Patient B “Diabetes needs Attention”
Patient B is 80 years old living in a Condominium with her son. She got four children. Two are away and one Daughter is living nearby..Her son is teaching in a University and only comes back at night so her daughter comes often to visit her..Usually thrice,twice to once a week.
Patient B is plum, about 70kg and 5’3inches tall. She is quite talkative, jolly and independent. She do simple house hold Chores like sweeping and some wiping.. she loves to sit on her sofa and watch movies. She loves to eat as well.. Sometimes she cook meals for her son but usually her Daughter always buy outside food or if not they will go out together to eat.
Patient B has diabetes for long time. She had been managing herself for a quite period of time. She inject herself with insulin and able to walk without assistance but slow. Sometimes she uses her walking stick…
One day, she felt that her right toe is becoming numb and got some redness. She did not mind cause she thought its just normal so she never told her children about it. But after sometime, she noticed that her toe becoming black. She quickly called her daughter and told about it so her daughter came and when the daughter saw it, she became worried.She suggested her mom to go with her and see the doctor. When the doctor checked, the doctor is quite unhappy so they admitted Patient B and did some checks. The results is quite bad.. Doctor talked to the family and said that the only option is to amputate the toe otherwise the infection will get worse. The operation was scheduled.
After the operation, Patient B had changed a lot..She refuse to talk and eat. Sometimes she just cry. Her daughter tried everything to make her smile by telling stories, asking what she wants, etc.. but Patient B doesn’t listen. She just lay down and sleep. She became depressed…
All the children came to the hospital and decided to engage a private care provider for their mom.. “Carer Helen” came to the hospital on the day of Patient B discharge. Carer Helen greet the patient and introduce herself but patient B did not respond. The family brief Carer Helen about the patient’s condition.. They waited for the discharge plan from the doctor which includes the medications and special instructions and go home..
Carer Helen had a hard time adjusting as the patient is not talking and also not cooperating. Patient B also didn’t want to stand nor move.. The carer had to transfer Patient B from bed to wheelchair, bed to commode.. Vise versa..
Everyday Carer Helen had to cook meal for the patient and for herself, do some light household help like sweeping,do the patients laundry, take care of Patient B by giving her a bath, Grooming, wound cleaning and dressing, preparing meals, taking her to the toilet, checking the glucose, give patient a bath and others..
Patient B never tried to look at her wound everytime Carer Helen had to the wound dressing. Carer Helen knows that after amputation, it’s normal that the patient grieve because the patient feels that something is loss from her body. And that she will give time for the patient to accept it.. she also knew that she needs to explain about the amputation so the patient will fully understand. Carer Helen then patiently educate the patient. She explained about the importance of amputation . She assured the patient that amputation of her toe will Not make her less independent and that she can still able to walk. The carer gives her health teachings on how the healing process of the wound is, importance of using diabetic shoes, diet, exercise and others..
One day while Carer Helen is dressing the wound, Patient B suddenly talk and ask the carer how is her wound. Carer Helen then describe the wound and tells the patient that the wound is healing well.
PATIENT B then started to talk to Carer Helen, telling stories.. making jokes.. Showing interests.. PATIENT B also started to check some stuff, giving instructions and others..
One day, Carer Helen called the daughter and told Patient B was mad and she doesn’t know why. Daughter came and Patient B talks continously telling the carer change the position of her cabinet etc.. The daughter’s face brighten up and ask the carer to talk to her privately…
The daughter was excited and so happy. She held Carer Helen’s hand and thanked her many times. She told Carer Helen that her mom is back. She said that her mom is used to be like that before the amputation. She talks non stop, that she is sometimes get mad but after that she will crack jokes, she is a jolly woman.. The daughter thanked her because they don’t really expect that their mom will be back to her old self.
Carer Helen stayed and work with them for a year until patient B wound is completely healed and dry, able to manage herself independently again. They get a maid who comes during day time to accompany patient B. Carer Helen becomes a family friend. The daughter always invite her when they have occasions or sometimes go out together to eat with the family…
Attention‼️Diabetic patient needs protective shoes. Must always pay attention to foot care, diet, exercise. Checking and maintaining their glucose. Insulin injection and don’t forget to stock some sweets incase their sugar drop ( prevent hypoglycemia)