Training and Trusting Family Members to care for T1 Child


(Punkiesmommie) #1

What if you have done everything you can to educate someone on things like treating a low and then when the time comes for them to do it they cant remember how it is done correctly? Do you continue to trust your Child with that person?  I Left my daughter in the care of someone who I should be able to trust. She had to get two units of Humalog at dinner because her sugar was over 200. When she gets that extra insulin we ALWAYS have to check before bed to make sure she has not dropped too low. When he checked her blood sugar it was 54, he treated it with a cup of milk. (1st and second mistakes, 1 milk is not fast acting, 2 only 11 carbs not 15, and btw glucose tabs were on hand) , He checked it again about ten minutes later and it went up to 62 , so he gave her 1! glucose tab that had only 4 grams of carbs. then NOTHING ELSE. no recheck to make sure it even got to normal!!!!!!!!! Hours later I come home I ask my questions .. I get this story. IMMEDIATELY i checked my daughters levels and it was up to 189. AWESOME THANK You Jesus. BUT WHAT IF? What if this did not happen ? What if it was one of those lows like one time before it took three tries to get it back up and he never would have known because he did not check again!? What if I never thought to ask because I trusted this person. It scares me to think of the consequences of the what if's . I ask what I can do to help them learn and they tell me they just have a hard time remembering unless they practice it regularly. but how do you practice treating lows that don't come around that often to practice ?  Anyone else have these problems?

 

Sorry to be so long winded. I am frustrated and I need help!! I feel so lonely when it comes to managing my daughter's care.


(Eric_Carpenter) #2

It can be rough trying to find someone who understands diabetes, I remember family members who assumed my glucometer was broken when I registered 400 and fed me lunch anyway.  If you want to keep using the same person, you might look at how you are presenting the information.  Are you giving separate, static pieces of information?  This can be hard to remember, and can be difficult to apply, especially in a stressful situation.  If the person cannot remember what to do, you might consider giving them checklists for special situations (for example, what number is a "low", a standard number of sugar tabs to treat it with, and a reminder to retest in 10 minutes).  Consider using the environment as a reminder, like putting glucose tabs beside the bed or with the glucometer.


(JDVsMom) #3

I totally understand where you are coming from - everything you wrote is exactly what I fear in trying to train someone else. I am terrified of a time of having to leave my son for some unexpected emergency with someone who I haven't totally trained on this!

Here is what I have done the handful of times I have left my son with someone else. I write down everything but limit myself to a half sheet of paper. the last one looked something like this.

Check BGs at 4pm, pre-supper, bedtime.

Give snack before going outside to play regardless of BG.

If BG< 100 treat with 1 pack fruit snacks and check 15-20 min later. If still <100, call me.

If BG>200, call me.

For supper, calculate carbs and divide by x. Round down to nearest half unit for Novolog. Write it down ____

Give 2 units Levemir at 6pm.

It seems like it is easier for them to remember if it is kind of a checklist and says specifically what they should treat with. I also prefer that they call me if there is a problem that they are not sure about. That said - I have been on 2 dates with my husband in the 4 months since my son was diagnosed because I don't trust anyone to care for our son!!! And it is starting to drive me crazy!

 

 


(cdavid1) #4

A checklist is the best way to go.

And if you don't have a glucagon kit on hand, get one, make sure the person watching your child knows where it is and how to use it! Diabetes is not an exact science and it takes a long time to understand everything, be patient and make sure you are thoroughly going over everything and make sure they know what you're talking about.


(sarahslp) #5

Can you have the person call you after each blood sugar check (unless your child is so low they need immediate help of course), so you can instruct him of the next step? I'm sure there are responsible people out there! Sorry this person hasn't been so.

Growing up, I had friends' parents do strange things w/ my food at sleep-overs! Luckily, made it through! When I was little, my Mom would often stop by late at night or early in the am during a sleep-over to help. (:

OK, so I was diagnosed back in the dark ages, but back then, doctors did tell my Mom to give me milk OR juice when I was low. Is this no longer advised?


(bassoonist1719) #6

I've heard that milk apparently works because of the lactose in it, but I haven't actually ever tried it.  If it is skim then it probably has a decent chance of working well without the fat.  I'm not positive on this info, though.

Other than that, I agree with what everyone else has said.


(JDVsMom) #7

Any food with carbs will work to treat a low. But that the glycemic index of the food will indicate how fast it will bring the BG back up. For instance glucose tabs have a high glycemic index (100) but milk has a low GI (40), and most juice is 70. So if you take the 15 g of glucose tabs or enough milk to equal 15 g, both will eventually get you to the same BG, but it will just occur at different rates, the milk taking longer. Since if you are having a bad low, you want the BG to get up fast, use something with a higher GI.  

