Found this article on one of the FB groups I’m in and read it…hadn’t ever thought about it, but after reading it, it’s added a new level of worry that I have for Liam that he’ll possibly have to experience in his lifetime (and, in this case, I’m sure I’ll be long gone and will be no help.)
Anyone have any experience here and is this a real and true concern for older diabetics?
When looking for an assisted living facility for my elderly Grandma I definitely noticed that several of them we looked into offered “diabetes care programs”
She doesn’t have diabetes, but I tend to notice things like that.
I didn’t delve into great depth of understanding as to what they meant by that but I assume it means at least some of their staff have some training…
They all also offered assistance with medications, as this is a problem that a great many seniors with a variety of ailments struggle with; properly taking their medications… and the level of service can vary from nothing to having an RN visit multiple times daily to administer and monitor medications and completely manage their prescription needs almost as if they’re in a hospital… of course they bill more for that level of service…
@Claudndaye I think that at this moment in time it is a concern. But I also think that there are generations before Liam that will pave the way. There are a lot more T1Ds headed into retirement now than there were before, and there will probably be a learning curve, but eventually there will be more knowledge about T1D and how to manage it for the elderly. The fact that there is an article about it now shows that it is on people’s radar which is good news.
The biggest problem for Liam will be as the boomers eventually die off there will be too much capacity in the elder care institutions and many of them will be going bankrupt. I suspect his diabetes care will not be the straw that breaks the camels back.
But @ClaudnDaye, you bring up a very important point I hadn’t thought much about.
And also to throw a curve ball into the discussion I’d suggest that all parents need to consider their own arrangements for their own old age…
The costs of assisted living, and/or nursing care, can be astronomical… and those can be the case for many years… so if your family is already at the mercy of the financial burdens of chronic health problems… please make sure that they’re not further burdened by the very predictable situation of the senior family members reaching old age…
If you’re fortunate enough to have had a career that offers long term care retirement benefits—- please consider it very carefully—- and all people approaching retirement please consult with a planner / professional who’ll help reduce these burdens on our already burdened children
My mom is Type 2, not using insulin but taking quite a cocktail of meds. Dad not diabetic, but also on many meds. So my family will be facing these choices soon. This month they are starting in-home/ visiting care, so will begin to learn more.
Have a neighbor with 90 yo mom, in assisted living, and still gives her own injections.
My mom is is long term care and she takes a large amount of medicine due to her Parkinson disease, I do mean a lot. The nursing home handles it very well. Her medications are done at an off site pharmacy that lays out each round of prescriptions on a blister pack according to her doctors orders. She get her meds on time as prescribed.
I myself worry about insulin in a long term care facility, it is my belief that as long as you have the clarity of mind to make dosing decisions you will be fine but if you are no longer capable I shudder to think.
Same here. I couldn’t imagine it would be any better than hospital care.
I’m hoping the closed looped systems are standard care by then, and much improved.
But of course, there will be a cure within 5 years, so why worry.
@ClaudnDaye Hopefully by the time Liam is ready for an old age home, diabetes will be cured and he’ll just need help to control drooling on himself.
I won’t need care like this for another 50 years or so. I’m certain by then closed-loop systems will be the norm.
Hopefully my food allergies will be cured by that point, too. Otherwise that’s probably the mistake that would do me in.
I’ve worked with elderly people for a few years as a CNA. Diabetes care in elderly people does scare me because that’s one of the times the difference between type 1 and 2 makes a much more major difference, when you CANNOT care for yourself anymore (otherwise it’s different but if you can care for yourself you can fight anything that’s not understood/mixed up, people with dementia may not be able to unless they still have a grasp on that) . Some people , even in nursing, don’t realize that type 2’s can take pills but type 1’s cannot. It’s bonkers. Hospitals don’t know wtf they’re doing with insulin for anyone, and I question it at the assisted living I work at as it’s dementia care. Diabetes and dementia are very common hand in hand conditions so it makes me scared af to get old,A LOT of my residents have a type of diabetes (mostly two but I do believe we have at least someone in the mix with type 1 /lada in the house, and all of them are on at least lantus or some sort of long acting insulin so there is insulin for everyone and I have to be on alert for low symptoms) . In the past I’ve cared for a few for sure type 1’s (who had it since childhood, likely took care of it well as they’re usually not straight up unhealthy) with dementia as well . Like I know most things have confirmed a link between 2 and dementia but there are studies that seem to link 1 as well. Dementia is my greatest fear in life after dealing with it with my future mother-in-law (who has early onset and has since she was in her late 30’s//early 40’s along with parkinsons, she has other chronic illnesses and problems but not diabetes at least thank god, I don’t think she could keep up with that and she’s not even far gone) and on the job. When you’re chronically ill and also have dementia it’s a bad mix. Scares me a lot.
I just hope I never end up with dementia or any related condition that includes it (like parkinsons) . I’m fortunate and it doesn’t seem to run too heavily in my family unless you live closer to 90 (my great grandma had it before her 2nd stroke that made her a vegetable , she was close to 90 when that all went down. My grandma is 84 years old and showing early signs of it, but that may be alcoholism related not just out of nowhere) , and I’m not trying to be a negative nelly but I really hope I don’t live that long. I am super content with the idea of living for 75 years and being happy during it , not living too long and not knowing who I am anymore 
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Hi @ClaudnDaye, thanks for this post. The author, Dan Fleshler, is a friend on Facebook. We are both members of the Joslin Medalists group there.
