M.S. (Master of Science)
Department of Health Studies
Non-insulin-dependent diabetes--Treatment--Illinois--Northern||Older people--Home care--Illinois--Northern||Blood sugar monitoring--Illinois--Northern
Type 2 diabetes mellitus (T2D) is a disorder in which blood glucose levels are abnormally elevated due to insulin resistance at the cellular receptor level. Uncontrolled T2D within the older adult population is defined as blood glucose levels ≥140 mg/dL. Higher blood glucose levels have been associated with an increased risk of co-morbidities such as cardiovascular events, hypertension, neuropathy, nephropathy, retinopathy, etc. Little research has been conducted to assess the practices of T2D management among the homebound older adult population. The current study considered homebound as "individuals who require effort or assistance to leave the home and do so infrequently due to physical and medical limitations." The purpose of the study was to examine what methods homebound older adults were using to control their blood glucose, the extent to which they were able to perform Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), as well as to determine if they were subject to depression. A questionnaire was used on 21 homebound older adults residing in DeKalb and Kane counties of Illinois to determine primary blood glucose control methods, the extent to which activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are performed, and assess the level of depression. Data collection began as soon as the informed consent were signed over a six-month rolling period to ensure all eligible participants were reached. The researcher traveled to the consenting participants homes and/or congregate sites to conduct data collection face-to-face. The questionnaire utilized a modified version of the Stanford Chronic Disease Self-Management questionnaire, Katz Questionnaire of ADLs, Lawton IADL Scale, Diabetes Self-Management Questionnaire and the Geriatric Depression Scale. Participants must have been 60 years and older with diagnosed T2D, part of Meals-on-Wheels or Salvation Army Golden Nutrition Dinner program. Self blood glucose monitoring (SBGM) was the primary reported method of blood glucose control in this study (n = 9, 42.9%), with average blood glucose of 146.56+/-49.99 mg/dL. Homebound older adults scored an average of 5.67+/-0.913 on a scale of 6.0, which indicates high ability to perform ADLs and an average of 5.95+/-1.86 on a scale of 8.0, which indicates a moderate independence in performing these activities. There was no significant correlation between blood glucose levels and ability to perform ADLs. There was no relationship between depression scores and blood glucose levels. Similarly, no significant relationship was found between depression score and ADL or IADL score. This study concludes the primary method of blood glucose control among the homebound older adult population is self-monitoring. Participant average blood glucose level was 144.5+/-39.1 mg/dL, which is slightly above the target recommendation of <140 mg/dL. Participants were highly independent in ADLs and moderately independent in IADLs. No significant relationship was found between ADL score and blood glucose levels. Similarly, no significant relationship was found between depression and ability to perform ADLs and/or IADLs.
Lawler, Laura, "Type 2 diabetes management among homebound older adults" (2016). Graduate Research Theses & Dissertations. 6538.
iv, 85 pages
Northern Illinois University
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