Home Health and Diabetes Management

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Home Health and Diabetes Management

Barbara EichorstContributor: Barbara Eichorst, MS, RD, DCES
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Aging can bring a new stage of opportunity and strength that can be applied to diabetes management. There is a force in aging that positively impacts our attitude and consequently brings a new perspective on how we approach diabetes. People with diabetes can re-engage in their diabetes management at any time and for many, that re-engagement happens when receiving home health.

While COVID-19 has shifted many of our professional and personal activities, causing us to work, study, and entertain from home, the shift has been even more significant to those living with diabetes, contributing to multidimensional changes in the self-management of diabetes. However, for those who are part of home health, not much has changed since COVID 19. This is because the term “home health” refers to those who are homebound and require skilled qualifying services. Skilled home care is provided by nurses, physical therapists, occupational therapies, or social workers to help manage serious illness or injury. They provide these services for various medical conditions such as

  • wound care
  • infections
  • cardiac issues
  • neuro rehab
  • behavioral health
  • respiratory conditions
  • surgical aftercare
  • endocrine conditions such as diabetes

Some treatment goals are to regain functional independence, become more self-sufficient, slow decline, and recover. In diabetes, treatment can include assisting with self-management that leads more in range in blood glucose levels.

Diabetes self-management for those who are homebound involves the same as for those who are ambulant. The self-care for everyone with diabetes includes

  • monitoring blood glucose
  • taking medications
  • eating healthy
  • getting daily physical activity
  • managing stress, illness, and risk
  • daily situational problem-solving.

However, for those who are homebound, these can be even more complicated by social determents of health such as

  • education
  • income
  • occupation
  • housing
  • environment
  • food insecurity and access
  • health care access
  • affordability
  • ocial support

Also, even before COVID, older adults have been facing a loneliness epidemic. Many adults aged 65 and older are socially isolated, with the challenge exacerbated by transportation barriers, hearing loss, dementia, and other factors.

Home health is not for everyone. To qualify, a medical doctor needs to certify that one is homebound and needs services such as skilled nursing care, physical therapy, speech-language pathology, or occupational therapy. These services are provided by home health agencies that Medicare approves. The duration of care depends on multiple factors, like the time needed to improve a given medical condition or develop a safe and effective maintenance program.

If you do need home health, you can also expect to get help with your diabetes. Diabetes can complicate wounds, infections, cardiovascular and neuro rehab, behavioral health, respiratory, and surgical aftercare. At the same time, home health could be one of the four critical times to receive or modify diabetes self-management education and support (DSMES), which should not only occur at diagnosis. DSMES might be needed to help meet treatment targets, when new factors develop, and when transitions in life and care occur.

 

* The content and views expressed are those of the author and do not represent her employer.

Barbara Eichorst, MS, RD, DCES, is the Associate Vice President of Clinical Practice and Research at Kindred at Home. Prior to Kindred at Home, Barbara has worked with Voluntis as a Diabetes Clinical Liaison, and with Healthy Interactions as Vice President of Clinical Care on a global program that involved over 120 countries. With the Conversation Map program, she has traveled to over 40 countries within the last eleven years. Barbara’s experience also includes work in Chicago as an insulin education specialist and a medical liaison. Barbara’s professional experience includes work at the Association of Diabetes Care and Education Specialists as a program director. Also, at the Chicago-based Rush University Medical Center, Barbara was a diabetes program manager. She has provided patient education in diabetes, weight management, cardiovascular disease, among many other chronic conditions at Loyola University Medical Center and Northwestern Memorial Hospital. Barbara’s professional focus is on behavioral interventions in disease management. She has contributed to multiple publications with her expertise in change activation, empowerment, and engagement.