When I'm getting old

So I’m starting to get to the point where I can refer to myself as an “oldster.” I’m 73 now, and have had Type 1 for just under 60 years (60 in December).
I’m still in pretty good health. My A1c’s are in the 6’s; my cholesterol is excellent, as is my other bloodwork. We walk daily, 1-3 miles; we do stretching and a little bit of weight work a couple times a week. I’ve got a mild case of Afib, and slightly high blood pressure, but not bad.
I’ve used an insulin pump for about 20 years. I just switched over to a Tandem t:slim and a Dexcom G6 a few months ago, both of which I love.
We have no children. We live comfortably in a medium apartment (by choice, as of a few years ago). My wife has been invaluable in managing my meals and other aspects of my life. I feel like I, and we, are in good control of things right now; certainly I have plenty of experience! :slight_smile:
So my question to you is: what happens when/if I can no longer, due to physical or mental disability, manage for myself? My wife and I have discussed this recently. She is not a techno-geek like I am, and is intimidated by all that goes into managing my various gadgets. She thinks she could manage to handle giving my multiple injections, as I did years ago, but doesn’t feel qualified to manage even the pump, much less the CGM. And of course the t:slim is a bit more complicated than my old Medtronic 580. I won’t inflict that kind of stress on her.
The only alternative I see is an assisted-living place that could manage my pump and CGM adequately. But do such places even exist? It seems to me it would take a lot of high-level skill for a staffer in such a place to be able to provide that level of care. I’d hate to put my life in the hands of someone who isn’t trained for it, and I don’t think I can expect that of most facilities.
Are there alternatives I’m not thinking of? How are some of you other oldsters, especially older-than-me-sters, handling these challenges? I should be able to manage everything for quite a while, I’m sure, but eventually I’ll have to face this problem. Any ideas?
I apologize if this has been discussed, but I couldn’t find anything.
–Keith

1 Like

I don’t know. While your wife may be intimidated by gadgets there’s no reason she - or anyone willing to learn, really, could not learn to use our tools. There may be individuals on this very forum who have learned skills they never imagined they could manage when they themselves or a loved one received the diagnosis. Perhaps now would be a good time to have your wife join you in doing some of the steps you do yourself, and eventually doing them herself. If she finds inserting the infusion set out Dexcom intimidating she may very more comfortable as she did some herself. The G6 is so big it’s scary to look at, but insertion is very easy. Maybe helping you in baby steps will help her confidence. I suspect is that way for many new users, especially those who are caring for children. It’s scary at first but comes easier with practice.

@khjalmarj , those are great questions. I am 73, T1D, mostly good health, but with increasing Vision problems, so I have similar concerns. I switched from DIY Loop to Tandem/G6 in April. As a first step, I suggest asking your wife to take the training and give it a try. I would not expect her to learn how to interpret data and make settings changes, but just learn the mechanics of changing the pump cartridge and sets, and G6 sensors and transmitters. Maybe you could set up an email with links to the related training videos so she wouldn’t have to remember everything. Have you discussed your concerns with your endocrinologist? I need to do that, it didn’t occur to me in the past. I have known one very elderly person, now deceased, using A Medtronic in an assisted living facility. I think that would vary from facility to facility. What about visiting nurse or other part-time help? Lastly, if you use Facebook, consider posting this question to a FB group such as CGMitC Off Topic, where more people might respond. Best wishes on getting some planning ideas!

Hi Keith @khjalmarj, your concerns are legitimate. What eldercare or assisted living facility understands diabetes tools or even knows there is a TypeOneDiabetes???

Without telling my wife that I’m teaching ing diabetes management skills, I frequently talk with her about the “how and why” i make bolus and basal rate adjustments and why i create a new pump Profile. She is older than I, and I’m older than you by a half dozen years, but I think that with a little encouragement, she could readily put in my G6 , and with a lot of pushing get a new cartridge into my t-Slim for me. Neither of us have great vision, so 10 years from now outside help will be needed.

Visiting Nurses could be hit or miss, a while back, one who lives nearby asked me for a quick course so she could help a patient. I know a woman who visits schools in the county to instruct school nurses about T1 student management, so I’m now thinking that a nursing home JDRF Chapter outreach might be my next volunteer activity.

THANKS, Keith for waking up my brain.

I’m only 33 and I’m already thinking about that stuff. I have no partner (and no prospects) and don’t intend to have children even if I find one. I have a younger sister, but I don’t want to be a burden on her or any future nieces/nephews. For now my answer is just to put everything I can into savings because I’m sure whatever solution I find is going to cost me and arm and a leg. If anyone on this forum has a decent solution, I’d very much like to know.

1 Like

I found this article which suggests private home care as an option, if that’s a possibility.

Hi Dorie @wadawabbit, I think that this art5adds emphasis to Keith’s anticipated dilemma.

I am aware that administering injection medication such as insulin is highly regulated within ALF, and by State regulations. A "nursing assistant ", may be performed to assist in cartridge or reservoir preparation, and with lining up and assisting glucose sensor insertion, but might be restricted with infusion set placement.

While in hospital, diatery personnel and hospital floor assistants have helped me calculate carbohydrates and have. made sure I’ve entered. When I’ve been hospitalized, I’ve always made an attempt to provide education when asked.

