III Part Series: Language of Diabetes
Part II: Avoid the Blame Game
Unfortunately, blame and guilt seem to be a frequent reality for people with diabetes. Meet Beth who comes to see me for her monthly diabetes education visit. Honestly, Beth shares that she comes for accountability and support in an environment that neutralizes guilt and blame at least for the visit time. It isDecember when Beth comes for her visit and she seems a bit deflated. She states, “…you know I almost cancelled my appointment because I feel so guilty because I have not been taken my diabetes medications this week.” On the surface, it is so easy to brush Beth off as a “non-compliant patient”. Yes, this term induces blame and does not address the why Beth is struggling with taking her diabetes medications.
In our fast paced healthcare environment, where volume is often more price than value, it is so easy and convenient to simply label a person with diabetes as“non-compliant” or “non-adherent” then move onto the next person on our schedule. It is like the analogy of the iceberg where you see the tip and not the massive base underneath the water. Back to Beth, I challenge the notion that she is simply “non-compliant” rather she struggles with anxiety and her diabetes takes a back seat when life gets overwhelming.
With regards to medications, the statement, “Beth takes her diabetes medication about 75% of the time,” quantifies the frequency of her taking her medication. Then it is possible to build upon the fact that she is doing well taking her medications a majority of the time, and now simply focus on building upon the frequency Beth is taking her medications.
What are alternative terms to “compliant” and“adherent”? When focusing on terms that emphasize the vital and active role people with diabetes play in self managing this condition, Utilizing terms such as engagement, participation, and involvement of the person with diabetes are much more ideal. Why is this? Diabetes is not a disease where a person is simply told what to do to better manage their treatment method, but rather it is a disease that requires ongoing engagement of the person with diabetes being active in the treatment decision making process. The person knows their body best and is the team captain. The bottom line is all about empowering the person with diabetes by focusing on their strengths and building upon what they are doing well. My call to action for readers is to drop the words compliant, adherent, non-compliance and non-adherence.
Good news! Beth was open to discussing tools and resources that could assist in her taking her medications more consistently as she sees clearly the benefit that her medication provides. She leaves her appointment strengthened and more confident in managing her diabetes.
Special thanks to Jane Dickinson, Susan Guzman, Melinda Marynik, Catherine O’Brian, Jane Kadohiro, Richard Jackson, Nancy D’Hondt, Brenda Montgomery, Kelly Close and Martha Funnell who wrote Use of Language in Diabetes Care and Education
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