Managing T1D for my elderly mother

[NB24]

Drs have told me that my elderly mother is no longer capable (mentally) of managing her T1D. I have a district nurse coming in twice a day to give her her insulin twice a day, but I also need some form of rapid response service in case she needs an insulin shot or sugar, as I live too far away and I travel a lot with work. Is this something that exists either through public services or a paid-for private organisation? It's needed in the Beverley area in East Yorkshire. Thank you

 

[grantg]

There is likes of a panic button that can be worn around neck I wonder if the dr would think she would have capacity to use should she require assistance. Is it the calculation side for dosage or a little more than that? If its just for meal prep you could look into homehelp for more frequent visits. Private Qualified Nursing care at home is very expensive. You'd need to check with anyone possibly hire that they are fully qualified and indeed insured to help admin insulin inclusive of able adjust dosages as required.

As you've said shes t1d, presume she is using a CGM device if so you could set it up to share data with yourself to receive alerts for highs/lows that could give ability for you to call for assistance should it be required if not already doing so. Would be worth asking district nurses if they have a list of numbers/companies that you could call? District nurses in my area gave a couple of companies which offered a tuck in service company for my late mother, my mum disliked that. My Gran also really disliked as sometimes they would run very late.

 

[Jaylee]

Drs have told me that my elderly mother is no longer capable (mentally) of managing her T1D. I have a district nurse coming in twice a day to give her her insulin twice a day, but I also need some form of rapid response service in case she needs an insulin shot or sugar, as I live too far away and I travel a lot with work. Is this something that exists either through public services or a paid-for private organisation? It's needed in the Beverley area in East Yorkshire. Thank you

Hi,

The twice a day insulin regime. Is this a fixed mixed insulin dosage?
How is your mum currently managing routine meal times that can be associated with this kind of insulin regime?

 

[Pipp]

Drs have told me that my elderly mother is no longer capable (mentally) of managing her T1D. I have a district nurse coming in twice a day to give her her insulin twice a day, but I also need some form of rapid response service in case she needs an insulin shot or sugar, as I live too far away and I travel a lot with work. Is this something that exists either through public services or a paid-for private organisation? It's needed in the Beverley area in East Yorkshire. Thank you

Hello @NB24. So sorry you have this concern for your mother’s wellbeing.
Care for relatives when they no longer have capacity to care for themselves can get very complicated. Less so if they have Registered Power of Attorney in place for health and financial decisions. I hope your mother has this, but if not as a next of kin / relative, you have right to access care on her behalf.

In a similar situation, I would contact your mother’s Local Council, Adult Services and ask for a Needs Assessment. From what you have told us, it seems she is in urgent need of care, more than has already been offered. If she lacks capacity, and is on her own, she would not be able to seek assistance for hypos, and could become very ill, very quickly. It can be difficult to get the right care in one’s own home, and perhaps her doctor could support you in finding the help from the Local Authority that is mandatory in circumstances like this. I would be very assertive in dealings with the Local Authority and Health Services to ensure her needs are met.

 

[NB24]

Hi,

The twice a day insulin regime. Is this a fixed mixed insulin dosage?
How is your mum currently managing routine meal times that can be associated with this kind of insulin regime?

Yes, the twice a day is fixed and has stabalised her. She's still in hospital at the moment, so it's about putting a plan in place for when she's discharged. District nurses will give her her main shots, I just ned a plan in the event she needs an insulin top up or if her sugars go very low. I'll have life lines in place etc...but I was wondering if there was a service where her sugar levels are monitored and someone can get to her quickly in the event that she needs something...beyond just having 24hr care...?

 

[NB24]

Hello @NB24. So sorry you have this concern for your mother’s wellbeing.
Care for relatives when they no longer have capacity to care for themselves can get very complicated. Less so if they have Registered Power of Attorney in place for health and financial decisions. I hope your mother has this, but if not as a next of kin / relative, you have right to access care on her behalf.

In a similar situation, I would contact your mother’s Local Council, Adult Services and ask for a Needs Assessment. From what you have told us, it seems she is in urgent need of care, more than has already been offered. If she lacks capacity, and is on her own, she would not be able to seek assistance for hypos, and could become very ill, very quickly. It can be difficult to get the right care in one’s own home, and perhaps her doctor could support you in finding the help from the Local Authority that is mandatory in circumstances like this. I would be very assertive in dealings with the Local Authority and Health Services to ensure her needs are met.

Thanks very much indeed - really helpful. I'll make those enquiries.

 

[grantg]

but I was wondering if there was a service where her sugar levels are monitored and someone can get to her quickly in the event that she needs something...beyond just having 24hr care...?

as per my original reply if she is using cgm then you could use following, be aware both highs lows and if shes feeling other than the cgm showing should be doing fingerprick glucose check. another thing to bear in mind is that they can be a little off sometimes. dexcome g6/g7 has ability to calibrate to fingerprick built in. if calibrating would require to do when graph is flat. There can be some decrepancy between readings from fingerprick / interestrial fluid relationship and runs around 10-15 mins behind. for me libre usually reads a little lower than it actually is pretty consistantly. exception first 24 hours more variable, i've found inserting sensor night prior makes it a little closer. Compression lows is another thing to be aware. Very occassionly both sensors can read a little bit further out. Libre extremely occassionly has switched itself off for me before the 15 days are up. with libre i know sometimes require to reboot your phone if readings aren't auto read, you can set an alarm for that as well.

see the follow 2 links for more details on sharing of data.

https://www.freestyle.abbott/uk-en/products/connected-care/librelinkup.html

Follow App for Friends & Family | Dexcom

By downloading the Dexcom Follow app for diabetes management, up to 10 followers can view your glucose data directly from their smart device.

www.dexcom.com

hope you find the above useful. would be worth requesting cgm if she doesnt have already best of luck when discharged

edit added following:
there is possibly an alternative to 24/7 nursing care. My gran lived in a sheltered housing complex where a warden stayed on site for a number of years if she required help she could pull cord in bathroom, livingroom & bedroom which would alert of issue. some sheltered that gave her a little bit more independant living until didnt have the capacity to call for help (she did not have diabetes), we then had to take the hard decision to place her into a nursing care home during covid after she unfortuantly had another stroke. That was the best thing for her health.

 

[Jaylee]

Yes, the twice a day is fixed and has stabalised her. She's still in hospital at the moment, so it's about putting a plan in place for when she's discharged. District nurses will give her her main shots, I just ned a plan in the event she needs an insulin top up or if her sugars go very low. I'll have life lines in place etc...but I was wondering if there was a service where her sugar levels are monitored and someone can get to her quickly in the event that she needs something...beyond just having 24hr care...?

Hi,

It is possible if your mum wears a CGM. For a family member to be a “follower.”
I’ve tried it with Libre linkup cross platform from my Android phone to my iPad?
You get all the alerts.
Phoning & checking up on your mum in the event of any issues…