• Fresh Views

    Language Matters Global Summit

    We’re taking a bit of a detour this week in our “Diabetes Technology and Solution-Focused Practice” series to focus on a special event – a Facebook Livestream Language Matters Global Summit. 

    We @AFreshPOVForYou have been supporters of the #LanguageMatters movement in diabetes care and education since early on. You can read previous blog posts here and here.

    Initially, when the Diabetes Australia Language Guidance Paper was published here, we were off and running, trying to incorporate strength-based, person-first language into all that we did. Deb was working at Sutter Health at the time and started a National Diabetes Month/World Diabetes Day campaign to educate healthcare professionals within the system about the rationale behind the movement and the meaning behind the words.

    Soon after the United States guidelines were published jointly by both the Association of Diabetes Care and Education Specialists (ADCES- formerly AADE) and the American Diabetes Association (ADA) the Use of Language in Diabetes Care and Education (Dickinson, JK, 2017) here. We were then even more inspired.

    As we’ve written about before, we were involved in the script development and production of the Telly Award winning video “Changing the Conversation,” with a purpose to raise awareness of the power of language and the impact language can have on a person’s well-being, quality of life and overall sense of self while living with diabetes. We’re so proud that this video has been shown around the world!

    And the use of language is the foundation of this solution-focused blog. We believe and live these principles every day and work to help others embrace the important messages and translate them into their relationships with their clients and co-workers.

    Yesterday, October 19, 2021 Diabetes Australia celebrated 10 years of moving the needle forward in the #LanguageMatters movement by hosting a Facebook Livestream Language Matters Global Summit. We were thrilled that this event included a showing of the Changing the Conversation video and Deb was so humbled to introduce the video once again to new audiences.

    As October turns to November and Diabetes Month activities, please consider sharing the YouTube link to this event and continue to raise awareness about the importance of and need to change the way we talk about diabetes to help stop the stigma, shame and blame often associated with a lack of knowledge combined with media hype around diabetes.

    We can all make a difference when we believe that #LanguageMatters!

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is employed by Dexcom, but her words and opinions in this blog are her own.

    Tami is employed by the University of Kentucky HealthCare Barnstable Brown Diabetes Center, but her words and opinions in this blog are her own.

  • Fresh Views

    RESILIENCE: Today’s word to jump-start solution-focused practice

    World Diabetes Day 2020 theme is the Nurse and Diabetes

    “Persistence and resilience only come from having been given the chance to work through difficult problems.” ― Gever Tulley

    Can you believe we find ourselves in the middle of November already? November is diabetes awareness month and the activities and events that take place create an opportunity to heighten awareness of diabetes care, education, and health outcomes. 

    Each year on November 14 World Diabetes Day (WDD) is celebrated, with global themes to improve access to critical medicine, care and therapeutics. This year’s theme is the role of the nurse in diabetes care. In many parts of the world, the nurse is frequently the healthcare professional that helps manage people with diabetes, especially in remote and rural parts of the world with limited health care access. 

     The goals of this year’s WDD emphasis include the following: 

    • to raise awareness of the critical role nurses play in the lives of people with diabetes 
    • to recognize the need for more nurses
    • for nurses to educate themselves about caring for people with diabetes

    You can read more about this year’s activities here.

    We @AFreshPOVforYou want to acknowledge that nurses are especially important members of the healthcare team in the midst of the global pandemic! We see the role that nurses play every day as front line workers and appreciate all they do! For those providing direct care to people with COVID-19…what resilience to get up every day and go into work…not only facing the challenges of day-to-day work, but often acting also as a support person, and at times a surrogate family member. 

    TODAY’S WORD IS RESILIENCE

    This month-long focus on diabetes awareness, brings about the opportunity to touch on one of the skills essential for people with diabetes to develop in order to live well with diabetes. That skill is resilience. And yes, resilience is a skill. We think about resilience as the ability to “bounce back” after challenging times. It’s having inner strength when life throws you challenges and still being able to hold your head up.  

