Type 1 Diabetes / insulin pump management for my mom with alzheimer's

Teachertee

My 79 year old father is my 76 year old mom's (with Alzheimer's diagnosed) primary caregiver.My mom also has Type 1 diabetes with an insulin pump she is no longer able to manage independently. I live about 15 minutes away and my sister lives about 1 hour away. She is now supportive and on board with many of the suggestions I am making after encouraging her to attend endocrinologist appointments in sort of an intervention style with me, my dad, and mom.

My dad is in denial that he needs help managing all of this. He's calling me in crisis mode constantly asking me to come over and help calm her down or resolve a problem of a lack of medical supplies...as he has continued giving her full independence with making phone calls to order what will be needed. I've suggested he sit with her or take over the ordering process and have offered to do so myself. He worries she will be humiliated or upset so he continues to give her full responsibility. He's now realizing he cannot manage all of this and does not want this to be my "summer project" (I am a teacher who just started my summer break.

Each month I set up their calendar for parts of her pump to be changed (one part is changed every 3 days and another is changed every 10 days). We also write in all upcoming appointments. That has helped, along with taking a photo, sharing it with my sis and checking in throughout the week reminding them what is taking place today or following up with appointments we could not attend with them.

It's so hard to see the decline but also the complete denial that is happening!

My mom was blackening their pots and pans trying to cook on their gas stove. I took the pots and pans away and said I was going to figure out how to clean them. I'm not returning them! They're actually gone and we now send over meals to be reheated in the microwave, with my dad's supervision.

Now she's also having extreme fluctuations with her blood sugar due to constant overeating and lack of self control around food. She's eaten lunch twice at least a time or two, along with insisting on eating a second helping of dessert yesterday as her pump / sensor alerted for a high blood sugar. I reminded her she had already eaten a large helping and she got very angry at me in front of everyone and grabbed the plate of flan, shoving spoonfuls into her mouth stating she will take care of it.

Such a hard journey to navigate. I feel like I am spinning my wheels! Not sure if I am asking for advice, as I am aware of supports that need to be put in place but appreciate you all reading through this lengthy post.

M1

Hi. Have you talked her endocrinologist? I wonder if it might be time to try something other than the pump. In older diabetics, low blood sugar is much more likely to be dangerous than high. Tight control is not so much the issue, though granted in a type 1 diabetic there is certainty still a risk of ketoacidosis if she forgot to take her insulin. Diabetes and mental illness of any kind is a bad combination, but i wonder if it would be easier for your dad to administer fixed doses than to deal with the pump. Not an easy choice to be sure.

Teachertee

M1,

Thanks for your response! We have talked with the endocrinologist and he mentioned that the dosing of the insulin injections could be difficult for my father, on top of my mom being quite oppositional in regards to management of her diabetes care. She's a retired RN, Certified Diabetes Educator and pump trainer...and even though that was more than a decade ago and her brain functioned differently, she's already combative with the take over we're already putting in place (tracking her blood sugar on the app, calendar for when to swap out pump and sensor parts, ordering of her medical supplies...etc.).

If/ or more like when she's forced to live somewhere with appropriate care they will likely remove the pump and switch over to injections. It's just so tricky in the process with my father in denial but slowly realizing himself that he's in way over his head. It's like he's just waiting for the next big crisis to occur instead of putting supports in place proactively. She's been in Ketoacidosis multiple times and it just zaps more of her cognitive abilities each time. My family is fortunate that it has not killed her...and the giant keyword is YET.

Thanks for your advice. We are in close communication with the endocrinologist and he's been so understanding, informative and kind to our family. What a journey! Be well, and thanks again.

Tara

M1

Oh I can only imagine how she will react to taking away the control when this was her professional expertise. I don't envy you. My partner still thinks she capable of fixing anything that comes up (she was a custom contractor) when in fact she can't do any of it any more and I have to just avoid the topics. Glad the endocrinologist is helpful and understanding, that's what it takes in any of these circumstances. Let us know what happens......