This morning I was sitting on the back of my boat watching the sunrise and thinking how very fortunate I am, and how much I have to be grateful for this Thanksgiving morning, when it occurred to me how many others did not feel quite so good today.
For people with diabetes Thanksgiving is the beginning of a difficult season that frustrates and disappoints them. They are constantly reminded of all the activities they will be attending and aware that, in someway or another they will all involve food. You cannot even go to the ballet without sugarplums being forced down your throat. TV ads will show all the tempting things and everyone you love or know will use the line, “you can eat it after all its Christmas time!”
Helping your patients prepare for the holidays should be a regular part of every education program or a major component of the support groups so many of us run for our “alumni”.
One of the ways of dealing with these frustrations is active planning on what to eat during holidays and how to make the best choices when there are temptations all around you.
Many years ago we started a holiday tradition at our hospital in New York. We invited all the alumni of our program to join us for an early holiday dinner, held at the beginning of November.
Our diabetes educator, Virginia Rago, worked with the dietary department to prepare a full Thanksgiving/Christmas dinner. The patients and their families joined us and we all dressed up in holiday clothes. Everyone paid a minor fee to attend and participate in the program.
Our dietitian, Monica Falker prepared a placard in front of each dish with the breakdown of components and included calorie count as well as the portion size. In those days we used the exchange list and that was included on the sign.
We often spend a lot of time during the year telling people what not to eat and this was a better activity to help them feel more a part of the world.
We escorted each person through the line and helped them select their portions and guide them in making their choices. On the table were some of the things that you would never encourage people with diabetes to eat. And ways to work around them.
For example candied sweet potatoes were such a temptation and we didn’t have the heart to say never, so we used fresh yams, artificial sweeteners and much less Marshmallows. It really worked well.
We suggested how to deal with all the food and good intentioned suggestions from their friends. We talked about planning activities that were fun and joyful and had that holiday feeling without eating every minute of the day. We talked about stringing cranberries and popcorn for tree decorating parties. Popcorn will fill you up and your craving for sugar cookies won’t be so strong.
This is the time when people have so many more alternatives in food choices. Encouraging your patients to call their dietitian really can help before they choose to “go off the wagon.”
We need to be extra sensitive to the depression that often occurs during this holiday season. Since many of our patients are not surrounded by loved ones and there may not be the holiday parties to attend, the depression and feelings of anxiety can quickly become overwhelming.
Encouraging your patients to get involved in activities at senior centers or volunteering to help at shelters or nursing homes is a great way to turn them towards the positive feelings of the season. Part of holiday planning should remind people that waiting for the door bell to ring can be less fun then making that call or ringing the doorbell themselves.
I wish you all a very warm and wonderful holiday season. Who knows, I may go outside and decorate a palm tree. Happy Holidays!
Ginger Kanzer Lewis has been teaching people with Diabetes for almost thirty years. She is a Registered Nurse with a Masters Degree in Education from Harvard University and Certification in both Diabetes and Continuing Education and Staff Development. Ginger has spent over twenty years teaching educational methodology to health care professionals while working as Director of Staff Development or Education in Hospitals through out the North East. Ginger is the immediate Past President of AADE and is a well known national and international speaker.