    People who see themselves as being resilient are typically those who have suffered adversity, faced significant challenges and were able to come out of their struggles stronger and with a different perspective on life. Often those who have faced the biggest challenges are the most resilient. Living with a chronic condition like diabetes means living with chronic stress, and that can make managing diabetes more challenging. That’s where building resilience comes into play. 

    While some believe that one is either resilient or not, research shows that resilience is a skill that can be developed over time with practice and support. And when a diabetes care and education specialist – whether a nurse like Deb, a dietitian like Tami, or other diabetes health-care professional – engages in a solution-focused approach to practice, the ability to build resilience is not only possible, but highly likely.   

    When we reinforce and recognize positive behaviors and strengths, people tend to do more of those things more often. In solution-focused practice we call these “exceptions” or times when problems don’t exist and life is working well. 

    In our recent research we learned about resilience. Participants in our study described resilience as strength, optimism, stubbornness and persistence. People acknowledge they have no choice to move forward with diabetes management. One participant acknowledged “stubbornness and persistence. They seem to pay off (sometimes) I’d say resilience too, but that is a moveable feast and very noticeable when absent.” This comment really made us think about the need to support the development of resilience.

    Cultivating resilience is critical in diabetes, especially in those who are not more naturally inclined to recognize their resilience. A friend of Deb’s that lives with diabetes shared a story where she accidentally gave a very large insulin bolus via her pump, almost her total daily dose of insulin at one time. While completely stressed and nervous, she texted Deb who immediately called her to help her problem solve. She spent the next four hours on the phone while eating more carbs than she had in the previous month, but was determined not to go to the ER. She wanted to take charge and manage the situation. So that stubbornness really paid off.  She never went below 70. With the help of her continuous glucose monitor (CGM) and support, she was able to manage the situation. While the day was extremely stressful, she was able to think through her options and what they meant to her. While this situation is unique and not a frequent occurrence, it does help to identify a need for planning for challenges.  A key focus in resilience is on recognizing stressors and building plans to work through the stressful situations and setbacks and come out on the other side feeling successful, even if it is just one very small success.

    EACH WEEK WE INVITE READERS TO PARTICIPATE IN A SOLUTION-FOCUSED CHALLENGE… This week, we challenge you to support your clients to develop their own resilience. Here are 4 ideas to try:

    1. Start all engagements with positive statements with focus on the individual’s strengths and what’s working well for them (even if it’s not directly related to their diabetes management).
    2. Encourage small personal experiments to gain small wins. Every significant step forward towards goals is a step in the right direction.  Recognize and celebrate these small steps. (Such as increasing time-in-range of 70-180 mg/dL from 50% to 55% or fitting in an extra 5 minutes of activity several days).
    3. Encourage your clients to engage in peer support whether in person or online. Help them learn how to seek support from others living with diabetes. Let them know that when they acknowledge their challenges and talk through them, they will often feel a sense of relief.
    4. Help clients to identify their VIPs (very important people in their life) who they can rely on for support.  Sometimes it may be simply someone to listen to challenges.  But, we also need people in our lives that “challenge us” and encourage us to see our true selves. Often we need different support people to play these different roles.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

    Deb is an employee of Dexcom but all comments are her own.

  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Reducing Risk

    You are braver than you believe, and stronger than you seem, and smarter than you think. – Christopher Robin

    National Diabetes Month is almost over, what informative and interesting activities were you engaged with this year?  

    Taking a solution-focused approach to diabetes self care

    As we near the end of the month, we are also finishing our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Problem Solving. And the prior weeks we focused on Taking Medications here, Monitoring blood glucose here, Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Reducing Risks 

    When looking at this picture above of the friendly neighborhood kitty balancing precariously across the covered porch rails, it reminds us of life with diabetes… trying to stay in balance never knowing when the bottom may fall out.  

