Motivating a Loved One Who Has Diabetes Burnout
People with diabetes take care of themselves with maximum energy every day, persistently monitoring how food, physical activity, and medications affect their blood glucose levels and weight. So it’s understandable that they might feel burnout on occasion, says Wendy Satin Rapaport, LCSW, PsyD, clinical psychologist and adjunct professor of medicine at the Diabetes Research Institute at the University of Miami Miller School of Medicine.
Burnout, a state in which people feel stress, sadness, or weariness from managing diabetes, is often characterized by a drop-off in self-care behaviors. You may notice your loved one is irritable and has skipped blood glucose checks for some time, for example. Naturally, this can be frustrating or frightening for you as a partner or parent. But there are ways to support your loved ones to get them back on track with their diabetes care.
No one has perfect blood glucose control. “That’s just diabetes,” says Alicia McAuliffe-Fogarty, PhD, CPsychol, vice president of Boston-based T1D Exchange, who has lived with type 1 diabetes for 30 years. Your job as a caregiver or relative, she says, is to take away that pressure to have perfect glucose readings.
Change how you talk to your loved one about diabetes. In their 2014 book, Approaches to Behavior: Changing the Dynamic Between Patients and Professionals in Diabetes Care and Education, Satin Rapaport and Janis Roszler, MS, RD, LDN, CDE, FAND, laid out a plan for better communication for families dealing with diabetes:
- Listen. Take the time to hear where people are coming from and understand why they’re feeling burned out.
- Empathize. Put yourself in the shoes of your loved ones and ask what they need from you and how you can be of help.
- Affirm. Let loved ones know that you understand why they made certain decisions. Remind them that they’re in the driver’s seat, but help them consider the consequences of their choices.
- Be positive. Communicate in a way that shows you’re working together to figure out a solution.
Sometimes people with diabetes will listen to others who have had diabetes longer and can provide some extra credence and guidance, says Barry Jacobs, PsyD, director of behavioral sciences at the Crozer-Keystone Family Medicine Residency Program in Springfield, Pennsylvania. Finding a diabetes support group may be one solution. He also acknowledges that it’s a delicate balance to motivate someone with diabetes without pushing too hard. If that happens, despite your best efforts, your loved one may continue to make unhealthy choices to demonstrate that he can have control over his life, Jacobs says.
Natalie Rende-Helberg, 44, of Tinley Park, Illinois, says she’s had a few bouts of burnout in the 40 years she’s lived with type 1. “Diabetes burnout ebbs and flows,” she says, adding that her family is very supportive. “They tell me to just take it one day at a time … and live for the good moments.” Taking walks with her 10-year-old daughter also helps. “She always tells me that she loves me,” she says. “And that is how I manage the burnout.”
Communication strategies vary depending on the age of your family member with diabetes. Read on for ways to address burnout by age.
Your child with type 1 diabetes is struggling to keep up with his health care, feels different from others at school, and has trouble expressing those feelings to you. How can you help open the lines of communication?
Let kids be kids. If your child comes home from school excited to tell you about a soccer game or something else, then listen. Avoid launching into diabetes management questions the moment he walks through the door. “If we keep pushing the diabetes and not letting them be children, it’s going to make the diabetes burnout worse,” says McAuliffe-Fogarty. “Our job as health care professionals and parents is to help our children integrate diabetes into their life rather than the other way around.”
Your teenager with type 1 diabetes seems to be on a rollercoaster with her blood glucose levels, and you’re not sure she is being as diligent as she says about her diabetes management. But trying to take control of her health isn’t working for anyone.
Think it over. Hormones go haywire during adolescence, affecting glucose control. Before you jump to conclusions about her efforts, consider whether hormones may be behind unsteady blood glucose readings. You want to work as a team and avoid power struggles, says McAuliffe-Fogarty. “Sometimes with diabetes, you can do everything right and your blood glucose is still high,” she says. “This is even more common with hormonal changes in adolescents.” Consider offering your teen nonfood rewards for taking care of her body. Come up with common goals and set realistic expectations, says McAuliffe-Fogarty. Whether goals include checking blood glucose a certain number of times a day or dosing insulin for food, the reward is for the behavior—not the number on the meter.
At a party, you watch as your husband with type 2 diabetes makes questionable food choices. You haven’t seen him check his blood glucose or take his medicine. He’s having fun, and you don’t want to be intrusive.
Ask for permission to help. Satin Rapaport offers this suggestion to the adult looking to help a loved one: You might say, “Do you mind brainstorming with me about how [you] can handle that differently for the next party without me being a nag?” If your loved one asks you to stop inquiring about his blood glucose, try to respect that. Adults need to find their own motivation for adopting a healthy lifestyle, and often that involves being able to participate in family activities. You might ask: “Do you want to keep up with your grandkids?" These kinds of questions often encourage people to take greater steps to manage their health, Jacobs says.