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Paula Trief Part 4, What Can Partners Do To Help The Patient?




In part 4 of this Exclusive Interview, Paula Trief talks with Diabetes in Control Publisher Steve Freed about the importance of education for the partner of a person with diabetes, among other things they can do to be of support.

Paula Trief, PhD is a Patrick A. Lehan Professor of Physiology and Biophysics and Chairman of the Department of Medicine Department at University of Mississippi.

 

Transcript of this video segment:

Steve Freed:  You know the partner program can be very beneficial for both people. I always tell the patients that I deal with, “If you do everything I tell you, both you and your spouse, you’re going to be healthier together than 95 percent of the population out there. Give them some incentive to work together. So what are some of the things the partners can do to help the patient?

Paula Trief:  Well as I said a little earlier, first they really need to know about diabetes. We have a lot of partners, couples, where the partner really didn’t know very much and sometimes that was because the patient just didn’t want them to. They were like, “Here’s my disease. Leave me alone,” because they were so worried that they would get kind of hounded. So first we start with education; they really need to understand the disease and what’s involved, not break through some of the myths. You know like you can’t eat sugar and those kinds of things. And then we think they can support each other in terms of their behaviors. So if I wanted to do an exercise program, then you could exercise with me or make sure that you take care of the kids so I can get to the exercise program and get to the gym — just being alert to my needs and being alert to the emotional needs. So if I’m down because I have diabetes and I’m feeling depressed or frustrated, don’t add on more depressed and frustrated feelings at those times. And then as I said they could just try to change themselves. You said work together and in many cases, probably the majority of cases, even if the partner doesn’t have diabetes they also have some health issues, in our sample.

Steve Freed: You know one of the things that you mentioned especially for type 2 – for type 1 diabetes, you have to get educated. So that’s a given. But type 2s like you said, most of them are not educated. And the reason for that is that the doctors never told them they have to get educated. It makes it difficult for you so, you’re not a diabetes educator, so when you find patients that are ignorant about their diabetes, don’t know what a carbohydrate is, or portion control. You want to get them educated so what do you do?

Paula Trief:  So I’ve learned a lot about diabetes so I can give them the basics and then I usually encourage them to get an appointment with – you know there are diabetes educators but most of our patients go through our Joslin Center or even in their primary care, if they go into a primary care, they have access to those kinds of classes. So I encourage them to go together essentially. There’s a lot of information online that people can get good information online and I encourage them to get that kind of information to go to their visits. Go to the patient visit with their doctor so they can ask questions. It’s not hard to get educated if you put your mind to it I think.

Steve Freed: It’s not hard to get educated like you said, if you put the word diabetes in Google, you get 36 million hits. And most of that information is wrong. They’re trying to sell you a product to cure you.

Paula Trief:  Yes. But if you go to the ADA web site there’s tons of information.

Steve Freed: So it’s important that they know where to go. Not just to go on the Internet and Google for diabetes. You know, it makes your job a lot easier if they’re educated. So what are some things that you try to tell the patients to avoid as partners?

Paula Trief:  Well we try to tell them to avoid this kind of nagging diabetes police role, but as I said I think that is really a challenge sometimes. And what I emphasize with the patient there is to recognize that in almost all cases, assuming we’re not talking some major marital weirdness going on, in almost all the cases the reason that the partner is hovering or nagging is because they’re anxious, that they’re nervous, and the patient needs to understand that; they need to understand that it’s because they love them and they care for them and they’re concerned about them, that that’s what’s motivating them. That doesn’t mean it’s OK but that that’s what’s motivating them. And that when they feel like they’re being nagged that’s when they should talk to them about that, they have to have a discussion about how are we doing this together. Not a discussion about diabetes but a discussion about the relationship.

You know a gentleman came up to me after my talk yesterday. And he said that he does groups with patients and partners and they had this discussion in the group about how many times can a partner remind someone to do something before it’s considered nagging. And he said it was three. He said they decided in their group that you could remind someone three times. Now in my house, that would be considered nagging. But I mean two would be considered nagging so you have to know your own couple. Everybody’s very very different. We talked about about the importance, if you’re in a health care setting, you usually have a little bit of time to get to know the people; you need to think about their age and the gender of the patient, the culture they’re in; in some cultures the women have very traditional gender roles and you need to understand how that may play a role. So it’s worth spending some time getting to know that couple. And not putting some kind of ideal on them like, this is the perfect couple at managing diabetes. It’s just helping them make small changes so that they feel like they’re making progress.

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