Diabetes in Nursing Homes - should it be respected??
- Thread starter TheSparkyPony
- Start Date
Hi Sparkypony
Interesting but also shocking..but also not surprising. Do they test the old lady often? What equates to a cure in their book? do they shove a mirror under her nose every now and then and if it steams up a bit..then in their book she's cured, disgusting. Can this lady verbalise how she is feeling? I feel so sorry for her.
I was in a well know hospital,oop North with Cellulitis for two weeks in my teens. due to lack of beds they had to put me on a Geriatric ward...I think it was at this point I appreciated my Type 1 and found comfort in the knowledge that it is supposed to knock a good ten years off your life, because some of the things I witnessed on that ward were heartbreaking.
Before I ever get anywhere near to the situation they were in I will be as happy as anything for one great big nighttime Hypo to get me out of it quick..life is sweet ,but not when you are in that situation.
There was one old dear opposite me who could not speak due to frailty ,she could not feed or get a drink for her self and I would watch as she would try helplessly attract the nurses attention, just to get fobbed off and an eye roll. They were treated with disdain is the only I can describe it,it was very sad.
Let alone the 92 year old lady who came in black and blue and screamed all night, she had been raped and beaten. The nurses even seemed to lose some patience with this lady during that night,she died the next day the nurse told me...like she was saying well do you fancy a cuppa :shock:
I was on strict bed rest, but used to drag my drip around on the sly to get them a drink, or just give their hair a comb...I used to get into awful trouble.
The crux of the matter is not the longevity of our / their lives, it is the QUALITY, and to treat someone with a bit of love ,respect and understanding should be strived for...but to treat someone so they are as pain free and as comfortable as possible should be mandatory.
This lady who is a Type 1 Diabetic and produces no insulin ,being given just tablets must feel terrible whether she knows it or not,or can actually vocalise it...it's a crime, and should be treated as one...slow murder.
Lesson to us all, love and look after your kids and hopefully they will do the same for you...having said that looking at my two, I think I would stand more chance in a nursing home run by ex NETTO staff.
I hope this lady does get some help, and other like her...good job for going public Sparky.
Interesting but also shocking..but also not surprising. Do they test the old lady often? What equates to a cure in their book? do they shove a mirror under her nose every now and then and if it steams up a bit..then in their book she's cured, disgusting. Can this lady verbalise how she is feeling? I feel so sorry for her.
I was in a well know hospital,oop North with Cellulitis for two weeks in my teens. due to lack of beds they had to put me on a Geriatric ward...I think it was at this point I appreciated my Type 1 and found comfort in the knowledge that it is supposed to knock a good ten years off your life, because some of the things I witnessed on that ward were heartbreaking.
Before I ever get anywhere near to the situation they were in I will be as happy as anything for one great big nighttime Hypo to get me out of it quick..life is sweet ,but not when you are in that situation.
There was one old dear opposite me who could not speak due to frailty ,she could not feed or get a drink for her self and I would watch as she would try helplessly attract the nurses attention, just to get fobbed off and an eye roll. They were treated with disdain is the only I can describe it,it was very sad.
Let alone the 92 year old lady who came in black and blue and screamed all night, she had been raped and beaten. The nurses even seemed to lose some patience with this lady during that night,she died the next day the nurse told me...like she was saying well do you fancy a cuppa :shock:
I was on strict bed rest, but used to drag my drip around on the sly to get them a drink, or just give their hair a comb...I used to get into awful trouble.
The crux of the matter is not the longevity of our / their lives, it is the QUALITY, and to treat someone with a bit of love ,respect and understanding should be strived for...but to treat someone so they are as pain free and as comfortable as possible should be mandatory.
This lady who is a Type 1 Diabetic and produces no insulin ,being given just tablets must feel terrible whether she knows it or not,or can actually vocalise it...it's a crime, and should be treated as one...slow murder.
Lesson to us all, love and look after your kids and hopefully they will do the same for you...having said that looking at my two, I think I would stand more chance in a nursing home run by ex NETTO staff.
I hope this lady does get some help, and other like her...good job for going public Sparky.
cally
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I am a nurse, and quite regularly come across elderly type 1 patients who have been put on 1 injection of lantus a day and no fast acting insulin with meals. The result is blood sugar levels that run about 15 mmols most of the time. Fast acting insulin is only given if blood sugar goes above about 25 mmols with the aim of bringing it back down to about 15 mmols.
