As we age, dietary needs shift, and older people with diabetes may require more personalized nutrition advice. In Kenya, malnutrition among the elderly is a growing concern, especially in care homes where undernutrition is more prevalent than being overweight. It may not always be appropriate to restrict fat, salt, and sugar intake for every older person. For instance, poor or irregular eating habits can increase the risk of hypoglycemia (low blood sugar).
In addition, oral health problems, effects of medications, and reduced mobility or vision can affect a person’s ability to eat comfortably. It is common for fluid intake to decrease in older people, which can lead to dehydration, especially during illness. In Kenya, the need for personalized dietary advice is critical, and a nutritional assessment by a dietitian can help address concerns like meal supplements, weight reduction, or the inclusion of manageable foods.
In care homes, nutritional assessments should form part of an individual’s care plan, taking into account personal food preferences. Care home staff, especially catering personnel, should be trained to understand the specific dietary needs of older people with diabetes.
Physical activity remains crucial for older individuals with diabetes in Kenya, as it strengthens muscles, improves mobility and balance, and enhances insulin sensitivity. It also helps maintain mental well-being and reduces the risk of falls. Even light resistance training and balance exercises can make a significant difference for older people, including those who are frail.
For housebound individuals, physiotherapists can teach exercises to improve limb strength and flexibility, which can be supported by caregivers. However, always consult with your GP before starting any new exercise regimen.
Hypoglycemia occurs when blood sugar levels drop below 4mmol/l. Older people in Kenya with diabetes may be at higher risk of hypos due to factors like insulin use, diabetes medications, chronic kidney issues, or poor food intake. Many older individuals find that their hypo warning symptoms become less obvious, or they may not experience any symptoms at all. Early signs observed by caregivers may include:
For housebound individuals, physiotherapists can teach exercises to improve limb strength and flexibility, which can be supported by caregivers. However, always consult with your GP before starting any new exercise regimen.
Unnoticed hypos can lead to serious symptoms such as confusion, speech difficulties, poor appetite, aggressive behavior, falls, unconsciousness, cognitive damage, and even heart attacks or strokes.
Treatment and Prevention: A hypo should be treated immediately with fast-acting glucose, such as a sugary drink or glucose tablets, followed by something starchy. If the person is unconscious, call for medical help. To prevent hypos, regular mealtimes with carbohydrate-containing snacks and relaxed glucose targets are essential.
Depression and anxiety are common among older people living with diabetes in Kenya. Conditions like painful neuropathy, foot ulcers, and the side effects of medications can contribute to emotional distress. Additionally, the risk of dementia increases with age, which can further complicate diabetes management.
Simple mental health screenings, such as tests for depression or dementia, can help detect these issues early. For those in care homes, screening on admission and annually is recommended. If living with diabetes and dementia, having the right support is essential for improving quality of life.
In Kenya, older individuals with diabetes are more likely to be admitted to the hospital when unwell, as diabetes can exacerbate other health conditions. During illness, blood glucose levels can rise quickly, especially in dehydrated older people. Extra monitoring and support from caregivers are essential to avoid complications.
A personal care plan that includes specific guidance on managing diabetes during illness is important, especially for those in care homes. This plan should clearly outline when medical attention is required.
As people age, physical changes such as reduced mobility or failing eyesight can impact their ability to manage diabetes independently. For example, conditions like glaucoma, cataracts, and macular degeneration are more common with age. Reduced mobility may hinder daily foot care, increasing the risk of missed early signs of complications.
In Kenya, it is important not to assume that symptoms are simply due to aging or diabetes. Any new symptoms should be investigated, and additional support should be provided for self-care and monitoring when needed.
By addressing these key areas, older individuals with diabetes in Kenya can lead healthier, more fulfilling lives. Whether at home or in care facilities, personalized care plans, nutrition, and mental health support are essential for managing diabetes effectively.