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Personal Experience

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Sugar is not only in candy.

Marcela Hromková
Language: English
Country: Slovakia
Typology: health care professionals
Text:
Mrs. Jana is 72 years old. She is a pensioner living alone in a small house with her dog and cat which are her companions. Jana understands them very well and loves to cuddle with them. Her husband died 12 years ago. Her daughters live with their own families in nearby villages. They visit their mother regularly as often as their work and private life allows them. Jana knows for some years she has diabetes and has been taking proper medications. Jana used to like attending various activities in her village, where she could meet her peers. They went for walks and trips around the surroundings and she was glad that her body served her well and had plenty of free time. She was also glad for visits of her family and friends and she always tried to prepare some titbits for them. Sometimes when she went to her doctor, the doctor told her that the level of her sugar is very high, mainly after the weekend full of titbits, spent with family or after celebrations with her friend, where her friend Danka served everybody her delicious homemade cherry liqueur. They laughed after it and it was very sweet. Sometimes when Jana remarked that she should not drink it, her friends claimed it is from the fruit so the one shot won’t harm her. Jana could spend hours working in her garden with flowers; she did not eat, did not drink, she just cut and water her pride, everybody admired her flowers. She liked compliments, her friends admired how much she can do at her age, only sometimes after waking up she got sick after few steps to the toilet and to the kitchen. She had cold sweats and felt like she was going to fall away. She did not know why this was happening to her, so she thought it was caused by her age. Even when her husband died she overcame her sadness, and she did not repent herself, so she did not tell the doctor. During one of her visits at the doctor, her doctor decided it is needed to change the medication, from pills to insulin. She told the most important thing about it to Jana in 15 minutes. When she got the machine for measuring the level of the sugar and the insulin pen, she did not know what to do with it. The doctor also gave her the brochure about diabetic diet and emphasized that she needs to take control about the things she eats. Jana was sitting at home, looking helplessly at all of these and she had the strange feeling that she does not know what to do, so she called her daughter and told her what bothers her. The daughter promised her she will find information how to deal with the situation. Online she found the possibility of ordering professional care help to the house and agreed on a visit with a nurse. The nurse found out that Jana is very active, reasonable, fully orientated but very unsure about the new situation. She cannot put together too many of new and complicated information and she cannot imagine that she will have to give herself injections and measure the level of sugar by pricking into her finger. The nurse proposed a plan of nursing in which she will visit Jana daily in the morning and in the evening for half an hour. In the morning she will help Jana to measure the level of sugar and writes down the level of the insulin she needs to have and help her to make a correct combination of the food so Jana won’t be hungry. In the evening they will go together through the meal and drink plan and the nurse will give Jana an injection. Gradually, when Jana get used to injections and checking the levels of sugar, she will know how to orientate herself in the right selection of the food and know how much water to drink. The nurse explained to her the procedure and repeatedly lead her during the rehearsal of self-controlling levels of sugar and application of insulin with the help of pen. This period of rehearsing changed Jana’s lifestyle, she was afraid to do activities she did before and to leave home. The nurse had talks with Jana during her visits in which she explained everything to her and supported her in getting back to her previous activities. Gradually Jana started to take her food and diabetic tools with her and started to live her life again. The period of getting used to all what the new situation required lasted for 2 months. Then the nurse ended her cooperation with Jana. Jana started to live her active life again and she was able to control her habits and take insulin on her own. OBJECTIVES: Implement correct diet and drink regime, bring Jana to conscious approach to eating, set the appropriate mode of activities and handle the insulin therapy safely and independently. MEANS AND STRATEGY: Nurse teaches Jana to distinguish different foods, count and estimate the amount of allowed bread units in the allowed portions, operate the sugar measuring machine and the insulin pen. She clarifies to Jana the nature of the disease and appropriate strategies to deal with it in everyday life. She encourages and motivates Jana not to give up her previous active life but to adjust it to the disease. Jana learns to recognize her body signals related to changes in her blood sugar levels. She also learns better to measure her blood sugar when uncertain in order to prevent unpleasant surprises. CONCLUSIONS: Despite the worsened diabetes conditions Jana regained her desired life quality and learnt to approach her disease and treatment constructively and manage her life independently again.


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