Nowadays, diabetes mellitus is an important and urgent problem. It is a “chronic, progressive disease characterized by elevated levels of blood glucose” (WHO, 2016, p. 11). Every 10-15 years, the prevalence rates of the disease double, and in 2015, more than 5 million people died from diabetes (Stanhope & Lancaster, 2019, p. 68). The aging population is the main reason for the increase in the number of patients with diabetes. Thus, in 2014, the prevalence of diabetes was 8.5% among the adult population (WHO, 2016, p. 21). Older adults are at a higher hazard of developing diabetes, and those under the age of 70 are more likely to die from this disease (WHO, 2016, p. 21). The problem is that diabetes is difficult to diagnose in the elderly because patients may not show any clinical symptoms. In many cases, diabetes is detected by chance during an examination for other diseases. It is vital to teach the elderly population how to prevent and detect diabetes at its early stages.
Diabetes occurs when a person has a disorder of glucose metabolism. Research showed that glucose metabolism impairs with age, with insulin sensitivity and insulin resistance (Karla & Sharma, 2018, p. 494). Older adults are at higher hazard of impaired insulin resistance due to various factors, including central obesity, vitamin D deficiency, hypomagnesemia, and other environmental factors (Karla & Scharma, 2018, p. 494). Therefore, screening in the elderly is important to prevent and detect diabetes. Since diabetes is difficult to diagnose because it is often asymptomatic, older people should visit their physician if they notice some of the following symptoms: Nocturia, urinary incontinence and urinary system infections, acute coronary syndromes, refraction impairment, dementia, and others.
Recent research showed that urban citizens are more likely to have diabetes than those who live in rural areas (Gatimu et al., 2016, p. 4). Moreover, women suffer from this disease more frequently than men. People with the highest level of education have the highest prevalence of diabetes, compared to those with high school or college level and no formal schooling. A sedentary lifestyle increases the chances of having diabetes too. High-wealth households have a higher prevalence of the disease than low-income households (Gatimu et al., 2016, p. 4). People with overweight had a prevalence of 9.1% compared to those with normal weight (1.52%) (Gatimu et al., 2016, p. 4). The main deterrents of diabetes are lifestyle changes and weight control. Bigelow and Freeland (2017) claim that at least 150 minutes of moderate-intensity aerobic activity per week may help prevent diabetes, along with healthy nutrition and weight reduction (p. 183).
The Available Community Resources
In this teaching project, I will be involved as an educator who will teach the elderly about the prevention and early detection of diabetes. One blood pressure monitor is needed to teach people to measure and control their blood pressure. Free tools for diabetes management are available online. Besides, many community health centers, worksites, schools, and faith-based centers offer printed materials about the disease and its prevention and management. Finally, “healthy lifestyle” classes are available in many communities. In these free classes, people are taught about the methods of prevention of diabetes, receive health nutrition advice, physical activity benefits, and tips on behavior changes.
Effectiveness of the Resources for the Community
Teachers play an important role in community education. According to Bisht (2016), “Teachers are seen as key actors of change within programs and projects” (as cited by Rao, 2019, p. 463). Thus, teaching sessions will be effective for promoting diabetes prevention in the elderly. Blood pressure monitors are effective for diabetes prevention because people with high blood pressure are at higher risk of this disease and its consequences (Diabetes and Blood Pressure, n.d.). Printed materials, such as informative flyers and brochures, are effective for diabetes management in communities because they inform participants about the main factors influencing diabetes development and its prevention. Finally, “healthy living” classes are effective for community teaching because they provide people with an opportunity to assess their current health problems, the risk of diabetes in their age group, and “exposure to unhealthy situations” (CDC, 2019).
The Selected Group
I have chosen the elderly for this project because they are more susceptible to diseases. People aged 40+ who have chronic conditions are overweight and have negative habits, like smoking or poor dietary habits, and those who live in wealthy households were chosen for the project because they are at higher risk of developing diabetes in older age. I randomly selected 10 participants, the patients of the local community health care center. All these people have frequent high blood sugar, but they are not diagnosed with diabetes. They were willing to participate in this teaching project because they wanted to be informed about diabetes and its detection and prevention methods.
