Dealing with Diabetes

Dear Linda:

My husband's been diagnosed with Adult Onset Diabetes. He's vowed to exercise at least 30 minutes a day and make changes in his diet, but I wondered if there's a way I can help.
Anne

Dear Anne:

       Your support and encouragement will be vital to your husband's success in making the lifestyle changes required to manage a lifelong disease that can result in heart, nerve and blood vessel damage, wounds, strokes, kidney failure, blindness and amputations.

       Type 2 (Adult Onset) diabetes develops when the pancreas can't produce enough insulin (aiding sugar to enter cells that supply energy) or when the body's tissues become insulin resistant, both resulting in unsafe blood sugar levels.

       Symptoms of Type 2 diabetes are itchy and hard-to-heal skin, tingling of hands and feet, and gum or urinary tract infections in addition to any Type 1 (Childhood Onset) indicators—extreme thirst, frequent urination, drowsiness, appetite and weight changes, vision problems, labored breathing and unconsciousness.

       After diagnosis, the physician should educate your husband about disease management and monitor his success in keeping blood sugar levels from going too low (hypoglycemia) or going too high (hyperglycemia). Consult also with an ophthalmologist for regular eye exams, a podiatrist for routine foot care, and a dietician for an approved diet and to learn day-to-day skills.

       Healthy eating, physical activity and blood glucose testing are crucial to disease management. Oral medication and insulin injections may also be necessary to control blood sugar levels. Contact the American Diabetes Association at 800-342-2383 with questions or to order their free information packet and their book The Complete Guide to Diabetes ($29.95). Visit www.askada@diabetes.org for other resources.

       Personal habits practiced over a lifetime are tough to break. You can help your husband by setting a good example for healthy living. Exercise with him. Suggest involvement in a sport or taking walks instead of watching television. Prepare meals that are tasty but low in sugar and fat. You will both benefit from these important lifestyle changes.

Do Not Suport Freeloaders

Dear Linda:
      
My mother and mother-in-law live in other states and will probably need financial aid in the near future. Though we’re not wealthy and still have a child to put through college, we’d like to help, except both mothers have repeatedly bailed out their adult children. We’re concerned that if we give either mother money, their children will be the beneficiaries. Any suggestions?

Stymied in Benbrook

Dear Stymied:

The sandwich generation is struggling with multiple challenges, the most prominent of which is still launching their children while having to care for their parents. The pressure of meeting these demands can cause severe financial, physical and emotional problems. Be careful not to take on so much that you drown in the process. You must set boundaries.
      
As you are under no obligation to offer support, despite your great desire, it’s perfectly reasonable to determine the conditions for the help you’d like to give.  Communication is crucial. Be honest about your concerns. Make it clear that you won’t help if the money’s used for the benefit of others, and put all agreements in writing to ensure clarity and better enforcement.
      
After telling your mothers that you’d like to help, do a budget to determine income and anticipated expenses. If there’s a deficit, you could agree to pay directly for those expenses that have created the shortfall. If the parent is then short in a particular month, you’d be right in asking for an accounting. If the deficit is not the result of giving to others, then you could consider additional support. One of your stipulations should be to do a regular audit.
     
If assisted living or long-term care is eminent, research legal avenues to protect your mothers’ assets. Visit www.legalhotline.org for the number in your area to call about creating a simple trust that pays a local caregiver or care facility directly. Also make certain that your mothers have given financial Power-of-Attorney to a responsible agent in case they lose the capacity to handle their financial affairs.

Parenting Grandchildrem

Dear Linda:

        My grandparents are raising my young cousins. They’re having trouble handling their needs and problems and don’t know where to turn. Any suggestions?

A worried Grandson

Dear Grandson:

       Parenting grandchildren is a growing phenomenon. According to the 2003 Census, 2.3 million grandparents nationwide are tackling the job—a challenging, child-rearing experience totally different from their own.

       Grandparents must contend with special physical, psychological and educational needs, emotional problems, and the interference of biological parents, often in trouble themselves. With less energy, physical strength and authority, grandparents are anxious, overworked, and prone to depression, particularly if they’re coping with the loss of their own children to drugs, incarceration or death.

       Emotions are conflicted. Grandparents adore their grandchildren, but resent the demands on their time and energy, the drain on an already reduced income, and the reality of a quiet retirement gone.

       The children are angry at their parents for the abandonment, resentful about being taken from their home, even if it’s characterized by abuse or neglect, and fearful about the future.

       Discipline, in particular, is difficult. Grandparents often choose extreme styles—too lenient as a way to compensate for the child’s shattered life or too demanding because they fear a repeat of the behavior of their own children.

