Impact of dementia on caring for patients’ diabetes

Abstract

Objective: To explore caregivers’ challenges and quality-of-life issues managing diabetes in patients with dementia.

Method: We conducted six focus groups with 21 caregivers of patients with dementia and type 2 diabetes. Focus groups were digitally recorded, transcribed, and translated using a software coding system. Emergent themes were identified and confirmed.

Results: Three themes emerged. (1) Memory loss was the first identified cause of self-care neglect leading to caregiver intervention. (2) Behavioral and psychological symptoms of dementia (BPSD) disrupted the daily diabetes care routine, with ‘denial’ of having diabetes or memory loss (anosognosia) being the most disruptive. (3) Caregivers reported that caring for both diabetes and dementia was highly burdensome, felt overwhelmed with BPSD, and wanted more support from family and patients’ healthcare providers.

Conclusion: Caregivers of patients with dementia and diabetes face extraordinary challenges managing both conditions and the accompanying BPSD. Their identified need for a greater response from the healthcare system should be tested in quality improvement programs for this overlooked yet rapidly growing population.

Keywords:

• cognitive impairment
• comorbidity
• caregivers
• quality of care

Acknowledgements

This study was supported by funding from a Veterans' Administration Health Services Research Career Development Award and from the West Los Angeles Veterans' Administration Department of Research and Development.