I am 79 years old now, with 73 years of T1D. I am experiencing problems with neuropathy in my legs which makes me occasionally fall down. I do have more and more trouble with my hands while working with my diabetes equipment. My wife helps me with that, but how long will she be able to do that? For those reasons, I am very concerned about assistant living and elder care.
I think you are jaded because you only see the worst cases. I’m 66, with all my physical and mental capacities, and I would be mortified to think I only have 9 good years left.
Look at people like @Richard157 who is 79 and sharp as a tack. Their longevity should be your goal.
My Tai Chi teacher, who is also a Chinese medicine specialist and acupuncturist, let me know that acupuncture can help with neuropathy problems. He has successfully treated arthritis in my thumbs and relieved my knee pain so I would definitely give this option a try if I developed neuropathy. It’s very important to find a truly qualified practitioner.
I can’t say I always see the worst case scenario , I just rather see happier higher quality of life vs quantity. If I’m 90 and healthy as possible and not like in horrible shape memory wise then yeah different story, but it’s becoming more of a negative thing to live past 90 with even like not many health issues vs even less health issues at a slightly younger but still old age.
My fave resident in the entire building is an adorable scrawny lifetime farmer who’s 96 years old, very likely just a bit senile he’s not really someone with dementia, as some of the people in my unit don’t have it but have other memory issues and are older and have health issues that make them less suited for the regular assisted living next door…cute as he is, and despite what I’m about to say about him he’s a rather positive catholic dude who smiles a lot and says some of the funnier things I’ve heard and is a joy to be around, he always tells me “I want the good lord to take me, I keep praying for it. There’s something wrong with living this old” because he feels people shouldn’t want to live this long …granted a lot of his complaints kinda come off as melodramatic (afaik he only has arthritis and can’t walk without a wheelchair but he’s pretty much still there and has very minor other health issues at most)…I feel like there’s some old people wisdom there when a lot of the patients and residents I have had in their 90’s that have most their facilities left still always talk about wanting to die even if they’re otherwise healthy just old af, there’s something crappy about it us younger (than them) folks don’t think about. Most of us would prolly be envious of someone 96 years old that lives a life of being a multimillionaire from their farming history (because he is , he doesn’t hide it at all he’ll let you know he’s pretty proud of it I think , he set his kids up for life lol) , who really isn’t that unhealthy at all, and gets to sleep like 10 hours a night after a nice cold beer and hanging out with people doing fun stuff all day (this is basically his routine, he lives a chill life after like 90something years of farming) …so it’s at least a little confusing and hard to understand until we get there I guess. So it leads me to believe there’s something there that makes it less exciting but it’s not like I wanna only live to 30 , 40, 50, or 60 or anything super young like that…but caring for this population has lead me to believe that living forever is kind of painful and less enjoyable than it should be.
My dad is 95. He walks around town, takes care of his dog, swears at his computer for not connecting to the internet (then gets help from upstairs neighbor), watches a lot of old movies hes already seen, even drives a bit in his old white Mercedes. For him, at least, I think his statements about being fully ready to not wake up some morning has a lot more to do with hoping for a quick, painless exit, rather than a prolonged, painful hospitalization. I don’t think it is really a sign that he wishes his life was over. But I do think that losing most of his friends and especially my mom has caused him to see his life as being in its final stage. That is, after all, where we will all end up, isn’t it?
As for me, as others have said, I’m counting on there being a functional artificial pancreas by the time I’m where he is. I think the systems that exist today (e.g. the Medtronic 670, not to mention Loop or OpenAPS) would be adequate for old age management. I mean, would you complain about a target of 120 mg/dL being too high when you’re 95 years old? So at that point, we should just need someone to make sure our supplies are coming in and changed over as needed.
A timely article…
A couple of comments from my perspective.
What are my “qualifications”? For starters, I’m old … turning 70 in a week (and T1D for 48 of those). I’m pretty healthy, too … walk 8-12 miles most days. Oh yes, both my parents developed either T2 or T2-like in their 80’s.
My comments (which are more general rather than diabetes-specific):
There are good facilities and not-so-good senior facilities. The good ones currently have 5-10 year waiting lists and getting longer every year until the “gray tsunami” passes. Most of my friends look at me like I’m nuts when they learn that I’ve been on the waiting list for a Continuing Care Life Community for several years and will likely move into a facility less than 2 years from now.
Virtually all of the best facilities have a health requirement to move in. Everyone assumes they can wait “until they need it”. Not always true …
EVERYONE should have a health care advocate, in my view, to go to bat for them either on a short- or long-term basis. This is also best done long before you think you may need it …
Long term care insurance? Everyone needs to make their own decision. I personally think the actuaries have done their homework well …
As the saying goes, “getting old ain’t for sissies” and nobody gets too much choice about what may be in store in later years … but I still believe in some proactive thought and advance planning.
And, yes, I expect to see widespread use of closed-loop pumps even in my lifetime … and who knows what even better things may be in store for you younger people.
Good luck,
John
