Nursing homes have an obligation to provide care for their patients, including those with diabetes. The American Diabetes Association (ADA) recognizes the high prevalence of need for diabetes care in nursing homes in their position statement, highlighting the unique challenge and importance of properly trained caregivers.
Diabetes Management Challenges
Many patients in long term care are living with comorbidities that require diabetes care in nursing homes. Proper diabetes management can be complicated by factors such as:
- Erratic intake of fluid and foods, which can affect blood sugar levels
- Staff not trained in diabetes care
- High staff turnover
- Absence of diabetes care protocols
- Excessive use of sliding scale insulin (SSI) to the exclusion or minimization of other treatments
Treatment Goals Best Practices
Properly training staff, continuing to update treatment plans as new information becomes available, and communicating regularly are all ways to make sure patients are receiving safe and effective diabetes care in nursing homes.
Proper treatment will include:
- Correct diagnosis of diabetes and comorbidities with contraindications accounted for
- Where practical, encouraging patient self monitoring and care, including physical activity
- Proper nutrition with a focus on carbohydrate intake
- Medication management
Taking time to put a diabetes care plan in place for residents can improve patient and staff experience while protecting a care facility from a potential lawsuit due to negligence.
