GUIDELINES FOR ORGANIZING CAMPS FOR ELDERLY PEOPLE WITH DIABETES
Any Diabetes Association can organize a camp for elderly people with diabetes. It should have facilities for educating the personnel, prior to the camp. It prepares pamphlets and information about the camp. It chooses the camp venue. It screens and prepares the participants for the camp.
A member of the team is an enthusiastic person involved in diabetes. He may be a doctor, nurse, dietitian, psychologist or a person with diabetes, active in the local diabetes association. Previous experience in basic treatment and education of people with diabetes is mandatory. Team members have to be physically fit, well organized, optimistic, talkative and friendly. They have to be prepared to spend 7 days with a group of people with different needs and unresolved health problems concerning diabetes. That group of people has been waiting for the camp and has intention of getting educated, socialized, entertained and their health problems solved!
Education of personnel
Diabetes Association must organize education for the team members.
Doctors have to be prepared for changing the therapy for diabetes, heart problems and hypertension, on a daily basis. They have to be prepared to introduce insulin therapy for the first time. They are expected to have all the therapy problems solved by the forth day of the camp.
Nurses are educated in using the meters, insulin-pens and dealing with acute complications of diabetes. They have to be prepared to answer questions concerning diet, in case the dietician is not present.
A person with diabetes has a role of a motivator. He has to be prepared to talk of his experience and motivate others. That person is usually assigned to lead physical exercise in the morning hours. He also is engaged in glucose measurements.
A booklet is provided to all team members on basic topics of education.
“Camp” refers to modest accommodation. Private accommodation, a youth hostel or a modest hotel is the best solution for elderly with diabetes. The hotel staff has to be friendly and helpful. The site has to provide a place for blood glucose and pressure monitoring and consultation with healthcare staff. It has to provide a room for education. The camp venue has to be located near a healthcare center. Walking routes of different distances, availability of a swimming pool and a place for exercise has to be checked. It is optimal to have two excursions by buses in 7 days to avoid monotony.
Information about the camp
Information should be provided to the public 6 months prior to the camp, for the first time. An article in the daily magazine is the best and the least expensive way. Paid advertisements should follow on a monthly basis. An interesting article in a monthly popular magazine is also helpful. Ads over the TV or radio are not helpful due to fast flow of information that can’t be captured by the future participants. The web site of the diabetes association is of some help, as elderly usually do not use the computers. Pamphlets in the primary health care units may be of help, if encouraged by the health care personnel. Diabetes Association must provide pamphlets that may be distributed daily. The main recruitment center, however, remains the office of the Diabetes association.
Registration of the participants
Registration fee must be modest. It ensures that a participant is going to attend the camp and not change his mind. This fee is not returned in case of absence. Registration should start 4 months before the camp. The full number of participants should be known a month before the camp.
A participant is any person with diabetes from the age of 40 to 80. He has to be prepared to share a room with other participant, in case there are no single rooms, and follow the daily activities.
Diabetic foot, serious retinopathy, serious heart disease, hypoglycemia unawareness, immobility of any kind and psychiatric problems.
Screening of participants begins 4 months before the camp. Each participant has to bring a letter from the physician, the latest laboratory results and an ECG. These can also be posted.
The optimal number of participants per camp is 25 to 30. They should be tended by a doctor, 2 nurses, a person with diabetes and a technician. A technician is a person who organizes the excursions, walking tours, buys necessary things for the camp, drives the participant to the health care center, if necessary.
Preparation for departure
Diabetes Association contacts each participant at least twice before the camp; on registration and on screening. The third contact is made a day before departure.
Each participant is informed about the time and site of departure by bus. He is also informed about the necessary clothing, foot wear and reminded to bring his own medication.
Participants are introduced to each other and to the personnel on departure.
If the participant is coming to the camp for the first time, his room mate is chosen by the personnel. Otherwise, participants are encouraged to choose their own room mates.
Each participant receives the camp diary, created by the Diabetes association. The diary follows daily camp activities. It provides space for daily recording of glucose/pressure monitoring, any changes in the therapy, meals and physical activity. The camp diary is obligatory. It has to be filled daily by each participant. It is a teaching tool.
Records carried by the personnel
A document is created of each participant with the basic information: age, duration of diabetes, other medical conditions, therapy, complications of diabetes, major cardiovascular events, and allergy. At the camp site, weight, height, body fat and waist circumference are noted. All the measurements, changes in therapy, meals and physical activity are daily noted.
Diabetes association prepares oral hypoglycemic drugs, insulin, glucagon, antihypertensive drugs, anti-arrhythmic drugs, nitroglycerine, antibiotics, non-steroid anti-inflammatory drugs, anti-viperinum serum, anti-shock therapy, bandages, iodine, alcohol, hydrogen-peroxide and saline and glucose solutions.
The basic camp pharmacy is neatly placed at the camp venue, usually in the nurse’s room. A small pharmacy with medicine for urgent situations (hypos, hypertensive crisis, anginal pain, allergy, anti-viperinum serum, bandages) is carried all the time.
Division of participants
Division of participants into groups helps socialization and education.
First division: Each nurse and a person with diabetes are allocated a group of 7 to 10 people for glucose/pressure measurements for the duration of the camp.
Second division: Participants are divided into 2 groups for walking tours – fast and slow group. Personnel are divided among the groups each day.
Third division: Participants are divided into sittings groups for education. The groups are: metabolic syndrome or glucose intolerant (usually the family members belong to this group), obese type 2 on diet alone, obese type 2 on orals, obese type 2 on combined therapy orals and insulin, obese type 2 on insulin, lean type 2 on orals, lean type 2 on insulin and type 1.
Sugar and pressure measurements 7:30, consultation about therapy 8:00, breakfast 8:30, exercises 9:00–9:30, education: 10–11:00, short/long walks 11:00-13:00, blood sugar measurement 13:30, lunch 13:30– 14:00, rest period till 16:30, walks or sightseeing 16:30–18:30, sugar/pressure measurements and consultation 19-19:30, dinner 20:00.
Types of camps
1. Beginner’s Camp: duration 7 days
2. Active Camp: duration 7 to 10 days
3. Business Camp: duration 4 days
Education is done either at the hotel site or, rarely, outdoors. Different methods of education are used in camps. The beginner’s camp is attended mostly by people aged 60 years and older. Simple and short education of 30 minutes is given to all participants at the same time during the 7 days of camp. Active camp is attended by participants aged 40 to 65 years with very different health problems and therapy. Daily educational classes may last 60 minutes or often longer. Individual education in groups of 4 – 5 is practiced in business camps. Lectures are shorter, but take place twice daily.
The topics covered are: 1. Type 1 and 2: different states and different treatment, 2.Carbohydrate, fat and protein counting, 3. Metabolic syndrome leading to diabetes, 4. Self management at normal and festival times, 5. Diabetes and complications – reversible, controllable or not?, 6. Diabetic foot.
Additional topics for the business camp: cardiovascular complications of diabetes, stress and diabetes, antioxidants – supplements in diabetes, insulin therapy.
The first visit is after 1 month for some. It is obligatory after 3 months with HbA1c, cholesterol and triglyceride results, blood pressure and blood sugar recordings in the diary
Diabetes Association of Serbia has organized:
in 2003. – 2 basic camps
in 2004, 2005, 2006 – 1 basic, 1 active camp
in 2007 – 1 basic, 1 active and 2 business camps.
In 2007 the camps were named SANOFI with reference to SA-samokontrola (self-management), NO-novi pristup (new way of education) and FI-fitness.