The Learner Needs of the Elderly
The learner needs of the elderly may vary, but such needs as health support, self-care support, social life, adequate finances, availability of transportation, and a safe home environment are common for the target group. People of advanced age may face challenges with mobility, health care, and self-care. Moreover, older people may feel lonely and socially isolated, which leads to depression and other health problems. Overeating, bad habits, lack of physical activity, obesity – all these issues may lead to diabetes development. A lack of access to information about the prevention and early detection of diabetes increases the risk of the elderly developing the disease in the future.
Education of Older Adults on Diabetes Prevention and Detection
Older adults should know that a healthy lifestyle is crucial for their health. If seniors are aware of all the negative consequences of diabetes, they will be motivated to change their lifestyles and adjust their habits accordingly. Since many people reduce their physical activity while aging, it is vital to explain that a sedentary lifestyle and obesity increase their chances of developing diabetes. They should also be taught to control their blood pressure and monitor their health at least once a year.
Experiential Learning Theory
I will use experiential learning theory for this learning project. According to this theory, people learn from their experiences (Arakawa & Anme, 2020, p. 2). Research showed that the experiential learning program enhanced knowledge about dementia and increased learners’ motivation and activity involvement (Arakawa & Anme, 2020, p. 2). This theory is appropriate for my target group because older people comprehend information better when they experience it and see the effects. After the learning sessions, they will apply the information about healthy lifestyles and physical activity and see the results in the nearest future. Moreover, since most participants have some chronic conditions and illnesses, they will be motivated to improve these conditions by changing their lifestyles and eating habits.
Self-determination theory focuses on motivation and people’s responsibility for making health-related choices (Migliorini et al., 2019, p. 1). This approach takes into account learners’ intentional choices and decisions, which lead to self-determined behavior. Since all participants of this teaching project are willing to participate in it, they will be likely to change their lifestyles and health-related habits. According to this theory, people with autonomous motivation tend to satisfy their psychological needs and act according to environmental changes (Migliorini et al., 2019, p. 2). Thus, if the elderly understand that some changes in their physical condition are inevitable due to natural processes, they will adjust their habits and lifestyles to preserve health and well-being.
Erikson’s Stages of Psychosocial Development
Erikson’s developmental theory subdivides human development into eight stages. The main goal of every individual is to overcome “the last stage of developmental crisis […] to achieve wisdom” (Perry et al., 2015, p. 254). Older adults often experience declines in physical and mental health, and these declines may serve as motivation for them to engage in self-management. According to Erikson’s theory, progress in early stages influence later stages (Perry et al., 2015). If older adults engage in self-care and self-management today, they will have better health in the future. This theory is appropriate for my target group because it provides a framework for understanding older adults’ interest in self-management and self-care.
Planning Process for the Project
The project will last four weeks for the same group. The teaching sessions will take place every Monday. One session will last one hour. During the first session, I will tell the audience some brief facts about diabetes prevalence, determinants, and health consequences. After that, the methods of prevention will be introduced to the listeners. They will be offered to make notes and create their strategic plans for the next several weeks. During the second teaching session and the following ones, we will discuss changes in the participants’ lifestyles, share experiences, and learn other methods of diabetes prevention and early detection. The last teaching session will be dedicated to life with diabetes.
Since the elderly may have visual and hearing impairments, the learning environment should be free of distractions and should have good lighting. I will use different learning materials to make the sessions more effective. I will need to speak clearly and avoid medical jargon. The personal approach to every participant is important because older people learn better when they understand that the new information will benefit them.
