Part of the book: Complementary Therapies for the Contemporary Healthcare
This chapter provides a brief overview of diabetes prevalence, the associated complications, diabetes-related mortality and management strategies to set the context for discussing palliative and end-of-life care. This chapter highlights: (1) The increasing global focus on palliative and end-of life-care; (2) The relationship among health trajectories, function and palliative and end-of-life care; (3) The imperative to plan care with the individual to achieve personalised care that meets the individual’s goals, preferences, values and spiritual needs across the various health trajectories; (4) The need to proactively plan for the transition to palliative and end-of-life care when appropriate and while the individual can make informed decisions. Proactively planning for changing care needs is more likely to achieve care consistent with the individual’s goals, values and preferences; (5) The key role of family carers and the effect of caring on carers’ health; (6) The importance of having timely, meaningful conversations about palliative and end-of-life care with people with diabetes and their families; and (7) The imperative to ameliorate suffering, optimise quality of life and personalising care.
Part of the book: Highlights on Several Underestimated Topics in Palliative Care
The aim of the chapter is to provide a brief overview of diabetes and the associated morbidities that affect life expectancy to highlight why proactively planning for palliative and end-of-life care is essential to quality personalized diabetes care. Life expectancy may not be significantly reduced if blood glucose, lipids and blood pressure are well controlled; but several diabetes-related complications and long duration of diabetes affect life expectancy. Significantly, complications and related organ and tissue damage can be present 10–15 years before type 2 diabetes is diagnosed. The challenge of prognostication is discussed as recommendations for when to consider changing the focus of care from preventing diabetes complications to palliation and comfort care. Life-limiting illness and palliative and end-of-life care are defined. A framework for integrating diabetes and palliative care is proposed. The framework could help clinicians and people with diabetes prevent/manage complications and plan care to maintain quality of life, dignity and autonomy and ameliorate suffering as their life trajectory changes. The framework aims to facilitate care transitions and help clinicians proactively initiate management and have timely meaningful conversations about palliative and end-of-life care with older people with diabetes and their families.
Part of the book: Palliative Care