       Help abounds, though, and great joy is possible. Grandparents must create an environment with structure and reasonable expectations, and establish predictable routines for eating nutritious meals together, completing homework, and doing chores. The children will begin to feel safe and a sense of belonging.

       Alert the teachers and counselors and enlist their help. Visit parenting.adoption.com/parents/grandparents-as-parents.html for custody, legal and financial information, and www.rce.rutgers.edu/pubs/pdfs/fs255.pdf for an extensive resource list.
Read Grandparents as Parents by Sylvie Toledo and Deborah Brown, Grandparenting with Love & Logic by Foster Cline and Jim Fay, and Raising our Children's Children by Deborah Doucette-Dudman, and write to the American Association of Retired Persons (AARP) Grandparent Information Center, 601 E. Street, NW, Washington, DC 20049 for a free subscription to Parenting Grandchildren: A Voice for Grandparents.

Avoid Dehydration

Dear Linda:
       I’m as dried out as sandpaper. What began as a problem with small patches of dry skin has become a full-blown case of cracked and bleeding skin. I’d cry about it, but I don’t have any tears.

Scratchy in Saginaw

Dear Scratchy:

At the very minimum, you’re dehydrated, a condition that’s not only threatening but among seniors even dangerous enough to cause hospitalization. See your primary physician for a thorough exam.

Water, though not exactly the fountain of youth, is at least the “fount of life” and the most critical substance in the human body. Every organ, tissue and cell needs water to function. It transports nutrients, promotes digestion, and carries away waste. Controlling body temperature and ensuring proper blood volume, water keeps skin, mouth, nose and eyes moist.      

Preventing thirst is crucial, particularly for those over 60, as it suggests that the optimum level of water in our bodies (50-75% of weight) is already compromised. Seniors are at particular risk because as aging occurs, the amount of water in the body is reduced and the ability to recognize thirst signals greatly diminished.
     
If enough water isn’t ingested, the body will drain the body’s organs and tissues. Symptoms are: headache, fatigue, poor circulation, muscle spasms, kidney failure, and increased body temperature and pulse rate. Weakness will escalate, and labored breathing, dizziness, and even delirium can result.
     
A minimum of 64 ounces per day of water, the no-calorie beverage absorbed faster than any other, is the remedy. Milk, juices, soup, and at least five servings of fruits and vegetables (high water content) are good sources for additional fluid intake.
     
Modify processes that dry skin. Wear gloves when cleaning and take warm rather than hot showers. Slather on oils or lotions before completely drying hands or body to lock in moisture.
     
Read The American Dietetic Association's Complete Food & Nutrition Guide by RA Duyff for valuable information and resources.

Inflammation

Dear Linda:
      
I’ve read that inflammation’s the culprit causing disease and aging. Is this true and what can I do about it?

Red Hot in Dallas

Dear Red Hot:
      
Inflammation’s the body’s defense mechanism or healing response (the immune system). White blood cell chemicals are released into injured tissues to rid them of foreign bodies like bacteria and virus. The increased blood flow may result in redness and heat (for fever). Some of the chemicals can cause fluid leakage into tissues, resulting in swelling, and the process may stimulate nerves and cause pain.
      
Problems arise when the inflammatory response continues after healing is accomplished or if healthy tissue is damaged—when symptoms move from being short-lived, localized and protective to long-term and harmful.
      
Chronic, low grade inflammation is now thought to be the underlying cause of many medical conditions including Alzheimer’s, cancer, diabetes, asthma, and gum/heart/kidney and intestinal disease. Some types of skin ailments (like psoriasis) and arthritis (joint aches) may also be the result of misdirected inflammation, so it’s critical to see a physician if you experience: joint/muscle pain or stiffness, fever/chills, fatigue/loss of energy, headaches, and loss of appetite.
      
Treatment can include anti-inflammatory drugs, activity and stress modification, and physical therapy to maintain joint movement and muscle strength.
      
Life style is critical. The wrong carbohydrates and fats, obesity, inactivity, smoking, high blood pressure, environmental pollutants, and lack of sleep contribute to inflammatory responses.

The Mediterranean diet (high consumption of brightly colored fruits/vegetables, bread/cereals, potatoes, beans/nuts/seeds, and olive oil—a monounsaturated fat with anti-inflammatory properties) is suggested. Visit www.americanheart.org for information.

Blueberries, green tea, seafood, and spices including ginger, turmeric, oregano, garlic and cinnamon are all anti-inflammatory. Consider a multi-vitamin and supplements high in Omega-3’s. Read The Perricone Promise and The Wrinkle Cure by Nicholas Perricone (Warner Books).

Regular, aerobic exercise reduces levels of inflammatory proteins in the body. Thirty minutes of walking or cycling at least five times a week is crucial.