    AADE7 Self-Care Behavior #7: Reducing Risks

    Taking care diabetes today can help people feel good today AND in the future. When blood glucose is in range, one is more likely to:

    • have more energy, both physical and emotional
    • be less tired and thirsty
    • pass urine less often
    • heal better and
    • have fewer skin or bladder infections

    Many say they are their “best self” when their blood glucose is in range. And managing diabetes TODAY means there will also be less chance of having health issues caused by diabetes over time. The important words there are “over time.” Taking care of diabetes now will help reduce the risk of heart attacks, stroke, damage to kidneys and nerves, and loss of vision. But It’s not just about the diabetes, it’s about supporting those with diabetes in living their best life! 

    A journey of a thousand miles begins with a single step. (Chinese Proverb)  Just one step.

    We want to support and guide our clients toward actionable steps they can take now to live well with diabetes and help reduce the risk or delay issues down the road. Then, the key is replicating that small step over and over again to build momentum and actually feel progress. Small steps add up. You may be surprised by the great impact these small, yet simple things can have! 

    The language we use when talking about diabetes complications is important to think about. When we use words like “prevent” as opposed to “reducing risk or delay progression” we imply that ALL complications CAN be prevented. Science tells us that this isn’t always true. Some people have genetic predispositions to either be “protected” from complications or to be at a higher risk. Healthcare providers can add to the stigma, shame and blame associated with diabetes when they don’t acknowledge the fact that some people will end up with complications……just because. We don’t want people to shy away from discussing health concerns, so let’s use our #LanguageMatters voice when we #TalkaboutComplications. That’s what The Grumpy Pumper (AKA Chris Aldred) has been doing this past year. Traveling around the globe, including a stop at #AADE19,  speaking openly and frankly about living with a complication from diabetes. You can read his blog here.  As Grumpy says, “Even with the best of care, people can get complications.” (from Diabetes Connections Podcast) So let’s use a solution-focused approach when talking with people with diabetes complications instead of rehashing any problems.

    When working with clients instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this:  By no means is smoking a simple habit to change. What can you do more of that may help you smoke less? Or what needs to happen to help you make changes?

    Instead of this: You need to stop smoking. Smoking is bad news with diabetes.

    Try this: How can you fit in an extra visit to see your eye doctor during national diabetes month?

    Instead of this: You are behind on getting your eye and dental exams.

    Try this: On a scale of 0 to 10, with 0 being never and 10 being always, how often are you able to get an annual flu shot to help prevent illnesses?

    Instead of this:  You haven’t gotten your flu shot.

    Three follow-on questions to help you not only feel  better today, but to help prevent problems down the road:

    • What is one action you can take to reduce your risk? Work closely with your healthcare team to identify the best strategies for you to help manage them and prevent progression to live your best life.
    • What can you do NOW, right this second…to make life better now, as well as down the road.
    • What single change can you make over the next week?

    And consider how people in your life can help. Loved ones, family, and friends can be close allies in your diabetes management. (last week we discussed VIPs, you can read it here)

    We can encourage clients to keep taking those small steps each day. Consistency and routine build on each other. Small steps add up. If people do the best that they can do…then they can say at the end of the day, I did the best I could, and that’s a good feeling.

    We hope you’ve enjoyed our series and that we’ve made you think before engaging with clients. And if you’re a person living with diabetes, we hope our choices resonate with you. Each week we’ve challenged you to try some flips into your conversations. Let us know what impact they have had. Please reach out to us to share feedback.  Let’s continue to join together  to raise awareness of all issues that can improve living with diabetes.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou


  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Problem Solving

    I will breathe. I will think of solutions. I will not let my worry control me. I will not let my stress level break me. I will simply breathe. And it will be okay. Because I don’t quit. – Shayne McClendon

    Tomorrow, November 14 is #WorldDiabetesDay! Deb and Tami have had some impactful moments in recent years during diabetes month and on #WDD. Deb has been involved in hosting events at the California state Capitol with speakers, music and lighting of the Capitol in blue. Deb’s also spend #WDD 2017 at the headquarters of  Novo Nordisk in Denmark. Tami has done TV spots, radio shows, Facebook Live and videos, provided community programs, participated in screening events and published articles – all to raise awareness and encourage people to know their risk for type 2 diabetes. 

