Nurses using safety needles - are they working everytime??? Dementia and type 1

[lookingaftermum]

My elderly mum has early stage dementia and needs nurses to come in twice a day to inject levamere and nova rapid. We have noticed that randomly she has days when her blood sugar never goes down after her injection from the nurse and then other days its fine. The nurses have to use safety needles and after using them myself its very hard to trust that the injection punctured the skin properly and insulin was injected as you cannot see the needle!

I am worried the nurses, in a rush, keep missing the odd injection. We tested it by cancelling the nurses for a while and doing it ourselves and her blood sugar came down. We have raised this with the community team and they have said there are no issues with the needles at they are not allowed to use the needles we use. Has anyone else got experience of this? or similar concerns?

 

[lessci]

Are the injection pre-loaded individual doses? Could you ask for the used ones to be left for you to see? I know me (non insulin) weekly jab has a window so you can see that the dose has been given

 

[Jaylee]

My elderly mum has early stage dementia and needs nurses to come in twice a day to inject levamere and nova rapid. We have noticed that randomly she has days when her blood sugar never goes down after her injection from the nurse and then other days its fine. The nurses have to use safety needles and after using them myself its very hard to trust that the injection punctured the skin properly and insulin was injected as you cannot see the needle!

I am worried the nurses, in a rush, keep missing the odd injection. We tested it by cancelling the nurses for a while and doing it ourselves and her blood sugar came down. We have raised this with the community team and they have said there are no issues with the needles at they are not allowed to use the needles we use. Has anyone else got experience of this? or similar concerns?

If the needle hadn’t touched the skin.

There would or should be evidence of the insulin dose pooling on the “injection” site?

 

[Antje77]

Are the injection pre-loaded individual doses? Could you ask for the used ones to be left for you to see? I know me (non insulin) weekly jab has a window so you can see that the dose has been given

Insulin pens do have a window, but a single pen holds 300 units.
A dose can be anything from 2 to 100 units, usually on the lower end of this.
It will be very hard to see the difference through the window.

 

[Jaylee]

OK. I’m unfamiliar with these devices.

Are they like the one featured in the video below?

Do the nurses perform an “air shot” to prime the needle?

Are they following the guidelines of use with this device doing the injection?

 

[ElenaP]

We have raised this with the community team and they have said there are no issues with the needles at they are not allowed to use the needles we use

Are these trained nurses, or are they carer workers? If trained nurses, then it is appalling that they cannot use insulin needles.
As it was obvious from the earlier conversations about Care Homes / Nursing Homes, this really is scary for the future of all of us on insulin. I wish someone, who has energy, would start a campaign to take this issue up with their MP or with Age Concern.

 

[Margi1975]

If the needle hadn’t touched the skin.

There would or should be evidence of the insulin dose pooling on the “injection” site?

Do you know what food your mother is eating? Does she feed herself or do her carers prepare her food? The variations could be as simple as her eating more carbohydrates on some days than others.

The latest pen injector for Levemir has the ability to download its past doses onto an app on a phone. I don’t know if novorapid is the same brand and can do that or not, but if not there may be a pen for it that can do the same. That way you can see exactly what insulin your mother has had, and if she has a Libre sensor to monitor her blood sugar, that does it automatically without her having to remember to scan the thing. So you can check both insulin usage and blood sugar throughout the day. And ask mother what she is eating.

 

[lovinglife]

Do you know what food your mother is eating? Does she feed herself or do her carers prepare her food? The variations could be as simple as her eating more carbohydrates on some days than others.

The latest pen injector for Levemir has the ability to download its past doses onto an app on a phone. I don’t know if novorapid is the same brand and can do that or not, but if not there may be a pen for it that can do the same. That way you can see exactly what insulin your mother has had, and if she has a Libre sensor to monitor her blood sugar, that does it automatically without her having to remember to scan the thing. So you can check both insulin usage and blood sugar throughout the day. And ask mother what she is eating.

That’s a very good point by @Margi1975 re what your mum is eating. In dads latter stages when he was still feeding himself I would do all his shopping in town on the Saturday- he was using ready meals from M&S with 30g carbs all microwaved for 4 minutes (not ideal I know but dad was also blind and deaf but it gave him 2 more years of independence) and his fresh food for delivery from Tesco

I used to shop before seeing what he had left as I knew what he should have, some weeks when I went down his fridge would be empty after 2 days of all his fresh stuff - vastly overeating, some weeks would be fine. Also noticed when putting his meals in the freezer some weeks there was too many left and others there wasn’t enough.

Do the team fill in a chart on every visit? Dad had one on time of visit, BG test, how much insulin (dad was on set dose mixed) and they always filled in a few notes on general welfare & observations. Such as asking what’s for tea - have you got it ready etc

This may not be happening I also discovered well meaning visitors were buying him sweets etc - which dad would never have touched in the past and he was guzzling them down!

 

[Lainie71]

That’s a very good point by @Margi1975 re what your mum is eating. In dads latter stages when he was still feeding himself I would do all his shopping in town on the Saturday- he was using ready meals from M&S with 30g carbs all microwaved for 4 minutes (not ideal I know but dad was also blind and deaf but it gave him 2 more years of independence) and his fresh food for delivery from Tesco

I used to shop before seeing what he had left as I knew what he should have, some weeks when I went down his fridge would be empty after 2 days of all his fresh stuff - vastly overeating, some weeks would be fine. Also noticed when putting his meals in the freezer some weeks there was too many left and others there wasn’t enough.

Do the team fill in a chart on every visit? Dad had one on time of visit, BG test, how much insulin (dad was on set dose mixed) and they always filled in a few notes on general welfare & observations. Such as asking what’s for tea - have you got it ready etc

This may not be happening I also discovered well meaning visitors were buying him sweets etc - which dad would never have touched in the past and he was guzzling them down!

It would seem that you had a very good system going and good carers. My dads carers were just happy to sit with my mum and drink cups of tea and chat! Had to pull them up quite a few times when I was there. The only time things really got done, was when the District Nurses called in. Dad didn't have diabetes that I know of and his mind was very sharp, but he was on end of life care and it was quite shocking the level of care he had. My mums in a pretty unresponsive way now and is unable to look after herself, I hope she is being cared for and not just left to "sleep" all day but I expect that is the case I dont want to get old