United Way, Meals on Wheels team up to fight diabetes in Tarrant County

By Terry Evans

tevans@star-telegram.com

MANSFIELD -- Agnes cried when she was diagnosed with type II diabetes five years ago.

"My mother was a diabetic and she had to have a toe amputated," she said. "That did not heal, so they amputated her leg just below the knee."

Fear of what the disease might do to her made the 76-year-old Meals on Wheels of Tarrant County client try hard to focus on her doctor's instructions.

But like many people, Agnes couldn't grasp all she was being told. She didn't have to use insulin or other medications, but she became so afraid of eating the wrong things that she started losing weight.

"I thought carbs were my enemy," said Agnes, whose last name is not being published at the request of Meals on Wheels.

Her doctor grew concerned about the continued weight loss.

"He said he wanted me to gain 15 pounds," Agnes said. "He sent me to an endocrinologist and I met with their dietitian. I left there feeling frustrated and still had a lot of questions."

Meals on Wheels then stepped in and connected Agnes with dietitian Kathie Robinson through a partnership with the United Way of Tarrant County's Diabetes and Nutrition Identification Management Program.

The program has significantly reduced hospitalizations and emergency room visits for clients like Agnes, said program spokeswoman Sherry Simon.

"This project works to help and educate persons with diagnoses of diabetes, at risk of diabetes and/or nutrition risks to hopefully prevent ER visits and hospitalizations," Simon said.

Agnes said that Robinson helped her reverse the weight loss.

"When Kathie came to see me she soon realized how stressed I was over all of this," she said. "I explained that I was trying to avoid all carbohydrates."

Robinson was patient with her new client and explained portion control, balanced diets and the benefits of exercise, Agnes said. Hearing this in the comfort of her own home helped her better understand her needs.

"When she's explaining something and I don't understand, I can ask questions," she said. "You may not even realize the questions you have until someone starts explaining."

Through home visits, Robinson not only gave Agnes the kind of education she needed to set goals that help her control her condition, but also became a friend who encouraged her to meet those goals.

"Having an educator who can spend time explaining things in layman's terms and answering questions is huge," Robinson said. "If people are discharged from the hospital with a new diagnosis of diabetes, the hospital situation isn't conducive to learning."

An independent evaluation of the program found last year that 42 percent of 1,000 Meals on Wheels clients studied spent less time in the hospital, Simon said. Preventable hospitalizations were reduced by 70 percent and emergency room visits decreased by 23 percent.

While the most important result was better client health, Simon added that by reducing hospitalizations the program potentially saved $11.5 million in overall health care costs.

Reaching the clients in their homes has an additional real-world benefit that office visits simply can't match, Robinson said.

"I had a client who was a hoarder," she said. "There was a small path through her home to her living room, where there was one chair. Syringes and lancets were laying everywhere."

A previous attempt had proved that the client wasn't emotionally ready for a hoarding intervention, Robinson said. But she was open to learning about the cautions of living amid the clutter.

"I told her that she had to keep her shoes on so she wouldn't cut her feet," she said. "Nobody would have known from an office visit how she was living. Everyone's different. They all have their own story."

Terry Evans, (817) 390-7620

Twitter: @fwstevans

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