Dear Diabetes Educator
My name is Evelyn. My father has had a stroke and he is in the hospital. Diabetes was diagnosed during this hospital admission. His case manager is telling me that I need to choose from three different rehabilitation centers that he may go to next for therapy. My father is a very independent man and would like to be able to live by himself again. What questions can I ask the rehabilitation centers about diabetes so I can pick the best one for his recovery?
You have an excellent question. It is not unusual for stroke patients to learn they also have diabetes.
Rehabilitation centers are places that are sometimes recommended by physicians to help people get stronger and learn to get back abilities they have lost. During this time, they also may learn new skills to help them remain as independent as possible. A reference to an excellent publication on stroke recovery can be found at: http://www.strokecenter.org/patients/caregiver-and-patient-resources/stroke-recovery-guides/
The first step you should take is to discuss with your father and his medical team realistic rehabilitation goals for him. You will need to ask the rehabilitation center if they think they can help your father reach his goals. Here are some questions about possible diabetes goals and then questions to ask the rehabilitation center:
- Goal question: Will my father be able to learn about his diabetes and learn the proper skills to take care of it? If the answer is yes:
Rehabilitation question: Is there a qualified diabetes educator on staff that can come to teach my father about his diabetes? Can family members come and learn as well? If there is not a diabetes educator on staff, then who will teach my father about diabetes?
- Goal questions: Will my father need to test his blood glucose (blood sugar)? Do you think he will be able to do this himself?
If the answer is yes, call your fathers insurance company to see if there is a preferred meter. Ask how to get the meter and the strips. Some insurance companies send a meter to the patient and help pay for strips and others expect the patient to buy their own meter which may be either fully or partially covered by insurance.
Question to the rehabilitation center: Can you teach my father to test his own blood glucose using the meter the insurance company recommends? Will your staff help to train family members if appropriate?
- Goal questions: What diabetes medications will my father need? Will he be able to learn to take his medications independently? What medications will he be on upon discharge from the hospital?
If the answer is that he should be able to learn to take the medications himself, then:
Question to the rehabilitation center: Will you be able to help my father learn how to take his medications independently? If insulin is part of his medications, can you teach my father to take his insulin safely?
- Goal question: What diet plan is your father going to need upon discharge?
Question to the rehabilitation center: Can your diabetes educator or registered dietitian teach my father and my family (if appropriate) how to fit the proper foods into his meal plan? Can she/he help with a meal plan that he will be able to handle independently?
Ask the hospital if you and your father can have an appointment with the certified diabetes educator on staff at the hospital to review if these questions are appropriate and if there are any more suggestions.
It is excellent to plan ahead so your father gets the very best treatment!
Thanks for your question,
Clara Schneider MS,RD,RN,CDE,LDN