Caregiving during Ramadan
RAMADAN is just a few days away, and this is the time Muslims around the world will be fasting by abstaining from eating and drinking from dawn to dusk. It’s a holy month where Muslims are expected to put in more effort to raise their level of closeness to God through various acts of worship.
Fasting during Ramadan is one of the Five Pillars of Islam, with rules outlined in the Quran that all observant adult Muslims are expected to adhere to. It’s hardly surprising then that there’d be people who’d want to fast despite the challenges to their health.
People who are excused from fasting during Ramadan are women during their menstrual period or postnatal bleeding, travellers, pregnant or breastfeeding women who believe fasting for long hours may cause harm to either themselves or their babies, pre-pubertal children, and those who are not well.
Now comes your role as caregiver to your loved ones, especially the very young, the ailing and the elderly. Be mindful of their condition and dietary needs as well as restrictions if they choose to fast.
I can still remember how my late parents insisted on trying to fast even though their doctors told them that with their condition, they could be exempted from fasting.
At that time, mum had just started haemodialysis and dad had been discharged from hospital for a major surgery. Dad suffered from a ruptured aortic aneurysm. Both were also diabetic.
One would think that it’s obvious they could be exempted from fasting, right? That’s not what they thought. Fasting to them was an act of worship they’d been doing almost their entire life. It was difficult for them to come to terms with not fasting during Ramadan. It just didn’t feel right and they felt guilty.
It took them some time to come to a happy compromise; of them waking up for sahur and then refraining from eating and drinking until midday when they needed to take their medications. We had to consult with their doctors and religious advisors who managed to persuade them that their health and wellbeing were just as important.
CASE STORY
Dad was in his 80s, diabetic and had suffered several severe episodes of hypoglycemia. The first time he had a hypoglycemic attack was when he was already warded in the hospital. So the doctors could give him intravenous treatment immediately.
Mum was also diabetic. Even though mum was a haemodialysis patient, she needed to keep her energy levels regulated. As it were, her food and drink intake had to be carefully monitored. Mum had also suffered and recovered from a diabetic coma.
Ever since then, we were very mindful of their condition and kept drinks and food that could help them recover and stabilise quickly. Dad needed to stay hydrated. Mum had to watch her fluid intake.
We always had things like natural no sugar-added pure fruit juices, chocolates, honey, dates, biscuits, and even soft drinks (but not the sugar-free type) at hand for those moments when their blood sugar level dipped and they needed a quick fix.
I was later told that chocolates shouldn’t be a first choice as they’re complex sugars and would take time before the body can digest and utilise it. Hypoglycemia can also happen when the dosages of medications have been adjusted after certain check-ups.
BE PREPARED
During that time, we learnt to detect their conditions, whether they were dehydrated or otherwise, or if they’re generally unwell. What was important was to check their blood sugar level, if we could. If they looked like they were having a hypoglycemic episode, we’d give them a packet of juice to drink before we tested their blood sugar levels.
You wouldn’t want them to faint just because you wanted to take the blood sugar reading first. Let them recover and be a bit more stable before doing the test. Once it’s normal, eating a snack or small meal can help stabilise the readings and replenish the body’s glycogen stores.
Sometimes, however, when a diabetic person is suffering from such severe hypoglycemia, he/she may not be able to eat or drink. So don’t try to force any drink if they’re unconscious. They could choke and this may bring about dire consequences. Calling for emergency medical help is the better option.
While you’ve prepared for possible episodes of hypoglycemia, it would also be a good idea to keep an eye on what your loved one is eating if they’re diabetic and wanting to fast. Avoiding large, heavy meals that are spicy and oily when breaking fast is a good start.
Eating food with high fibre content and low glycemic index at sahur would delay hunger pangs and keep you feeling fuller longer too. When in doubt, it’s always a good idea to consult your doctor.