Diabetes Care in Nursing Homes

Managing Diabetes in Nursing and Care Homes

Many long-term care facilities offer services to help older adults with diabetes. Residents and families expect these facilities to provide high-quality care.

Poor diabetic care of elderly patients in assisted living facilities can sadly result in avoidable complications and even wrongful death.

Older adults with diabetes have an increased risk of:

• Cardiovascular disease
• Foot disorders
• Hyperglycemia (high blood sugar)
• Hypoglycemia (low blood sugar)
• Kidney failure
• Malnutrition
• Peripheral neuropathy (numbness/tingling in hands/feet)
• Vision problems

Staff must know how to provide proper diabetes care in nursing homes. Failure to keep diabetic residents healthy may be considered nursing home neglect by federal and state laws.

Thankfully, compensation may be available to pay for diabetes treatment and better care for your loved one if neglect occurred.

What Should a Diabetes Care Plan Include?

Management of diabetes in older people is a group effort involving the resident, their family, nursing facilities, and on-staff caregivers. Diabetes management can greatly impact the patient’s quality of life and life expectancy.

Elderly people in long-term care settings should have an Individual Care Plan (ICP) that includes specific guidelines on how to properly manage all of their health conditions. This care plan is especially important for patients with diabetes.

Health care providers should be contacted to provide insight on resident’s Individual Care Plan

Before a resident moves into a nursing home, their primary care doctor or health care provider should be contacted to give their insight into the proposed plan.

Further, nursing home health care professionals should get a detailed health history from the resident and perform a physical exam.

Medical personnel should record a patient’s:

• Average blood glucose (sugar) levels
• Blood pressure
• Brand/type of insulin shots used (basal insulin)
• Family health history
• Frequency of glucose monitoring
• Glycemic control
• Home medications
• Length of disease (how long they have been diagnosed with diabetes)
• Other diseases/conditions (comorbidities)

Managing Diabetes Care in Nursing Home Residents

Diabetic patients are unable to keep their blood sugars at healthy levels. In turn, a big part of managing diabetes care in nursing homes is having a process in place to keep blood sugar levels within normal ranges.

To provide proper diabetes care in nursing homes, staff must:

• Administer diabetes medications
• Encourage residents to follow self-care practices like physical activity
• Monitor blood sugar levels based on the risk factors for hypoglycemia
• Provide proper nutrition to manage carbohydrate and fat intake

Diabetes management procedures can be complex, but they are key to keeping patients safe. Thankfully, new strategies are being implemented to improve the ways diabetic patients receive care.

Two organizations, the American Association of Clinical Endocrinologists (AACE) and the American Diabetes Association (ADA), recently came together to recommend better ways of managing diabetes care in nursing homes.

Notably, these groups recommended monitoring patients who receive sliding-scale insulin (SSI). SSI gives insulin in different dosages based on a patient’s blood sugar.

That said, using sliding-scale insulin alone is not an effective treatment — it can lead to hypoglycemia or hyperglycemia.

These groups also suggested:

• Converting SSI regimens to safer treatment options
• Reevaluating all SSI orders within a week of beginning them
• Using a patient-centered approach to providing diabetes care in nursing homes

Consequences of Improper Diabetes Care in Nursing Homes

It is critical for nursing home patients with diabetes to keep their blood glucose levels within healthy ranges. If blood sugars become too high or too low, the consequences can be severe.

Complications of poor diabetic care include:

• Alzheimer’s disease
  Type 2 diabetes may increase the risk of Alzheimer’s disease and dementia.
• 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 lead to care complications.
• 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 amputations.
• Kidney damage
  Diabetes can damage blood vessels that filter waste from the blood in the kidneys. Severe damage may cause kidney failure.
• Nerve damage
  Excess sugar (hyperglycemia) can damage tiny blood vessels that nourish nerves, especially in the legs. Not enough sugar (hypoglycemic damage) causes tingling, numbness, or burning pain that 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.

Nursing home residents with diabetes can also face a wide range of related complications beyond those listed above.

“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

Complications from diabetes often develop gradually. The elderly population is especially vulnerable as complications are more likely the longer someone has had diabetes.

That said, nursing home staff are trained to avoid these complications. Get a free case review if you or a loved one was harmed in a nursing home. You may qualify for financial aid.

Diabetic Care and Nursing Home Neglect

Because nursing homes have a duty to keep residents safe, improper diabetes care in nursing homes may be considered neglect. The prevalence of diabetes has increased, making a well-trained staff necessary to avoid serious harm.

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.

While it can never undo the harm done, 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 and skilled nursing facilities have a duty to keep residents safe. Thankfully, financial support may be available for those harmed by poor diabetes care in nursing homes.

Filing a nursing home abuse legal claim can help you get compensation to care for your loved one. Compensation can cover medical bills, funeral expenses, and any other related costs.

Holding a nursing home legally accountable also may prevent other vulnerable residents from being harmed.

Our skilled patient advocates can help you access compensation today. Get a free case review today to start the process and get justice for nursing home abuse.