How to Teach a Non Compliant

Diabetic Patient

When you learn how to teach a non-compliant diabetic patient, you should learn about more than just the physical symptoms and illness. As you investigate the causes of non-compliance, you will find ways of helping the patient comply with

treatment and management.

Steps

1
Look past the apparent "non-compliance" of the diabetic patient. If he or she has come to you for treatment, the patient wants to get better. The patient may not realize he or she can speak up if there are questions or concerns about a treatment plan.
- Initiate a conversation with your patient. In treating diabetes symptoms, you are working to prevent a potentially life-threatening disease from getting any worse.
- Probe for reasons for your patient's non-compliance with the treatment plan. Depending on whether the patient takes oral medication or insulin, it is vitally important that he or she understands, not only what has to be done, but why it has to be done.
2
Reread your patient's file and look for other reasons for non-compliance with the treatment plan. Primarily, try to rule out psychological issues such as depression, bipolar disorder or some form of psychosis.
- Schedule an appointment with your patient. If your review of the file did not turn up any psychological issues that could get in the way of his or her ability to follow her treatment plan, you need to have a discussion and learn what is keeping the patient from taking medication or insulin. The patient may be so upset by a diagnosis that he or she is in denial. If this is the case, help the patient understand that, if the condition is treated, it won't get any worse.
- Talk to your patient about any psychological diagnoses he or she may have. You may need to obtain a family member's help in ensuring your patient begins to comply with the diabetes treatment plan.
3
Examine your client's ability to communicate and understand what you're saying about daily management of the condition.
- Look at your culture and that of your patient. If he or she is from a different culture, or if the patient does not speak English, your challenge is to work through these barriers so the patient is able to understand you and begin establishing good blood glucose control.
4
Talk to your patient and the family. Probe for evidence of dependence on drugs or alcohol and, if she or she suffers from substance abuse, begin working with the family.
- Explain to your patient and the family that he or she needs to address the addiction so he or she can be more successful in managing the diabetes.
5
Ask your patient if he or she is experiencing stress in other areas of life. If the patient is dealing with a difficult work situation, unemployment, poverty, parenting issues or marital difficulties, these all get in the way of managing the diabetes.
- Offer your patient assistance via referrals to other specialists or clinicians so he or she can gain control of stress.
6
Consider the possibility that your patient may be obtaining an intrinsic reward in staying sick. If the patient stays sick, he or she doesn't have to work and may be able to avoid stressful situations.
- Explain to your patient that, by not treating the diabetes, in the long term, the condition will get worse.
- Evaluate the possible reasons for your patient's non-compliance -- if his or her family provides special attention because the patient is sick, they are creating a cycle that is difficult to stop. Educate the entire family that coddling your patient is not helping.
7
Talk to your patient and spouse about why he or she feels as if he or she is not making any progress. Ask him or her to bring all medications to the next appointment so you can discuss each one in depth.
- Discuss the instructions he or she was given for taking their medications or injecting insulin. You may find that she or she was given erroneous or incomplete instructions and the dosages are not at the correct therapeutic levels or the patient has been told to inject incorrectly.