Background
Elderly subjects mostly suffer from a range of chronic illnesses in addition to age-related disabilities and dysfunction. At our diabetes care centre, we often come across disabled elderly either living alone or with family members who are unable to provide any support, and with multiple disabilities hugely affecting their self-care management skills. The situation is even worse in those with multiple comorbidities of diabetes such as impaired vision, amputation, stroke, cognitive dysfunction etc.

Aim
To conduct an informal survey among our diabetes patients aged 65 years and above who are living alone and/or are managing their disease condition themselves due to the lack of a supporting caregiver. The difficulties faced by them were identified to postulate effective solutions.

Method
We made an informal survey among our diabetes patients who lived alone and/or lacked a supporting caregiver (n=167, 68% males, mean age 75.8±13.2years, mean diabetes duration 15.5±7.85years). The difficulties faced by these individuals during diabetes management were analysed by our diabetes care team including clinicians, diabetes educators, nurses and psychologists to bring out some effective solutions to manage this emerging social issue.

Results
Majority of the individuals who participated in the survey (96.5%) asserted the need of a supporting caregiver to effectively manage the burden of their disease conditions. Various barriers faced by these patients towards an effective diabetes management as well as some solutions or recommendations that were identified during a discussion session with our diabetes care team are provided here.

Discussion
Diabetes management demands a lot of self-care behaviours and works best only with the support of a caregiving member, especially in the case of disabled elderly and disabled patients. Diabetes team should take special care while addressing the needs of this special category and every effort should be made to motivate these patients and identify a caretaker from among the family, friends or neighbourhood and empower them with easily adaptable diabetes care routine and management practices.

Elderly living alone with diabetes – an emerging major social issue?