Whether or not we recognize it explicitly, we are all caregivers (aka, T3s). Whether we serve a family member, someone in our neighborhood or church, or just others on the dLife forums and in the dLife community, we are each part of someone else's diabetes support team.
We may not have to deal with the day-to-day diabetes management of anyone other than ourselves, our spouses, our parents, or our children -- but we all know people with diabetes. By being active in dLife's forums and the dLife Community, we are in effect T3s to other members with diabetes -- and by learning more about diabetes through dLife and its links to other online diabetes resources, we may become peer counselors to the T1s, T1.5s, and T2s we know in Real Life.
Caregiving is more than making sure someone has tested his blood glucose, taken her metformin, or bolused appropriately for the celebratory piece of birthday cake. Caregiving starts with care. We provide support because we care. Whether it's because that person is a friend, relative, or loved one, a neighbor or a member of our religious congregation, or just because that person is a fellow human being, we have a vested interest in helping that person become as healthy and as happy as he or she wishes to be, and can be.
From there, caregiving depends on knowledge and relationship-building. By being active participants in our own diabetes care, and proactive in learning more about how diabetes affects, and is affected by, medical knowledge, emotions, finances, relationships and so on, we become sufficiently versed in diabetes lore to become "subject matter experts" without being medical professionals. We can guide others to some degree with basic knowledge and directed questions, but their diabetes is their own, and in the end, its management is up to them and their medical teams.
It is the relationship-building and communications skills that are perhaps the most difficult for many of us to master. One issue d-bloggers occasionally address is "what does and doesn't offend me [regarding me and my diabetes]". For some, this starts with how one does -- or does not -- identify them as having diabetes. dLife has a video segment and several posts (start here) on which people were asked whether they preferred to be called "a diabetic" or "a person with diabetes". (Pet peeve: "diabetic" is an adjective, not a noun. A person or pet may be diabetic, but cannot be a diabetic. "Person first or disease first" notwithstanding.) Many Type 1 activists are offended by pitches that suggest they can be cured or "get off insulin". Both T1s and T2s are often offended by the idea that they "brought [diabetes] on themselves".
Then there are the "Diabetes Police". The biggest differences between medical professionals and Diabetes Police are that the former have licenses to be Diabetes Police, and that (if they are any good at getting their patients to "comply" with doctor's orders) they understand that the way a message is delivered is at least as important as its content. Let's face it: while most of us are more willing to accept "You shouldn't eat Hostess Twinkies" from our doctors than from our bosses' second-cousins-once-removed, there are better ways of opening us up to healthier diet choices -- as an example, "Would you prefer home-made apple cobbler, or a fresh pear, instead?" In the end, though, it is our choice whether to accept the healthier choice, or not.
You can catch more flies with honey than with vinegar. Even if your object is confrontation, try opening up a dialog rather than posing as judge and jury. Asking "I thought people with diabetes couldn't eat cake?" starts a discussion in which you can teach -- and learn -- through asking questions (sometimes referred to as the "Socratic method"). "Should you be eating that cake?" puts the person with diabetes immediately on the defensive. Caught unawares, he is more likely to lash back at you ("Mind your own business!") than to explain that he's accounted for that cake in his meal plan, or that his blood glucose is too low and there isn't a better alternative to-hand.
This said, as diabetes activists it's still sometimes difficult for us to not give in to the knee-jerk reaction when we find a Type 2 who has never been instructed to test his or her blood glucose, or who says his doctor -- in the absence of all other risk factors, illnesses, and signs of complications -- considers an A1c of 9.5 "acceptable". What we're not seeing is the story behind this apparent lack-of-care. Two skills we learn in customer service are active listening and showing empathy. Perhaps money is so tight that even with patient assistance programs, the money it would cost to test would mean going without food. Maybe the doctor is the only one in the area who will accept Medicaid patients, and his diabetes training is decades out-of-date. Or maybe the medications needed to control other, more immediately life-threatening, conditions counter all attempts to further stabilize that person's blood glucose levels.
At all times, and even moreso when our T3 moments are passing encounters, we need to listen and to understand what is being asked, without being judgmental about it. We need to use our listening skills to determine whether the person in question needs or wants our assistance, call upon our knowledge of diabetes to determine whether or not we have anything useful to present to that person, apply situational awareness to understand the limitations of both our knowledge and the person's ability to act on our potential advice or information, and use our communication skills and empathy to present usable information in a constructive manner.
When we do this, the spark of caring becomes the hearthfire of caregiving, rather than the incendiary destruction of "Diabetes Police"... and we are able to help.
