Managing Diabetes in Nursing and Care Homes
Providing quality diabetes care in a long-term care facility is a very serious aspect of a resident’s care plan. Poor diabetic care of elderly patients in nursing homes can sadly result in avoidable complications and even wrongful death.
Older adults with diabetes require ongoing monitoring and treatment to reduce their risk of developing such complications as:
- Cardiovascular disease
- Foot disorders
- Kidney failure
- Ocular problems
- Peripheral neuropathy
Staff must be trained to understand how to care for patients with diabetes, who are often frail and at increased risk for injury. Failure to provide adequate diabetes care in a nursing home may be considered nursing home neglect by federal and state law.
In cases of neglect, compensation may be available to help pay for treatment and better care for your loved one.
What Should a Diabetes Care Plan Include?
Proper diabetes care in nursing homes begins with establishing goals and deciding which interventions to use. An individualized plan of care that factors in the resident’s condition, preferences, and participation is the best way to manage diabetic care in nursing homes.
Prior to being admitted, a nursing home resident’s loved one should contact the resident’s primary care provider. This will allow diabetic care in nursing homes to be in line with previous treatment, levels of control, and goals.
Two organizations, the American Association of Clinical Endocrinologists (AACE) and the American Diabetes Association (ADA), joined together to update health care professionals on diabetic care in nursing homes.
Some highlights of the recommendations made include:
- Convert sliding-scale insulin (SS) regimens to safer treatment options
- Reevaluate all SS orders within a week of beginning them
- Use an individualized, patient-centered approach to provide diabetes care in nursing homes
Further, nursing home health care professionals should perform a detailed health history and physical for each newly admitted resident with diabetes.
Medical personnel should record:
- Average blood sugar levels
- Family health history
- Frequency of glucose monitoring
- Glycemic control
- Home medications
- Hypoglycemia incidence
- Length of disease
- Patient’s health history, blood pressure, basal insulin, comorbidities, and current glucose control
Management of diabetes in older people is a group effort, involving the patient, caregivers, and nursing facilities. Patient quality of life and life expectancy is closely tied to how diabetes is managed.
Managing Diabetes in Nursing Home Residents
Nursing home residents should have an Individual Care Plan (ICP) that includes specific guidelines on how to properly manage all of their health conditions.
This is especially true for patients with diabetes. For those who are diabetic, their bodies are unable to keep their blood sugars at healthy levels. In turn, a big part of diabetes care in nursing homes is having a process in place to keep blood sugar levels within normal ranges.
Diabetic care for elderly people in nursing homes may also include:
- Administering diabetes medications that are appropriate to long-term care settings
- Encouraging nursing home patients to practice good diabetes management, including self-care and physical activity
- Providing proper diabetic nutrition, including correct intake of carbohydrates
- Monitoring blood sugar levels based on the risk of hypoglycemia
Diabetes management and care procedures in nursing homes are complicated, but they are a critically important way to help keep diabetic patients safe and free from suffering.
Consequences of Improper Diabetes Care
It is critical for nursing home residents with diabetes to keep their blood glucose (sugar) levels within healthy ranges. If blood sugars become too high or too low, the consequences can be severe.
Some possible complications include:
- Alzheimer’s disease: Type 2 diabetes may increase the risk of Alzheimer’s disease and other dementias.
- Cardiovascular disease: Diabetes increases the risk of heart problems, such as coronary artery disease with chest pain (angina), heart attack, stroke, and narrowing of arteries (atherosclerosis).
- Depression: Depression in diabetes patients is common and can complicate diabetes care in nursing homes.
- Eye damage (retinopathy): Diabetes can damage the blood vessels of the retina and possibly lead to blindness, cataracts, and glaucoma.
- Foot damage: Nerve damage and poor blood flow to the feet may cause cuts and blisters to develop into serious infections. Because cuts heal poorly with diabetes, they may end in toe, foot, or leg amputation.
- Kidney damage: Kidneys contain millions of blood vessels that filter waste from your blood, but diabetes can damage them. Severe damage may cause kidney failure.
- Nerve damage: Excess sugar (hyperglycemia) can damage the tiny blood vessels that nourish nerves, especially in the legs, causing tingling, numbness, burning, or pain. Hypoglycemic damage usually starts at the tips of the fingers or toes and spreads upwards.
- Skin conditions: Bacterial and fungal infections are more common in people with diabetes.
Complications from diabetes often develop gradually. Since the longer you have diabetes, the higher your risk for complications, the elderly population is especially vulnerable. If diabetes care in nursing homes is not adequate, complications can be disabling or even deadly.
Diabetic Care and Nursing Home Neglect
Diabetic care in nursing homes is a critical component of a resident’s ICP. Because nursing homes have a duty to provide adequate care for residents, improper diabetes care may be considered nursing home neglect.
The prevalence of diabetes has increased, making a well-trained staff necessary. Failure to provide proper diabetes care in nursing homes can result in preventable complications in residents.
“Diabetes increases the risk of cardiovascular and microvascular complications but also increases the risk of common geriatric syndromes, including cognitive impairment, depression, falls, polypharmacy, persistent pain, and urinary incontinence.”
– American Diabetes Association
In a tragic case in Texas in 2018, a resident with diabetes wasn’t able to eat or talk for seven hours when his blood sugar dropped so low that it caused dangerous hypoglycemia. The man was found on the floor without a pulse and died a few hours later.
Poor diabetic care in nursing homes may result in premature death or avoidable complications. Filing a nursing home abuse lawsuit can help you get justice from those responsible for carelessly harming your loved one.
Find a Nursing Home Neglect Attorney Near Me
Nursing homes have a duty to keep residents safe. If you suspect that your loved one suffered complications from poor diabetes care in a nursing home, financial support may be available.
Filing a nursing home abuse legal claim may help you get the compensation you need to get the best care for your loved one. Your actions may also help to prevent other vulnerable nursing home residents from being harmed.
Get a free case review today to learn if you may be eligible for compensation related to improper diabetic care in a nursing home.