There are two types of health
literacy – one where you are able to read written directions and your medicine
bottles; the other where you are given directions or explained your condition
and you are able to internalize, comprehend, and take action to take care of
yourself.
For diabetes, we may all too often
jump to the conclusion that health literacy is the first kind; when there are
problems, it’s because people can’t read when to take their oral medication or
something similar. However, after reading a NYTimes article including a story
of a patient with diabetes who ended up dying from complications, we realize
there’s a huge barrier to care in comprehension that needs to be fixed in our
health care system, too.
Jack, the patient, was a former
start athlete who had diabetes, high blood pressure, vascular disease, and
kidney failure. He had two leg amputations. Most of the nurses and doctors
described him as “out of control” because of potential drug use or refusal to
acknowledge his medical conditions. But as the author suggests, it may have
been because no one ever explained his condition and the importance of
self-care
How often does this occur in real
life? More often than we’d like. New studies suggest half of Americans have
struggles obtaining, understand, or acting on health information, which
researchers now call “limited health literacy”. Being familiar with diabetes,
we understand just how important self-care is and how it really makes the
difference of living a relatively healthy life and having a story like Jack’s.
But what can we do?
Patients can
take a more active role in educating themselves about health. This can be
gathering up the courage to ask your busy doctor a question if you’re unsure;
calling back to double check directions on your medication; and empowering
yourself with more education and information so you understand why self-care is so important. Never be
embarrassed if you don’t understand something a doctor is saying – after all,
they’ve had years of medical training; they should be able to explain it
clearly and in a way that you can understand and act on. Also, we highly
recommend asking for a diabetes educator if you don’t have one. As we
understand it, only 30% of people with diabetes have educators – you deserve
one if you don’t have one! Medicare pays for ten hours of diabetes education
the year you are diagnosed and two hours a year thereafter – although we don’t
think this is nearly enough, it should be a great start. If you need an
educator, call 1-800-832-6874
Doctors and educators can
ask a follow up question such as “Did I explain this clearly?” or ask patients
to repeat the directions back to demonstrate understanding. Patients, if you
feel rush, interrupt your doctor and ask “Oh, can I repeat this back to you to
make sure I’ve understood you clearly” so your doctor AND you are clear about
their directions. We know doctors are busy and already pressed for time, but
catching those red flags of misunderstanding could save a patient’s life,
especially for diseases that are so patient-centered like diabetes.
What else can be done to improve health literacy?