Older people experience more stress, leading to higher cortisol levels and, consequently, poorer short-term memory (Zurakowski et al., 2006, p. 356). The study showed that older adults did better with the self-directed printed homework packets than with the PPT slides “in acquiring knowledge of cardiovascular health” (Zurakowski et al., 2006, p. 356). Moreover, the elderly focus more on the meaning than on details, which means that self-directed homework assignments should be written clearly and understandably and contain no unnecessary details. Finally, older adults need more time to comprehend and process information, so printed homework packets will help them recollect the new data and better comprehend it later.
The teaching sessions made it easier to prevent the development of diabetes in older adults. Participants were informed about the risks of diabetes for their age group and how to minimize these risks. Through teaching sessions, it was easier to attain the main teaching goal – diabetes prevention. The participants learned about the importance of healthy lifestyles, normal weight, and physical activities in diabetes prevention. They had an opportunity to learn why self-care and self-management are important and how healthy nutrition influences their health.
I am satisfied with the teaching session. All participants demonstrated their interest in the subject. They reflected on their current lifestyles and diets and promised to change some of their habits to have healthier lives. Four weeks were enough for one group to accomplish teaching goals and achieve the first positive results. After each teaching session, the participants engaged in discussions and shared their experiences. After the last session, they evaluated their results, and most of them were satisfied with their new habits, diets, and lifestyles. I am happy that all participants understand the importance of lifestyle changes for diabetes prevention.
Only ten people participated in the project, which is not enough for diabetes prevention in the community. Moreover, all participants showed their interest in the teaching project, which means that they were willing to change their lives before the sessions began. If more people were involved in the project, the results would be different. Finally, some participants did not want to give up smoking and reduce sugar consumption in their diet. Thus, although they know about the consequences of such habits and the risks of diabetes development, they will not change their lives.
What Would I Change?
If I were teaching this topic to a similar group later, I would increase the number of participants and their choice. I chose only those participants who showed their interest in this project. However, if a bigger number of people were involved, including those not interested in the topic, a bigger number of people would change their attitude to diabetes mellitus. I would also change the duration of this teaching project. I think that more time is needed for people to see the first results of their lifestyle changes. Finally, I would choose another teaching method, gathering people in some public places, like a park, for example. It would attract other people, and more individuals would be informed about the methods of diabetes prevention and the consequences of this disease.
Arakawa, H., & Anme, T. (2020). The effect of an experiential learning program on motivations and activity involvement among dementia supporters in Japan. PLoS ONE, 15(12), 1-12.
Bigelow, A., & Freeland, B. (2017). Type 2 diabetes care in the elderly. The Journal for Nurse Practitioners, 13(3), 181-186.
CDC. (2019). Characteristics of an effective health education curriculum.
Diabetes and blood pressure. (n.d.).
Gatimu, S. M., Milimo, B. W., & Sebastian, M. S. (2016). Prevalence and determinants of diabetes among older adults in Ghana. BMC Public Health, 16 (1174).
Migliorini, L., Cardinali, P., & Rania, N. (2019). How could self-determination theory be useful for facing health innovation challenges? Conceptual Analysis, 10(1870), 1-10.
Karla, S., & Sharma, S. K. (2018). Diabetes in the elderly. Diabetes Therapy, 9, 493-500.
Mordarska, K., & Godziejewska-Zawada, M. (2017). Diabetes in the elderly. Menopause Review, 16(2), 38-43.
Perry, T. E., Hassevoort, L., Ruggiano, N., & Shtompel, N. (2015). Applying Erikson’s wisdom to self-management practices of older adults: Findings from two field studies. Research on Aging, 37(3), 253-274.
Rao, P. S. (2019). The role of teachers in promoting a global community and cultural exchange. Research Journal of English Language and Literature (RJELAL), 7(2), 462-466. Web.
Stanhope, M., & Lancaster, J. (2019). Public health nursing e-book: Population-centered health care in the community (10th ed.). Elsevier Health Sciences.
World Health Organization. (2016). Global report on diabetes.
Zurakowski, T., Taylor, M., & Bradway, C. (2006). Effective teaching strategies for older adults with urologic concerns. Urologic Nursing, 26(5), 355-360.