Observing diabetes management practices of Mexican-origin caregiving dyads in home settings

Families can play an important role in an elder's diabetes care. However we know little about how elders and their families manage the disease in the home. This study qualitatively examined the pattern and range of assistance that family caregivers provided to Mexican-origin elders with type 2 diabetes. We conducted in-home observations of six caregiver-care receiver dyads living in East Los Angeles. We conducted an initial interview separately with each dyad member on cultural beliefs about caregiving and diabetes, and subsequently visited each dyad in their home 10-15 times over 3-4 months. Observations were recorded retrospectively after each visit. The written notes were examined for patterns across dyads, using Atlas.ti software. The mean ages of caregivers and elders were 49 and 74 years, respectively. All elders were functionally independent. We found that caregivers provided primarily intangible support rather than direct care. Four of the dyads had structured routines for taking medicines—in three of these dyads, elders were in charge of their own medications. All caregivers were solely responsible for meal preparation. While we observed various diabetes care practices in most dyads, only two dyads engaged consistently in several practices, namely glucose monitoring, foot care, and medication management. Only three dyads performed regular physical exercise as part of their daily regimen. Our results suggest involving caregivers is a promising strategy for better glucose control given their level of involvement with elders' diabetes care—however, both caregivers and elders would benefit from more education and training in diabetes management skills.