 Google "glycemic index" to find out more on the science. or click here for some GIs of common foods. http://www.lowglycemicdiet.com/gifoodlist.html

If my son is just below his target (say 90) then I'm not so concerned what I or anyone else treats with as long as it is the right amount of carbs. If he is well below target (70 or lower) then I want the BG to get up as fast as possible and for that I swear by fruit snacks. He likes them, they come in little 15-19g packs that I can easily keep stashed everywhere, and I always see at least some improvement with in 15 minutes and less likely to over treat the low than when we treat with juice first. We were also taught that after an extreme low that it is a good idea to follow up with a moderate snack, like 4 oz milk and half a PB sandwich as these foods will have a little more BG staying power (being lower GI foods) and will help keep the BG from crashing again. 


(2boysmom) #8

Well, you are a step ahead of me. We have no one else trained to care for my son so either myself or my husband is always with him.  We have one family member that has taken an interest in learning, but she is so busy that she doesn't have time to spend any real time learning.  I really miss being able to get some time "away".  Even just a dinner out would be nice.

I agree it does feel lonely!

 

Brenda


(LauraJ) #9

Is there a local JDRF chapter that you could contact about a baby-sitter who has T1?? I just thought of this idea (i'm 18 and always looking for cash!!). You might be able to find someone who you dont have to "train", but just specify exactly what your child needs.


(Punkiesmommie) #10

Well the instructions on treating a low always say "fast acting" sugar. And as far as I know things like frosting , cake gel, glucose tabs bring it up really fast.  Milk has a pretty low Glyemic Index so I never thought of it as a way to treat a low. But it seems like it worked in this situation but like you said it took a while because when he checked it ten minutes later is was only 62. but when I checked her later it was 189. so eventually it worked.   thanks for you feedback :)


(Kaprice) #11

As parents of a diabetic child we will always have to be concerned.  I have taken it slow with family members that take care of my son for short periods of time.  They have been trained how to take his blood glucose levels and how to treat lows.  We fully take on the responsiblity of giving our son shots. How I feel is that the person most likely that is taking care of your child does not deal with diabetes on a daily basis and I feel you cannot expect them to remember everthing. I remember how long it took both of us to remember everthing before it became second nature.  My recommendation is to check in frequently even though the person has been trained and coach them on what the next step should be for your childs care.  This will make the experience more comfortable for you as well as the caregiver.  Good luck


(Punkiesmommie) #12

[quote user="Eric_Carpenter"]

It can be rough trying to find someone who understands diabetes, I remember family members who assumed my glucometer was broken when I registered 400 and fed me lunch anyway.  If you want to keep using the same person, you might look at how you are presenting the information.  Are you giving separate, static pieces of information?  This can be hard to remember, and can be difficult to apply, especially in a stressful situation.  If the person cannot remember what to do, you might consider giving them checklists for special situations (for example, what number is a "low", a standard number of sugar tabs to treat it with, and a reminder to retest in 10 minutes).  Consider using the environment as a reminder, like putting glucose tabs beside the bed or with the glucometer.

[/quote]

Thanks for your feedback. That is incredible they thought the meter was broken. I mean wow. Our pediatrician just told us that she has another child diagnosed in the early stages like Cheyenne and they just were in denial even after an Endo gave them the diagnosis they did not treat it and the child actually ended up sick. Terrible. I am going to bring this person with me to more Dr's Appointments with Cheyenne and I am going to have some charts posted in the house. I realize that even though this is burned in my head , it is not as easy for others. Hands on, easy access resources and starting a habit of checking every time for this person may be the trick as well.


(DancinVicki) #13

Lows are such a confusing thing.  I've had diabetes since I was 11.  I've had some scary ones, but never anything dangerous.  The hardest part sometimes is trusting that the sugar you take will work.  but it will.  Yes, milk will not make you feel better right away, but it will bring your sugar up.  You also don't want to scare a caretaker so much that they overfeed your daughter with sugar.  I guess the stress of the low, or even the stress of worrying about it coming up will make your blood sugar go up anyway.  The thing is too, protein helps your blood sugar sustain longer.  so the milk is probably what made it go up and stay up.  Juice or glucose tabs, on the other hand, could make her crash again, as you described happened before.  sometimes it's best to treat with a bit of glucose tabs or juice, and then a bit of protein. So, perhaps the milk was a good idea.  The only trouble is, when you feel the low and feel sweaty or shaky, it's not so nice and you want it to go away fast.  it's tricky.  i'm still learning after 24 years.  but i still try to tell myself to relax and let the sugar work, even though i want to drink a whole bottle of juice!  hang in there.