Family members and other non-professional whom we have educated and trained may give insulin.

I think home health care worker is the best option, but interview them and find one that has a parent who has diabetes or has diabetes themselves. The treatment for type 1 and type 2 are very similar so with the increased incident of type 2 finding the experience should be obtainable.

With the increased incidence of diabetes - whatever type - forward thinking young people considering careers in medicine might do well to get additional training in diabetes care. I would imagine diabetes nurse practitioners could do very well.

Hello Keith, you have asked a very good and important question. I am 80 now, and type 1 for 74 years. I have nerve damage and weak muscles in may parts of my body, and some arthritis in my hands. I can manage my pump and CGM for the time being, but it is becoming somewhat awkward to do so. My wife, like yours, would not be able to manage the pump and CGM. I think her giving me shots would be the likely solution. If something happened to her, I am at a loss for finding an appropriate solution. I suppose an old folks home might suffice, but could we depend on the staff there to administer our shots on time?

1 Like

I have worried about the same thing for years. What if I outlive my husband (who could change my infusion sets and glucose sensors)? I would consider a home nurse, but doubt whether that person could be there all the times I would need help. I think I would let a residential facility decide how they wanted to treat me. Once I can no longer look after myself, I am likely not going to live much longer, so I would not need the fanatic care I currently give myself to stay alive longer.

1 Like

I will share the part of my story. I am 62. I was in the hospital for six weeks with pneumonia back in 2014. The nurses inside the hospital knew nothing about diabetes. It shocked me that they attempted to apply a cookie cutter type of care to my lack of a pancreas. I told the doctor to just let me do it. He said to please tell the desk what I was doing, but I just blew that off.

A doctor asked me one time, “Who treats your diabetes?” I said, of course, that I do. He then asked who was my endo…

2 Likes

Hi @ChatdeBatz welcome to TypeOneNation! For my 2 surgeries over the years I think that having an early conversation with the doctor in charge makes all the difference in the world.

2 Likes

Hi Keith!

Can I start by applauding your ability to manage your diabetes, especially in the dark ages? I’ve been diabetic for 40 years and that’s how I reference the primitive tools we previously used to control it. Anyone remember urine in a test tube? Ha ha!! :laughing:

Anyway, I’m new to insulin pumps having just today contacted Insulet to get information about the Omnipod but I’ve used Dexcom for 3 years now. I understand that Insulet and Dexcom are releasing an Omnipod pump called the Horizon in 2021 that works in tandem with the soon to be released Dexcom 7. This will likely simplify the application and possibly remedy some of your wife’s understandable reservations. I don’t have any experience to draw from regarding how technical the pumps are, but I hope to once my coverage is determined.

Wishing you and your wife the greatest health and continued success managing your diabetes! :blush:

Aimee~

Aimee said:
“Anyone remember urine in a test tube?”
OHH, yes! I was a science geek at the time (almost 14 years old), and the idea of dropping a pill into a test tube containing my urine and some water, and watch it fizz up and change colors (and sometimes overflow just a bit) was wonderful! If the solution stayed light yellow, it meant my urine was suger-free, but that was boring. When the solution was a +4 in sugar, it would turn the most amazing blues and greens! Almost enough to make me want to be sure I was “spilling” sugar just to see what colors I would see this time.
Did you boil your syringes, too? Ah, for the good old days… not!!

1 Like

a trip down memory lane? then this should be a real hoot!

Did you become an artist? Fashion designer? Mad scientist? Just wondering.

Remember Clinitest . I rarely got the blue color which meant that at some time in the previous couple of hours that my BS may had been 130 or less.
Now, I wonder how much longer than 130 mg/dl. Was i really at 100, or was i as low as 22? In retrospect, very scary.

1 Like

@Dennis. A doctor at the hospital was a bit of a scientist and so I did a 0% and he drew blood. 3 hours later he told me I was about 190 mg/dl so i renamed my kit to “190 test“ for me. It was the best they had for home monitoring for a little while. Don’t miss it either.

1 Like

As a little kid watching it fizz was fun. Sadly that did nothing to encourage a future in scientific endeavors, as I did not do well in those classes. But pardon me - like Sophia Petrillo on The Golden Girls - I digress.
Getting the sample without getting hands wet was challenging for us girls. I don’t recall if paper Dixie cups were available back in those dark ages ago my mom confiscated the plastic mixing bowl from my Easy Bake Oven and kept it in the bathroom for me to use :tired_face::grimacing:.
That reminds me - who remembers the 24 hour urine catch? Again much easier for the guys, and as you were collecting your sample you had to - horror of horrors - keep it cold! In the fridge! Where your FOOD goes!!! When I was working I didn’t want to use one of my precious days off for the sole purpose of peeing in a bottle, so I did it over the weekend - and the bottle had to sit in the fridge (placed discretely in a bag) for two days.
I recall waiting for my doctor to call me back to the exam room and a woman was checking out. The receptionist told her a 24 urine test was listed so she handed her the container bottle. Oh the expression on that woman’s face as she looked at the bottle, then the receceptionist (like "Say WHAT???"- over and over again.
Ah, the good old days.

1 Like