Diabetes Self-Management Articles

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Getting a Hand From Social Agencies

by David Spero, RN

Coping with painful neuropathy and caring for her aging mother had taken over Julie’s life. She would cook, clean, and provide care until pain and fatigue stopped her. As soon as she felt a little better, she would start in again: shopping, doing laundry, and managing the household chores. In the evenings, she worked for four hours telemarketing, “where at least I got to sit down.” She rarely experienced comfort, leisure, or decent blood glucose control. She knew she was drowning but had no idea where the life preservers were kept.

“My friends told me I needed help,” Julie recalls, “but they didn’t come over and give me any.” Then a neighbor told her about Consumers in Action for Personal Assistance (CIAPA), a (now defunct) San Francisco nonprofit agency running a government program to fund housekeeper and home care services. With CIAPA’s assistance, Julie hired a twelve-hour-per-week housekeeper from her neighborhood. This man did the shopping and heavy cleaning for Julie and her mother, enabling Julie to rest, relax, and even get out in the sunshine once in a while, without having to leave her mother alone.

The effects of getting some household help went far beyond having a cleaner kitchen. Julie was able to pay more attention to what she ate instead of grabbing things on the run. She had time to exercise a little, her neuropathy pain eased somewhat, and her glycosylated hemoglobin (HbA1c, an indicator of blood glucose control), came down a full percentage point. “It was a lifesaver,” Julie said. “I felt like I had a chance again.”

Expect the best, prepare for the worst
This article presents information and skills no one ever wants to have to use. Everyone wants to manage his own health and have a long, positive life of independence. If it becomes necessary to seek out help, most people would rather get it from family or friends than from governmental or volunteer agencies. These are healthy, sensible attitudes, but sometimes the road turns. Just a few bad breaks can leave one needing more help than friends or family are able to provide.

Karen Weissmann, LCSW, of the California Pacific Medical Center’s Center for Diabetes Services points out, “Now, nearly everyone is working. American society depends on paid helpers.” As Julie found out, getting that help can be an important part of self-care.

Lawyer David Landay writes in Be Prepared: The Complete Financial, Legal, and Practical Guide for Living with a Life-Challenging Condition, “Preparing for the worst separates an informed positive attitude from simple blind hope…[it] enables you to maintain the kind of environment that will enable you to expect the best.” Learning how to utilize social agencies may actually reduce your need for them and increase your control over your life.

Social agencies can provide money and services such as housing, transportation, food and meal preparation, advocacy, counseling, psychotherapy, in-home physical care, housekeeping, financial management, information, and referrals. Nobody wants to be in a position to require such benefits, and if everyone were wealthy enough, nobody would need them. But in the real world, some people can and do buy all of the above goods and services, while others need help from time to time. Needing help from an agency doesn’t make you a failure in life or in diabetes management, but knowing how to work with agencies can make both a lot easier.

All shapes and sizes
Social agencies can be governmental, religious, or nonprofit. Government agencies include the Social Security Administration and the Centers for Medicare and Medicaid Services. Individual states and municipalities may also have less well-known organizations that can help.

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