It is a difficult one because I work with the elderly and most of the patients are in hospital because they have had a fall. A lot of them do have dementia but not all.
The main aim with elderly diabetics type 1 or 2 seems to be to stop them going hypo so that they don't fall again resulting in another stay in hospital.
As a type 1 diabetic myself I do find this quite worrying but am not sure what the answer is?
I find the worst culprits in giving hospitalised diabetics the wrong food are the friends and relatives who often bring in totally inapropriate food which we are not allowed to stop them from eating!
It is a difficult one because I work with the elderly and most of the patients are in hospital because they have had a fall. A lot of them do have dementia but not all.
The main aim with elderly diabetics type 1 or 2 seems to be to stop them going hypo so that they don't fall again resulting in another stay in hospital.
As a type 1 diabetic myself I do find this quite worrying but am not sure what the answer is?
I find the worst culprits in giving hospitalised diabetics the wrong food are the friends and relatives who often bring in totally inapropriate food which we are not allowed to stop them from eating!
borofergie
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cally said:
It would be difficult to enforce a diabetic friendly diet though wouldn't it? The NHS mantra is that diabetics need to eat complex carbs with every meal. You could hardly blame nursing home nurses from following the same line.
ladybird64
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I have got strong feelings on this issue having a daughter with type 2 in a residential hospital and at present my 90 yr old mum, also type 2 is in a NHS hospital.
As we are talking primarily about the elderly here, this is my view to the opening poster.
Regardless of age, care should be centred towards what is needed to treat medically and psychologically/psychiatrically and not be defined by age. These people have paid into our Health system for their entire lives and often have to pay every penny they have ever accumulated to get appropriate "care". That care should include their diabetic needs being properly met and not sidelined because some bunch of know-alls decide it's what is in their best interests. To not treat a type 1 with appropriate insulin is tantamount to ill treatment in my view and I would certainly advise that someone contacts the CQC (care and quality commision). Contrary to popular belief, they do carry out unannounced visits to check on residential homes etc and Social Services should be informed.
I have had a lot of experience of hospitals and I know geriatric care is not easy. However, since my mum (normally extremely lucid and cheerful) has been on the geriatric ward, I have been disgusted by the generalised attitude of nursing staff (not the doctors) towards their elderly charges. Quite frankly, if you have no time for elderly people and their associated problems (type 2, dementia, urinary infections) then you should not be working there.
My mum has had delirium, an acute psychotic state caused by physical factors. She has been terrified and hallucinating, has been extremely dehydrated and unable to eat because she couldn't rationalise. She has kidney trouble due to the dehydration and diabetes but was left without any encouragement to drink, she also didn't eat for four days. If it wasn't for the visitors who were coming to see wives, mothers etc these patients probably would have been left to get on with it. Visitors (some that I saw were very elderly and disabled themselves) sitting with their loved ones trying to get them to eat or drink and if they brought in foods that weren't suitable, well, at least they were doing their best. I also know the time limitations of staff but other wards managed to cope and with kindness too.
Considering that staff must have the seen the (uneaten) sandwiches sitting on my mums trolley when they came to give her meds, they most certainly were not worried about diabetes. And considering that all the "tea ladies" were dishing out biscuits with the cups of tea and nothing was said, well...
Sorry but the line from Scrooge came to mind "decrease the surplus population".
Elderly have as much right to proper diabetes care as anyone else. No insulin for type 1 is disgraceful just as allowing a type 2 to run very high levels which will make them feel ill is also disgraceful.
The only way for these types of attitudes to be changed is for those involved in care to act. Some people can't look out for themselves (dementia patients, severe learning disabilities just to name two) and they need people to be on their side, to have enough empathy so that they get the care that is their right.
Simples.
PS. And sorry for the long post-it's a subject very close to my heart.
As we are talking primarily about the elderly here, this is my view to the opening poster.
Regardless of age, care should be centred towards what is needed to treat medically and psychologically/psychiatrically and not be defined by age. These people have paid into our Health system for their entire lives and often have to pay every penny they have ever accumulated to get appropriate "care". That care should include their diabetic needs being properly met and not sidelined because some bunch of know-alls decide it's what is in their best interests. To not treat a type 1 with appropriate insulin is tantamount to ill treatment in my view and I would certainly advise that someone contacts the CQC (care and quality commision). Contrary to popular belief, they do carry out unannounced visits to check on residential homes etc and Social Services should be informed.