    The theme of #WorldDiabetesDay this year is the impact that diabetes has on the family. One of the goals is to promote the role of the family in the prevention, management, care and education of diabetes. In a solution-focused approach, the family is important, and we call them VIPs – .and this definition is broad – it includes any one who is a “very important person” in your life. Someone who can provide support when needed, who will notice changes being made, and  who can respect personal decisions and choices. What’s really important is that these VIPs are not the “diabetes police”, or people who make managing diabetes harder. As you think about problem-solving, think about including VIPs in both the discussion and the plan to help foster success and respect.

    Taking a solution-focused approach to diabetes self care

    This is week 6 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Last week we shared about taking a solution-focused approach to Taking Medications here.  And the weeks prior we focused on Monitoring blood glucose here,  Healthy Eating  here, Being Active here, and Healthy Coping here. This week, we are talking about Problem Solving.

    AADE7 Self-Care Behavior #6: Problem Solving

    With diabetes, “problem” solving is part of the daily routine…figuring out when, what, and how to eat for meals and snacks. What kind, how much, and when to fit in physical activity. When to check blood glucose, how to time any medications, and the list goes on.

    And then life throws curve balls, and no matter how well you plan, unexpected things happen that can send blood glucose out of range. And that’s when more problem-solving skills are called into action to determine how to handle the scenario and what to do to prevent it from happening again. 

    Also, diabetes needs may change over time, requiring adjustments because previous solutions no longer work.

    In taking a solution-focused approach, we typically don’t focus on solving problems….as you know. We focus on solutions…looking for what is already working and trying to do more of that.  So this self-care behavior is not as intuitive to translate. Here are 4 strategies to help diabetes care and education specialists and people with diabetes flip the problem-solving paradigm.

    1. Practice self-compassion. Diabetes is different every day, even when people make similar choices. We learned from our Twitter research that people living with diabetes would like to practice more self-compassion. They want to be kinder and not blame themselves. 
    2. What has gone well today? When you are faced with challenges, think about what DID work for you during this challenging time. Instead of doing a deep dive into all of the issues that might have impacted you, spend some time focusing on your successes. Then tomorrow, try to do more of what worked.  
    3. Keep a journal of solutions. When things are going well, keep track of these small wins so the next time you are faced with a challenge, you have some “go to” solutions ready to try.
    4. Share with your VIPs. Ask your VIPs about their ideas.  Do they have some ideas about what works well for you and the times they see your successes.

    When working with clients, instead of traditional problem-solving exercise, try to focus on existing solutions to create change.  Begin by exploring these 3 questions to flip the conversation.

    1. Tell me about a time when you felt the happiest about your diabetes management?
    2. What was it about that day or time that made it better?
    3. Can you think of times when the challenge you are facing now was not present in your life? What were you doing then?

    We challenge you each week to try some flips into your conversations and let us know what impact they have. Let’s join together throughout the month of November to raise awareness of all issues that can improve living with diabetes.

    Join us next week for our final installment as we discuss a solution focused-approach to the self-care behavior around reducing risks.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou

  • Fresh Views

    Flipping the Paradigm: Applying a Solution-Focused Approach to Taking Medications

    Self-care is never a selfish act – it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others. Anytime we can listen to true self and give the care it requires, we do it not only for ourselves, but for the many others whose lives we touch. -― Parker Palmer 

    Big Ben in London, England 

    @AFreshPOVforYou is one-year old!

    Happy birthday to us @AFreshPOVforYou! Our blog is officially one-year old, 56 posts later! 

    Over the last year we have focused on Possibilities, Opportunities and creating a Vision (POV) for the future by taking a solution-focused approach to life with diabetes. We’ve been excited to share our work and learnings by speaking at the AADE19 Annual Meeting, helping diabetes care and education specialists learn how to incorporate a solution-focused approach into their practice. We also shared our Twitter research findings at the European Association for the Study of Diabetes conference in Barcelona, Spain. And we’ve conducted a survey, focus groups, and have a few papers in process. It’s been a great year and we’re excited to see where this next year leads us!

