Hope Warshaw wants to help providers better understand what it’s like to live with diabetes

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Hope Warshaw, certified diabetes educator, registered dietitian and board member of the American Association of Diabetes Educators (AADE), has been dedicated to diabetes care for over 30 years and written numerous books

Hope and I had worked on some written material two years ago, but I first met Hope at last year’s AADE annual meeting where we broke bread over breakfast. I love her spunk and commitment to helping patients and providers work better together to improve care.

Hope put forth the idea of interviewing me for a post on her blog exploring this topic. I asked Hope if I could share, and she readily agreed. Here’s the article: 

Dialoging about Diabetes: PWDs Offer Ways to Improve Communication and Care – #1 Riva Greenberg

As a diabetes educator/healthcare provider (DHCP) I’m observing that the rapidly growing world of online diabetes social networks is helping people with diabetes (PWD) find and give support and feel supported. People are connecting, building relationships and feeling more positive about their diabetes. I’m delighted to see this trend!

As a DHCP I’ve long realized I can’t walk a mile in a PWD shoes. I can’t know what it is like day in, day out to deal with this challenging and relentless disease. But, what I do know is that we can learn from each other to help shift the dialog between providers and PWD to be more positive and supportive.

In my Dialoging about Diabetes blogs I’ll interview diabetes activists and social networkers. I ask them to offer us DHCPs ways to alter what we do and say to better support your diabetes care efforts and make living your real life…just a bit easier.

Two more goals: Help more PWD get connected and encourage more DHCPs to open the doors of social networking to PWD.

This first Dialoging about Diabetes interview is with Riva Greenberg. Greenberg describes herself as: a person with type 1 diabetes for 39 years, a patient advocate, diabetes book author,blogger for Huffington Post health coach and speaker. To learn more about Riva Greenberg check out her website.

HW Q: If you could give DHCPs tips to improve our understanding of the challenges PWD face in managing diabetes while living their real life, what would you tell them?
RG A: My basic tip is for HCPs to ask their patients more questions. Then listen with focused attention. It is by hearing what is going on for this person that you will understand the challenges managing diabetes presents as a whole, and specifically. People, when given an opportunity to share, are a treasure trove of information about what and where they need help as well as what they’re capable of and willing to do.
Greenberg offers DCHPs these thoughts:

  1. Start off looking for successes: “What has gone well for you since we last met?” Offer congratulations for any positive self-care action.
  2. Next, ask: “What have you found difficult?,” “What would you like to do better?” The answers will reveal the person’s challenges as well as opportunities for improvement.
  3. To assess a person’s support network, ask: “Who are the people who help and support you with your diabetes?,” “How do they help you?,” “How else would you like to be helped?”
  4. Ask questions that explore the person’s life beyond diabetes: family life, job, school, finances. A person’s actions are all rooted in their life systems. Try to understand a person’s challenges within the whole context of his/her life.

And Greenberg reminds us: Don’t forget the follow up questions to obtain a deeper understanding. Probing questions will begin to reveal how a person manages their diabetes amid managing his/her life. A goal is to make this as seamless and integrated as possible.

HW Q: How do the day to day challenges of managing diabetes impact one’s ability to manage diabetes?
RG A:
 Given how busy we all are these days, life just gets in the way sometimes of doing great managing diabetes. Just last week I was having my bathroom renovated, was fighting a bad cold and had to vacate overnight since I had no toilet! Rushing out the door to my friend’s house I discovered when I got there that I forgot my insulin! This happens to me once every few years. If, however, you’re going through a particularly stressful time, like a divorce or a job loss, you can be sure it will be tougher to complete your diabetes to dos and the stress will interfere with your management and your blood sugar control. Since life will always throw challenges our way, the best way to stay healthy is to know how to manage diabetes and have ways to get through the tough times. It might be doing yoga, exercise, spending more time doing a hobby you love or with friends or family or a writing exercise about what you’re grateful for or using positive self-talk.

HW Q: How can DHCPs be more empathetic, understanding?
RG A: 
This is a great question and very much at the heart of the DHCP:PWD relationship. Many HCPs operate from a traditional “expert-model:” I’m the expert and I’ll tell you what to do. But unless the patient identifies why a change or action is meaningful for them to do, they won’t have much motivation and the change won’t last very long. DHCPs should aim to explore who their patients are, what’s important to them and what they’re willing and able to do. It should be a collaborative effort then to determine actions and goals. If the DHCP takes this approach, empathetic understanding will increase automatically.

HW Q: What messages do you have for PWDs about more actively communicating what they need from their DHCPs? 
RG A: Become more knowledgeable about diabetes: read a book, magazine, and web sites. Bring any questions your have on a piece of paper to your DHCP and write down the answer. Ask about any concerns you have, this may be about yourself or your family, they’re also affected. When your DHCP tells you something ask for clarification if you don’t fully understand. Don’t leave confused or not knowing what to do or why.

HW Q: How do you feel that social networking/being connected online can help people feel supported, possibly improve their care?  
RG A: Only someone with diabetes can know what it’s like to live with from the inside-out. Social networking has given people an incredible resource to share our knowledge, our woes and our successes and they provide support. When living with a chronic illness, support is like medicine.

HW Q: How do you encourage DHCPs to see social networking as an advantage to their efforts and an avenue for PWD to get increased support? 
RG A: Web sites can’t replace the face-to-face interaction with a trained provider. The more knowledgeable people become using social media, the better they may be able to deal with/manage their diabetes which can make a DHCPs job easier. Also, since providers are so short of time, a patient may actually become an expert on something their DHCP may not be and the information flow can go from patient to provider. I talk about this in one of my Huffington Posts, “Are Doctors Losing Their Relevance Due to Social Media Health Sites?”.

Greenberg’s parting comment: Since diabetes will require we have a relationship with our health care providers on a regular basis for the rest of our lives, striving to have one that’s collaborative and rewarding is to everyone’s benefit. If we can work better with our providers it’s one less stress and one more tool in our toolbox.

Thanks for sharing Riva!

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