title: Impact of dementia on caring for patients' diabetes.
abstract: OBJECTIVE
  To explore caregivers' challenges and quality-of-life issues managing diabetes in patients with dementia.
  
  
  METHODS
  We conducted six focus groups with 21 caregivers of patients with dementia and type 2 diabetes. Focus groups were digitally recorded, transcribed, and translated using a software coding system. Emergent themes were identified and confirmed.
  
  
  RESULTS
  Three themes emerged. (1) Memory loss was the first identified cause of self-care neglect leading to caregiver intervention. (2) Behavioral and psychological symptoms of dementia (BPSD) disrupted the daily diabetes care routine, with 'denial' of having diabetes or memory loss (anosognosia) being the most disruptive. (3) Caregivers reported that caring for both diabetes and dementia was highly burdensome, felt overwhelmed with BPSD, and wanted more support from family and patients' healthcare providers.
  
  
  CONCLUSIONS
  Caregivers of patients with dementia and diabetes face extraordinary challenges managing both conditions and the accompanying BPSD. Their identified need for a greater response from the healthcare system should be tested in quality improvement programs for this overlooked yet rapidly growing population.
authors.affiliation: Health Services Research and Development Center of Excellence, Veterans Affairs Greater Los Angeles Healthcare System, Sepulveda, CA, USA. denise.feil@va.gov
authors.forename: Denise G
authors.initials: DG
authors.lastname: Feil
authors.forename: Revana
authors.initials: R
authors.lastname: Lukman
authors.forename: Barbara
authors.initials: B
authors.lastname: Simon
authors.forename: Amy
authors.initials: A
authors.lastname: Walston
authors.forename: Barbara
authors.initials: B
authors.lastname: Vickrey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003704:Dementia / Q000150:complications* / Q000451:nursing*; D003717:Denial, Psychological; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000451:nursing*; D017144:Focus Groups; D006801:Humans; D012648:Self Care