Conformity, Acquiescence, Agreement, Resignation, Submission, Obedience, Resignation, Willingness, Consent and Yielding, all capture a word we hear about patient behavior, Compliance.
When it comes to diabetes there are certain rules of compliancy that even the most rebellious of us must bow to and _ yes, comply with. They are the basic guidelines of healthy and balanced meals, adherence to medication or insulin if needed and moving to physical activities on a regular basis. When put in these terms it is not just compliancy, it is managing and controlling diabetes to a favorable out-come, so I thought.
Cases in point, Paul is a fairly healthy 78-year old T2 who no longer checks his bg because he is simply tired of doing it. His weight is average, he takes his daily doses of Metformin and gets in some exercise. “Why bother sticking my finger everyday when there is no need? I’m too old to do that anymore”. The problem is he is so close yet so far away. Checking bg’s is a necessary tool that must be used.
Silvia has had a number of health problems besides her T2 diabetes. She is quite overweight and resists any thoughts of exercise and physical activity. She sees her “diabetic doctor” every three months and laughs because the doc says the same thing at every visit. Lose some weight and get moving. Silvia laughs but does not get it.
Ron is a nurse who ignores his T2 diabetes because he is simply too busy to take care of it. He doesn’t have the time to eat right or exercise but he does take his medication. He is always exhausted and keeps gaining weight. He is now taking insulin and complains about tingling in his feet. . Since he is a nurse this behavior is unbelievable. It must change.
The reason I am telling you about these people is two-fold. One is letting out my frustration by writing about it and the other is to figure out how to get them and others like them to be “compliant”. Why can’t they embrace the fact that if they take care of their diabetes perhaps some of the other problems will diminish. My dream proposal is to have doctors write prescriptions to all non-compliant patients for exercise. They are given scripts for medication so why not prescriptions to go to the clinic or hospital or other facility three times a week to do an activity. It might be that a trainer or exercise physiologist accompanies them for a walk, jog or bicycle ride or perhaps a deal can be worked out with local health clubs or gyms or community centers for setting aside time for diabetes and exercise sessions.
Maybe it’s a pipe dream but good things always begin with a dream and baby steps. Next week I am taking Paul, Silvia and Ron for a one-mile walk, probably kicking and screaming, along the beautiful River-walk along the Hudson River in New York City.
Any chance you know some non-compliant PWD’s and now feel inspired to get them started on a MoTo Move activity?