    And it’s now national diabetes month 

    We purposely launched this blog right before #WorldDiabetesDay last year, to kick off our new adventure. And here we are again. What are you doing for diabetes month? Do you have an event or an idea you’d like to share with us or our readers? Please let us know in the comments. We’ll be adding in some diabetes month discussions throughout November, along with sharing insights about using solution-focused approach to self-care behaviors.

    Taking a solution-focused approach to diabetes self care

    This  week is week 5 of our 7-week series on applying a solution-focused approach to the AADE7 Self-Care Behaviors for managing diabetes. This series is focusing on “flipping” the conversation from a “problem focused” (traditional medical) approach to a solution-focused conversation. Have you tried any “flips” in the past 4 weeks? Please let us know if you have, and what your experience was. 

    Last week we shared about taking a solution-focused approach to Monitoring blood glucose – you can read it here.  And the weeks prior we focused on Healthy Eating  here, Being Active here, and Healthy Coping here.. This week, we are talking about taking medications. 

    AADE7 Self-Care Behavior #5: Taking Medications

    While taking medication of some type is often required somewhere in the journey with type 2 diabetes, it’s not always simple to engage in this self-care practice. We hear that routinely from clients we work with. Here are 3 challenges that frequently bubble up…

    1- Remembering. No matter what one’s age, remembering to take medication can be a challenge at one time or another. After all, life happens and can derail even the best intentions. In our experience, missing medication doses can also be linked to the dosing frequency, side effects, or diabetes distress. When it comes to remembering to take medication, solution-focused strategies to consider include, using a medication reminder app, using a pill box, pill packs, keeping the medication in view as a reminder (if it doesn’t require refrigeration), marking a calendar when a dose is taken, and setting an alarm on a smartphone or clock. (The mention of a clock, reminded us of Big Ben in London, so that’s our fresh view for today!)              

    2 – Stigma. With type 2 diabetes, there is often stigma associated with taking medicine. There is a false sense that people “should” be able to manage diabetes through healthy eating, being active and losing weight. But we know that is not always reality. Given that diabetes has a genetic link and is a progressive condition, things change over time. What works today, might not work next month or next year. So talking about diabetes medicine using a positive, solution-focused approach can help build a trusting relationship and a therapeutic alliance in which to discuss medicine choices and barriers while using a shared-decision making approach.  

    3 – Cost/Access. We must also be cognizant of the cost of medicine when considering options. Although there are some incredible, effective new medications that impact the patho-physiology of diabetes, these new drugs often come with a high price tag. And they may not be included on insurance formularies. And the cost of insulin is beyond crazy. The American Diabetes Association has a website to help people navigate this complex issue and provide a list of resources. Unless we have open conversations, we may not know that people are not taking their medicine because they are not able to afford it. How can we say they are “non-compliant” or “non-adherent” when this is the case?  We need to change the language we use in diabetes, especially around medication taking. The #LanguageMatters conversation is essential when talking about medications.

    When working with clients instead of focusing on what is not working well or what is “wrong”, here are 3 illustrations of how to flip the conversation:

    Try this: Diabetes is a progressive condition. It’s common for people to need more medicine over time. Can we talk about the benefits of adding insulin?

    Instead of this: You’ve failed oral medicine, you need to take insulin.

    Try this: What challenges do you have when taking your medicine?

    Instead of this: You’re not compliant with your medicine.

    Try this: How many days each week do you take your medication?

    Instead of this:  How often do you forget to take your medication?

    We challenge you each week to try some flips into your conversations and let us know what impact they have. Let’s join together throughout the month of November to raise awareness of all issues that can improve living with diabetes.

    Join us next week as we discuss a solution focused-approach to the self-care behavior around problem-solving.

    We welcome anyone interested in our approach to Subscribe to our blog and we’ll email you when a new post is published!

    If you are a health care professional and interested in learning more about our solution-focused practice and approach, when you subscribe to our blog, we’ll send you in return a FREE resource of 10 Solution-Focused Questions to start a solution-focused discussion with your clients. 

    Follow us on Twitter and Instagram @AFreshPOVforYou


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