In an emergency, please do put on your own oxygen mask before you help others put on their masks"
- Heard during in-flight announcements
This common sentence, often used by flight attendants, has a deeper meaning in life when it refers to family members taking care of people with illnesses. Take care of yourself first, before helping others. This is true for all chronic health conditions, but is especially true when people with Diabetes develop an advanced Diabetes related complication and need the help of a carer, or, as they are commonly referred to, a "caregiver". Diabetes related complications, such as kidney failure requiring dialysis, eye disease causing blindness, or a crippling foot amputation - all of these require extreme care and commitment by family members or close ones. Often the disease, the diseased, as well as the therapy take precedence, and the caregiver suffers silently in the background.
Who is a caregiver?
A caregiver is an individual providing physical and psychological care for a person in need. This usually refers to a family member. In prolonged chronic illnesses, patients require support, sometimes even for day-today activities such as bathing, using the toilet, walking and eating. Following an acute catastrophic illness, usually families and friends pitch in for help and support. But as the disease smolders and takes on a more chronic nature, only a spouse, child, sibling or worse, an elderly parent is left to take care of the person in need. Over a period of time, this leads to chronic stress on the caregiver, manifesting as both psychological and physical ailments.
People with advanced chronic health conditions need to give both time and space to their caregivers. And caregivers, more importantly, need to make time and space for themselves. Caregivers must nourish their own body and mind, take periodic breaks/ holidays so that they can re-energise themselves and their care. Most importantly, caregivers need to do this without a sense of guilt and patients need to support the health of their caregiver without an accusatory attitude.
Apologies for the somewhat stark and bluntly written paragraphs above, which dwells on Diabetes-related complications. This, I admit, is not really a feel-good style of writing, but I could not find a way to gloss over these awkward truths. Of course people with Diabetes need not worry excessively. With diet, physical activity, monitoring and medications, people with Diabetes can and will live a healthy and a complication free life. But caregivers have a role to play even in apparently healthy people with Diabetes. Like for instance, by supporting good nutrition by not stocking junk-food at home, and also by allowing their partners (especially women with Diabetes) to take a break from their household chores and do their exercise. Healthy home food is important for people with Diabetes. Indeed, there is no such thing as a purely "Diabetic diet" and a diet for people with Diabetes should be a healthy one which everyone can also consume.
In these pages, we salute the caregiver, and, via real life examples, we show how both the patient and their caregiver can together find happiness. Caring for a loved one can be a fulfilling experience and this often forges a bond of emotion and closeness. As you browse through the articles in this issue, may you, as a caregiver or a person with Diabetes, feel inspired to make your life more joyous and peaceful.
Dr Unnikrishnan AG