Diabetes & diets - You can't always get what you want

You can’t always get what you want. But if you try sometime you find you get what you need.

Something tells me that classic lyric from Mick Jagger and The Rolling Stones had nothing to do with managing our health or our diets.

But the words ring more true than what I could have ever imagined when it came to managing the meal planning for my mother.

For this edition of Keeping it REAL Caregiving, I want to step back from the policy-talk and take a dive into the personal. As you know, I cared for my mother, Miss Nellie, in the final years of her life. She passed away a little over a year ago and there are days when it still doesn’t feel quite real that she’s gone.

Nellie Yarbough after picking tomatoes

In fact, searching in my pantry for a food item inspired this post. I spotted a box of Bisquick baking mix sitting in the far corner. It is safe to say the box hasn’t been touched in more than a year and should probably be tossed out. But that iconic bright yellow box made me think of Nellie and our almost daily ordeals of mapping out meals. For any of you who are caregivers to an elder, I hope this story can offer some insight.

Breakfast, lunch and dinner meal battle

Let me set the scene for you. On any given day in our household this is how it would go.

*For lunch and dinner, replace appropriate food items but almost identical conversation*

Me: Mom, what would you like for breakfast?

Nellie: I don’t care - just some food.

Me: Okay, how about an egg, some grilled turkey (left-over from the night before), a few slices of sweet potato and some sliced oranges?

Nellie: I don’t want that. (Wrinkling her forehead and making a face as if she had just bit into a rotten apple). I’ll just have a bowl of Cheerios and some peaches.

Me: Mom, you need to have something more substantial. Cereal has no nutritional value and you’ll be hungry in about an hour. You should have some protein.

Nellie: Okay, then make me some pancakes and hash browns (indignation rising in her voice).

Me. How about two pancakes and a slice of turkey or chicken. Pancakes and hash browns are just carbs, which convert to sugar. You know you are not supposed to have that much sugar. Your levels will spike.

Nellie: Whatever. I just need some food. Hand me that other piece of donut that is in the fridge and… is there any orange juice in this house?

Me: No. I’m not letting you start the morning with a donut and no, there’s no orange juice. That’s pure sugar. I can cut you up a few pieces of fresh orange? It is healthier for you; without all the processed sugar.

Nellie: Muttering under her breath… look of frustration and disgust on her face.

This food tug-o-war played itself out until I thought Nellie was going to figure out a way to hire a hit man and take me out!

The meal battles subsided a bit once I hired in-home care to help us. One of her aids would sneak her donuts (I knew this but let it slide once in a while). Another of her aids would swing by McDonald’s on her way to our home and pick mom up Mc’D’s hash browns or a sausage McMuffin. Mom liked the salty flavor of the fast food. And let’s face it - once in a while, those hash browns do have a way of hitting the spot.

In the final five years of me and mom living together, I think I turned into somewhat of a food-Nazi. It is not that I was trying to be a horrible daughter or deprive her of yummy food. Quite the contrary. I LOVE to cook - from scratch - and would gladly prepare anything mom might wanted.

During a visit to a nutritionists office to try and figure out what was causing continual weight loss despite my constant attention to full meals, mom told the nurse, “I can’t find anything to eat in her [my] house!” The nurse looked at me with an accusatory glare. Great - now she thinks I am neglecting my mother!

Really? At any give time there was usually enough food in my house to feed an army. During the caregiving years, there was ALWAYS something cooking in the crockpot and pre-prepared meals stacked in the fridge. What Miss Nellie meant - was there were no ‘unhealthy’ foods in the house.

To try and keep the peace and give mom options while keeping MY sanity AND making it easier for our home-care aids to help with food prep, I even resorted to making daily menu lists.

Each day I would make a “select your choice” menu pretty much outlining most everything in the fridge and pantry available to eat. I thought it would solve the issue - and make meal planing easier. It did not.

Even with a menu outlined, miss Nellie still couldn’t identify anything she wanted. The problem wasn’t that my household didn’t have plenty of food - it is that she wanted foods laden with SUGAR and SALT and other choices that were bad for her health.

Diabetic meal planning

My mother battled diabetes for years. It was never severe enough that she had to take insulin shots, but she did have to manage her blood sugar levels. She took several different medications to keep it under control.

Each morning she would use a little lancet to draw a drop of blood and place it onto a testing strip and place that strip into the monitoring device. We tracked her blood sugar levels each morning and afternoon. It was a benchmark to determine what other medical issues might be going on.

For diabetics, maintaining a healthy blood-sugar level can be a matter of life or death.

Plus, diabetes impacts African Americans at a higher rate than others. The more I learned about the disease and the range of other health-related complications it can cause (vision damage, high blood pressure, stroke and more), the more I insisted on helping my mother manage her sugar levels via diet.

I think she hated that. But I knew if left to her own devices, Nellie would have chosen pancakes with full-sugar syrup (or worse) for her meals.

I urge you to look at your food labels and pay attention to how much sugar is in each serving of your food choices.

Sure, I can look back now and chuckle at these moments when we wanted to kill each other over breakfast, lunch and dinner choices. But while it was happening, it was exasperating! I simply wanted to provide only the very best for my mother. She wanted to eat 'the fun foods that will kill you.'

I wanted to keep her healthy and prevent a diabetic attack that could lead to a hospital visit (I’ll save those stories for another day) and she wanted foods that just tasted GOOD to her.

To mom's credit, she LOVED peaches. So it was quite the treat that our backyard peaches produced enough that she could have fresh picked peaches her final three seasons of life.

This food-battle-reality is not unique to my home. I recently had a conversation with a law enforcement friend. He recounted a story of dispatching to a home in which a mother had called 911 to report her son was not letting her have what she wanted to eat (seriously - I think he said it was DONUTS).

I jokingly replied, “Well, maybe the mom is diabetic and the son was watching out for her health.”

That officer then said, “Yep, that was exactly it! The son wasn’t trying to neglect or abuse his mother. He told us he just didn’t want to end up at the hospital!” (SMH…she called 911!)

During these ordeals, I learned that as we age, it turns out we often lose the ability to distinguish flavors and people often turn to salt and sugar to make up for the lack of perceived flavor.

So when your elder no longer enjoys the foods they always have and only want junk food filled with sugar and salt… they are not deliberately trying to make you insane… that REALLY is, in many cases, what the taste buds can still enjoy.

Time, tastes & tolerance

What do you want for breakfast, mom? Just some food. How about xxx? Whatever, just some food. Did you like dinner? No, I wanted xxxx. Why didn’t you tell me what you wanted? Because if I told you what I wanted you weren’t going to let me have it anyway… (Repeat)

Sigh… it was a never ending battle that neither of us won. Did consuming uber-nutritional meals perhaps add one or two more years to Nellie’s life? I like to think the answer is yes. Did we waste precious personal time fussing over meals, losing our tempers and managing frustrations? Yes. Was it worth it? I don’t know.

Lesson learned: Balance the wants and needs against the very real march of time. There is no easy answer in this one.

You can't always get what you want but if you try sometime you find you get what you need...

Ciao~ Julia