Health coaching at home
by Jennifer Leeflang
Mar 30, 2016 | 11384 views | 0 0 comments | 128 128 recommendations | email to a friend | print
People can get diabetes at any age, but the risk increases as we get older. According to the Centers for Disease Control and Prevention, over 11 million older adults in the U.S - nearly 26 percent of people 65 or older - are living with diabetes.

Most of this older population has type 2 diabetes, meaning that the body does not know how to use insulin properly. Conversely, those who have type 1 diabetes, previously known as juvenile diabetes, produce little or no insulin.

When there is little or no insulin or it is not used as it should be, glucose builds up in the bloodstream and does not access the body’s cells, potentially causing heart, kidney, blood vessel, and/or nerve damage.

As a registered nurse and the leader of Partners in Care, a licensed home care agency affiliated with the Visiting Nurse Service of New York, my colleagues and I work hard to help our elderly clients minimize discomfort and potential complications from various conditions, including diabetes.

Some of this work includes making lifestyle changes, which can be extremely difficult for some clients. For example, when Sashana Jones, a certified home health aide with Partners in Care, was tasked with helping Henry, an 85 year-old diabetic, a challenge arose.

Henry recently suffered a stroke that weakened one side of his body, making it difficult to move about easily. Since he had limited ability to exercise, he put on significant weight, ultimately affecting his blood sugar levels.

In order to manage his diabetes, Jones spent months and months trying to get Henry to forego his beloved sugared drinks and bread products.

Due to her training as a health coach, Jones knew that one of the best ways to help Henry improve his diet was through motivational interviewing, a technique in which the caregiver assists the patient on setting his or her own goals for better health, collaborating on a plan to get there.

It is not about what Jones wanted for Henry, but rather getting Henry to realize what he wanted for himself. This method resulted in him eating smaller portions, substituting water for sugar drinks, and consuming more vegetables.

Although Henry still cannot manage a full exercise routine, he works on stretching and therapeutic movement and these lifestyle adjustments have allowed him to shed some pounds and stabilize his blood glucose.

For many people like Henry, it is important to remember that while managing diabetes can be serious, there are certainly ways to cope with the condition. In addition to managing your insulin levels and taking medication, there are lifestyle choices one can make to help deal with diabetes. Here are a few things to keep in mind:


Eating healthy is always important, especially when living with diabetes. It is important to know how various foods affect your blood sugar levels and how much to consume. Some tips to remember:

• Carbohydrates are the foods that often have the largest impact on your blood sugar levels.

• Try to eat a well-balanced diet, including starches, fruits, vegetables, proteins, and fats.

• Avoid sweetened beverages; they are high in calories and offer little nutritional value. Not to mention, they can cause blood sugar to rise quickly.

• Do not skip meals. Keeping consistent eating habits is extremely important for your blood sugar levels.


When you exercise, your muscles use sugar for energy, helping your body to use insulin more efficiently. This means improving your blood sugar levels. Keep in mind:

• To talk to your doctor about what blood sugar levels are appropriate for you before starting to exercise.

• Check your blood sugar level before, during, and after exercise to ensure your levels stay at a safe place. Just in case, always bring water, a small snack, or glucose tablet.

• Make an exercise plan to figure out what types of exercise if appropriate for you.


Stress can make blood sugar levels difficult to control, which is why it is important to keep your stress under control. If you’re feeling stressed try some of these techniques:

• Try relaxation techniques such as deep breathing exercises.

• Make sure to get a good night’s rest (at least six hours) every night.

• Engage in healthier habits such as taking walks throughout the day.

Jennifer Leeflang is senior vice president for Partners in Care.
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