-head and wants to drive a Lamborghini before she pops her clogs!

 

[Adamgross80]

I thought I would give an update as the advice and responses have been amazing. Thank you all.

So, first, Dexcom is up and running again. It is such a relief. His glucose levels have reduced significantly. His mmol/L is about 12-13 during the day and 6-7 during the longer periods with no food (e.g. middle of the night). They are still high and fluctuate too much, but the reduction is positive news and we are making him aware of this. As a result, his mood his greatly improved.

Additionally, we have spoken to a private healthcare company. They are going to streamline his meds to make things simpler, help him with his diet and visit him once a day. Hopefully, through this, his glucose levels will reduce further. We also have the reassurance he will not forget to take his insulin or pills, and is being checked daily.

Unfortunately, we believe my dad has vascular dementia. He is going for a memory test in the next few weeks. If we are right, it's going to be a long road ahead. However, the good news is that my dad is far more willing to receive help and generally in better spirits (undoubtedly due to the reduced glucose levels); and we no longer have the feeling of being lost.

He will never be 100% . But that's life. And, with the right support, we're able to deal with it.