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It takes a village, but our village has been in quarantine by Amy Rich, DNP, CRNP, CDE

By Megan Watts posted 04-26-2021 15:00

  

I recently have found myself providing more psych and mental health support and referrals to my patients who are 65 years old and above.  “It takes a village” traditionally refers to raising children, but I strongly believe it takes a village to support a patient who has diabetes as they navigate through management and treatment.  Suggested lifestyle modifications, hypoglycemia treatment, and medication management are all easier with support from others.  

During quarantine, the village has been taken away from many individuals. The loss of face-to-face interactions with health care teams, family, and friends has left many of my patients with mental health struggles, including depression and anxiety.  A year ago, many healthcare professionals predicted the potential for this surge, mostly based upon our basic need for human interaction.  I traditionally find older adults to be very stoic when it comes to providing answers to the depression screening questions, and those same stoic patients have recently disclosed they are experiencing symptoms of depression. 

Many of my patients are also grieving the loss of loved ones due to the devasting number of individuals who were lost to COVID-19.  Their grieving presents somewhat differently than the normal emotional expectations we have, mostly because everyone is in isolation, and in many cases proper goodbyes were not had.  I believe the depression symptoms they are describing may be much worse, yet older patients feel the need to hold back their true feelings for fear of becoming burdensome.  Symptoms patients are disclosing must be taken seriously.

I have recently found local Psych/Mental health care providers in my area who are taking new patients and who are offering tele-medicine. I have also decreased the time between follow-ups to ensure my patients who are reporting new symptoms are getting the support and help they require and desire.  I provide my patients with numbers to two local psych/mental health providers and a counselor and tell them to call me in a week if they are not able to get in.  Just like the hypoglycemia and hyperglycemia treatment protocols in place, patients must also have a protocol to deal with anxieties and depressive symptoms when they present.

 

Amy Rich, DNP, CRNP, CDE

Doctor of Family Nurse Practitioner

Certified Diabetes Educator

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