As we age, many changes can take place in our health. Cognitive changes happen in some people at a relatively young age and in others, at a much older age. Older people with type 2 diabetes have a higher risk of changes in cognition and a higher risk of developing vascular dementia and Alzheimer’s disease. Effects on cognitive functioning are also seen in type 1 patients. This is a significant problem as over 27 percent of the people in the United States over the age of 65 have diabetes.

When cognitive functioning declines, it impacts the ability to take care of the special needs of the elderly with diabetes. When a caregiver or a person with diabetes becomes aware that cognitive changes are happening, it is helpful to be informed about resources available in order that they may effectively handle situations that are likely to develop.

Here are 7 things you need to know to help yourself, an elderly family member or friend:

1. Doctor Visits: If memory is an issue, bring a family member or loved one to visits with the doctor. Ask the doctor if notes can be taken or if the visit can be recorded. You may also want to ask the doctor to write down significant orders and give you simple written information on topics covered. If friends or family are not available to help, hiring a health advocate to attend medical visits and help set up necessary care may be an option. Call your insurance to see if the service of a health advocate is covered. Call your local home health agency and your local health department to see if they also offer services.

2. Diabetes Control:
The risk of hypoglycemia is great in many elderly people with diabetes. If the physician did not individualize goals for blood glucose and hemoglobin A1C, ask if this is a good idea.

3. Medicare:
Medicare part B and part D covers many needs of older people with diabetes. Check the information from Medicare here to see what is covered. If you have private insurance instead of Medicare, call to see what your benefits are.

4. Nursing Services: You may want to ask the doctor if a nurse can be hired to help set up care in your loved one’s home to help manage their diabetes. Nurses can set up pill boxes and some brands of insulin can be pre-filled in syringes for a few days and labeled and dated. This may be a possibility if your loved one is able to correctly remember to take their tablets and insulin but not able to draw up the correct dose of insulin or to open medication bottles. Ask your physician if this is a possibility.

5. Nutrition Services: Ask your loved one’s dietitian if they would write a week or two of appropriate menus. These could include microwavable dinners or meals prepared, labeled and dated if the person is competent to work the microwave. If there is a homebound situation, see if there is a local Meals-on-Wheels program that offers selections for people with diabetes. Find more information here.

6. Significant Cognitive Decline: If your loved one has significant cognitive decline, you may wish to look into an assisted living residence. Check to see what is included in services and visit the facility as they can differ significantly. Assisted living homes may be run by local governments or may be private.

7. Nursing Home and Hospice Services: Nursing home and hospice assistance may be needed along the continuum of care. It is wise to know what is available in your community. Ask for information on the types of services available ahead of time. It is wise to make decisions regarding end of life care at the earliest point when one still has the ability to understand options and express informed preferences.

Be proactive for yourself or your loved one’s future care. It will give you time to plan and arrange the care you would like to have when needed.