Spicing up Your Life

Dear Linda:

       I keep hearing about the health benefits of cooking spices. It seems they cure everything from the deadliest cancers to an ailing sex life. Should I be spicing it up?

Dull in the Kitchen

Dear Dull:

       For centuries, our ancestors considered spices and herbs to be the answer to many medical problems. Over time, spices became more respected for their culinary enhancements than for their medicinal value, but researchers are promoting them again for their healing properties.

       Experts don’t suggest substituting spices (plant bark, root, bud or berry) or herbs (herbaceous plant leaves) for a healthy, well-balanced diet, and warn that consuming too much of any food additive can be risky, but advocate the use of spices for diet diversification and boosting the health value of a meal.

       Use fresh instead of processed spices and herbs. They contain higher levels of antioxidants. Buy spices whole and grind them just before use, crush dried leaves or herbs, and use whole sprigs in long-cooking dishes for maximum benefit. Add sprigs of oregano or rosemary to vegetable, rice and pasta cooking water. Herbal teas (sage, rosemary, thyme, oregano, peppermint, spearmint) retain antioxidant properties even after a 30-minute boiling time.

       For many, peppermint treats gastric and digestive disorders, tension and insomnia. Mustard relieves respiratory problems. Cayenne pepper and Tabasco sauce can increase metabolism and fat-burning ability up to 25%. Ginger inhibits nausea and vomiting often caused by morning or motion sickness. Allspice relieves indigestion and gas, and cinnamon combats diarrhea, boosts glucose metabolism, and kills bacteria and other micro-organisms. Turmeric neutralizes free radicals, protects against cancer, and is a natural anti-inflammatory. Cumin is a protective agent against carcinogenesis. Garlic can decrease blood pressure, is a natural antibiotic and beneficial in the treatment of diabetes. Oregano has 3-20 times higher antioxidant activity than other herbs.

       Consult your physician before making any dietary changes and don’t substitute spices or herbal supplements for prescribed medication. Read Spices of Life by Nina Simonds (Alfred A. Knopf) to learn recipes for a healthy lifestyle.

Emergency Calling

Dear Linda:
      
      My mom’s an ailing widow. Until now, I’ve been able to call everyday to make sure she’s okay, but I’m being deployed and won’t be able to for the next year. She wants to remain in her home and is well enough for that, but she needs to be checked on. The problem is that all her other relatives and friends have passed on. What can I do?

A Concerned Son

Dear Concerned Son:

       Your mother must be very proud. To have a son care so much about his mother and his country speaks volumes about the job she’s done raising you.

       Before you leave, be sure all her legal (i.e. Last Will and Powers of Attorney), medical (i.e. Insurance and Living Will and Directives), and financial (i.e. Trusts and Bank Accounts) documents are in order. Put all her important papers in a fireproof box. Make duplicate copies for yourself in case you need to confer about them long distance.

       Develop a Care Plan to accomplish her Activities of Daily Living (like trips to doctors, pharmacy, grocery store and hairdresser), and identify any special needs she has. Then ask for help from people in the community—her neighbors, members of civic, religious and social organizations. Contact the National Eldercare Locator (800-677-1116) for help in identifying local service and aging agencies.

       Her level of independence should determine the amount of support she needs. There are in-home agencies that handle housekeeping and meal preparation chores, personal care and grooming needs, and therapy and nursing requirements.

       If all she needs are phone calls, there are agencies that provide only that service. No special equipment is necessary. Any touch-tone phone can receive agency calls, and you should be able to choose call times—generally made twice a day. Follow-up calls should be made if Mom doesn’t answer, and the agency will need a contact list for emergencies.

       Senior Care Call Companions is another alternative. It is not an automated call center that has a computer dial your loved ones number, instructing them to hit a button to signal they are ok. They are a unique company that gives clients a personal phone call each day, visiting perhaps about the weather, grand kids, or any number of topics. Their most popular plan is  $45.00 per month, and there are no long term contracts to sign.Their number to call is 971-209-0936.

      Another option is to purchase a Touch 'N Talk. A 2-way speaker phone, it is the first product to allow instant communication. The mini wearable pendant (which is water resistant and pacemaker safe) can contact family, friends, or neighbors, at any time from ANYWHERE in or around the home or yard within a 600 foot range. If  programmed contacts are unreachable at  the moment – the system can optionally default to contact a 911 emergency operator.

     Touch 'N Talk is a one time purchase and does not have a monthly, activation or set-up fee, and it runs on batteries, "so whether you are just checking in with a friend, need some quick help from a neighbor, or are in an emergency, the Touch 'N Talk pendant will allow you to communicate your message instantly and efficiently from anywhere in and around your home, and all with one button activation."

      

  

      

.