Assisted Living Facilities will be facing a flood of elderly (and not so elderly) patients as the “baby boomers” (people born 1946-1964) become seniors. These boomers are the largest segment of the population, and their rate of Diabetes is the highest recorded of any generation before them. In addition, the entire American population is experiencing a similar increase in the rate of Diabetes.

This epidemic will present significant challenges to our future health care facilities. Now is the time for these facilities to start preparing for the special needs that large-scale diabetic care will present.

1. Facilities with specially trained staff in diabetic care will be ahead of the game and certainly look more attractive to the family members who will need to trust their loved ones to the facility they choose. This training will help staff spot problems early, and provide immediate care, thus helping prevent some of the more serious side effects of this progressive disease.

2. The proper equipment for Diabetic care can make a major difference in the quality of life for the patient and how properly the facility is able to monitor, stabilize and prevent further complications from the disease. This equipment can range from special insulin pumps to control the disease to prosthetic devices that aid in amputee movement (a common diabetic complication).

3. Having the latest and best medication on hand, with a full understanding of how the medication works and its indications.

4. Providing meals by chefs who have been taught to prepare diabetic friendly cuisine.

5. Building modifications (like handrails, ramps, and elevators) that make access in the facility easier.

6. A gym (big or small) with trainers and dietitians that help diabetics get proper exercise and lay out an eating plan specific to the resident’s needs (many times people are pre-diabetic and may be able to eat more things). The exercises can help maintain muscle mass and improve circulation, a common problem with diabetics that can lead to loss of mobility or amputation. These are just a few of the areas a facility can look to improve.

Diabetes affects every group: men, women, children, and the elderly, regardless of ethnic background. In fact, minorities are at even greater risk. Some speculate that those from Asian, African, and Hispanic heritages are less able to tolerate the foods that are so abundant in the American diet, than are those of European ancestry. In addition, socioeconomic status often leads to these populations eating cheaper fast food that often contain high fat, cholesterol, and sugar. The consumption of these foods often leads to obesity, which is the greatest indicator of diabetic risk.

Diabetic kidney disease (nephropathy) accounts for 42% of new cases of end-stage renal disease and is the fastest growing cause of kidney failure, transplantation (over 100,000 cases each year) and the need for dialysis. Nervous system damage (neuropathy) affects over 60% of diabetics, causing numbness, pain, and altered sensation, particularly in the feet and legs. Diabetic eye disease lower limb amputations in the U.S. occur among people with diabetes. High blood pressure often affects diabetic patients, which increases the chances of stroke and heart attack. Higher rates of infection, periodontal disease, complications of wound healing, gangrene, and many other complications can occur. Sometimes, because of this insulin resistance, the blood can become so high in glucose that crystallization can occur and cause major circulation problems.

Certain lifestyle changes in the American culture will potentially expediate this epidemic.

With both parents often working to support their families, there is less time to prepare meals at home. These meals often contain more health benefits than the fast food options. Families consuming processed foods and sodas that contain more complex carbohydrates, fat, sodium, sugar and many other cheaper, less healthy ingredients... these lifestyle changes are not projected to change any time soon.

Further precursors to diabetes include the increasing time spent being sedentary. Physical education programs in schools are often the first to go during budget cuts. At home, computer games and television often replace the physical activity of American youth. This has contributed to increases in obesity among the entire population and to the increase in type II Diabetes in children, a phenomenon almost unheard of just 20 years ago.

How does all this affect the world of Assisted Living?

Unless a cure is found for Diabetes, the disease progression is almost guaranteed to be the largest single health issue for this generation and the ones that follow. The cost of diabetes exceeds the 100 billion dollar mark each year, and has increased between 40 and 70% among different age groups in the last 10 years. With 10 % of each health care dollar, and 25% of each Medicare dollar already going to treat people with Diabetes, the cost is astronomical.

Diabetes information on the internet:

American Diabetes Association

Diabetes Foundation Inc.