Avoid appointments altogether. order Vadadustat Inquiring further, he stated that he always tries his best; however, life events seem to get in the way, increasing his stress level and affecting his blood sugar numbers. He explained that during some appointments there had been some serious communication expressed to him about his inability to improve his blood sugars and self-management routines. At one point, Joe was instructed to decrease his stress level, period. This seems like such an absurd directive, and the instruction itself contributes to the person’s stress. Joe is still struggling to reduce the stress in his life, but he does not know how. I wondered how someone could reduce the stress of a divorce or the death of a family member. The idea of community comes to mind again here, but community is not an important concept in modern health care. Sadly, community is thought of as a place, not a relation. Over the next two months we discussed some of Joe’s life stresses, which included housing, access to healthy foods, Quinagolide (hydrochloride) side effects financial struggles, and mobility. I assisted him with accessing his local food bank, and with the help of the Community Care Access Centre (CCAC) he obtained a walker and other home safety equipment. As our relationship grew and we continued to develop trust, Joe continued to slowly reveal his deeper struggles of living with diabetes. He spoke about having fear of diabetes when he was a child, watching his grandfather die of the disease, and feeling threatened by family members of “catching” diabetes if he ate too much sugar. Many of our conversations cycled and intertwined with multiple aspects of his life, past, present, and future. By paying close attention to his stories, I was able to notice that he was reflecting more and more on how he felt about diabetes that day. In addressing some issues within his situation of resources and accessibility, things that have hindered Joe’s self-care in the past, diabetes was becoming more of a priority for him. He recognized the need for attention to the diabetes portion of his life but felt overwhelmed in trying to deal with the other aspects of life that often took priority. During our subsequent visits, Joe and I explored the idea of control with his fluctuating blood sugars, and he started using a calendar to track only his low blood sugars along with the reasons why he felt they had occurred. I followed up with him one month later, and his calendar was blank. He explained to me that he was better able to manage the sugars with his current practice of home monitoring and adjustment of dose. We reviewed his new process of care, and he said that he felt the calendar was helping him to be more accountable for his sugar levels. Joe started attending his appointments more regularly and was very excited to share with me that he and the diabetes education team felt that he was doing so well that he would be able to extend his visits to every six months. Joe and I keep in close contact and are able to discuss any issues or concerns he may have with his self-care plan. As a RNHC, my role is not to change persons living with diabetes. Instead, I hope to better understand their struggles as they see and experience them and provide them with the support to navigate through the challenges they face with selfcare while connecting with community resources. Persons commit to exploring change when they feel they are ready and5 have the support and resources to do so. Joe’s situation helps show how healt.Avoid appointments altogether. Inquiring further, he stated that he always tries his best; however, life events seem to get in the way, increasing his stress level and affecting his blood sugar numbers. He explained that during some appointments there had been some serious communication expressed to him about his inability to improve his blood sugars and self-management routines. At one point, Joe was instructed to decrease his stress level, period. This seems like such an absurd directive, and the instruction itself contributes to the person’s stress. Joe is still struggling to reduce the stress in his life, but he does not know how. I wondered how someone could reduce the stress of a divorce or the death of a family member. The idea of community comes to mind again here, but community is not an important concept in modern health care. Sadly, community is thought of as a place, not a relation. Over the next two months we discussed some of Joe’s life stresses, which included housing, access to healthy foods, financial struggles, and mobility. I assisted him with accessing his local food bank, and with the help of the Community Care Access Centre (CCAC) he obtained a walker and other home safety equipment. As our relationship grew and we continued to develop trust, Joe continued to slowly reveal his deeper struggles of living with diabetes. He spoke about having fear of diabetes when he was a child, watching his grandfather die of the disease, and feeling threatened by family members of “catching” diabetes if he ate too much sugar. Many of our conversations cycled and intertwined with multiple aspects of his life, past, present, and future. By paying close attention to his stories, I was able to notice that he was reflecting more and more on how he felt about diabetes that day. In addressing some issues within his situation of resources and accessibility, things that have hindered Joe’s self-care in the past, diabetes was becoming more of a priority for him. He recognized the need for attention to the diabetes portion of his life but felt overwhelmed in trying to deal with the other aspects of life that often took priority. During our subsequent visits, Joe and I explored the idea of control with his fluctuating blood sugars, and he started using a calendar to track only his low blood sugars along with the reasons why he felt they had occurred. I followed up with him one month later, and his calendar was blank. He explained to me that he was better able to manage the sugars with his current practice of home monitoring and adjustment of dose. We reviewed his new process of care, and he said that he felt the calendar was helping him to be more accountable for his sugar levels. Joe started attending his appointments more regularly and was very excited to share with me that he and the diabetes education team felt that he was doing so well that he would be able to extend his visits to every six months. Joe and I keep in close contact and are able to discuss any issues or concerns he may have with his self-care plan. As a RNHC, my role is not to change persons living with diabetes. Instead, I hope to better understand their struggles as they see and experience them and provide them with the support to navigate through the challenges they face with selfcare while connecting with community resources. Persons commit to exploring change when they feel they are ready and5 have the support and resources to do so. Joe’s situation helps show how healt.