I have had a lot of experience of hospitals and I know geriatric care is not easy. However, since my mum (normally extremely lucid and cheerful) has been on the geriatric ward, I have been disgusted by the generalised attitude of nursing staff (not the doctors) towards their elderly charges. Quite frankly, if you have no time for elderly people and their associated problems (type 2, dementia, urinary infections) then you should not be working there.
My mum has had delirium, an acute psychotic state caused by physical factors. She has been terrified and hallucinating, has been extremely dehydrated and unable to eat because she couldn't rationalise. She has kidney trouble due to the dehydration and diabetes but was left without any encouragement to drink, she also didn't eat for four days. If it wasn't for the visitors who were coming to see wives, mothers etc these patients probably would have been left to get on with it. Visitors (some that I saw were very elderly and disabled themselves) sitting with their loved ones trying to get them to eat or drink and if they brought in foods that weren't suitable, well, at least they were doing their best. I also know the time limitations of staff but other wards managed to cope and with kindness too.
Considering that staff must have the seen the (uneaten) sandwiches sitting on my mums trolley when they came to give her meds, they most certainly were not worried about diabetes. And considering that all the "tea ladies" were dishing out biscuits with the cups of tea and nothing was said, well...
Sorry but the line from Scrooge came to mind "decrease the surplus population".
Elderly have as much right to proper diabetes care as anyone else. No insulin for type 1 is disgraceful just as allowing a type 2 to run very high levels which will make them feel ill is also disgraceful.
The only way for these types of attitudes to be changed is for those involved in care to act. Some people can't look out for themselves (dementia patients, severe learning disabilities just to name two) and they need people to be on their side, to have enough empathy so that they get the care that is their right.
Simples.
PS. And sorry for the long post-it's a subject very close to my heart.
It was a very good post 'ladybird' because you were talking from experience.
When it comes down to the GP's in the home where my daughter works, firstly, the management are reluctant to call them out, and she said that routine visits hardly exist there. Also, there is a residential nurse, by residential I mean full time, and my D said it's like the nurse is banging her head against a brick wall, trying to get the diabetic residents looked after properly.
I said well surely she has authority? My D sarcastically laughed and said you wouldn't believe how much power the owners of these homes have. What they say goes.
I then said well why don't the seniour staff get the Social Services involved? She said they've tried but they don't 'want' to get involved!
She also said about family bringing in chocolates, and cakes, etc., and she said she couldn't understand why they, of all people would do this.
Once, she was tending to a diabetic woman with dimentia. Her family came, and her daughter handed her mother a Mars Bar. My D reminded her of her mum's diabetes and suggested it would take her sugar too high.
The daughter just smiled and said 'Oh it's ok, the manager knows and it makes her happy having a treat.'
My D walked away totally disheartened. She told me that the staff are not allowed to take these 'treats' away from them.
Helena
When it comes down to the GP's in the home where my daughter works, firstly, the management are reluctant to call them out, and she said that routine visits hardly exist there. Also, there is a residential nurse, by residential I mean full time, and my D said it's like the nurse is banging her head against a brick wall, trying to get the diabetic residents looked after properly.
I said well surely she has authority? My D sarcastically laughed and said you wouldn't believe how much power the owners of these homes have. What they say goes.
I then said well why don't the seniour staff get the Social Services involved? She said they've tried but they don't 'want' to get involved!
She also said about family bringing in chocolates, and cakes, etc., and she said she couldn't understand why they, of all people would do this.
Once, she was tending to a diabetic woman with dimentia. Her family came, and her daughter handed her mother a Mars Bar. My D reminded her of her mum's diabetes and suggested it would take her sugar too high.
The daughter just smiled and said 'Oh it's ok, the manager knows and it makes her happy having a treat.'
My D walked away totally disheartened. She told me that the staff are not allowed to take these 'treats' away from them.
Helena
Diabetes Uk have been running a campaign to improve the care of diabetics in Nursing Homes.
Something important and useful for a change! I wish them every success.
The last few posts struck many a chord with me but on the whole, it is difficult to explain the situation regarding residential care to those with no experience of it.
The scale of the problem is overwhelming and hospitals aren't much better. Well meaning staff members are powerless if the culture of the ward or establishment is entrenched in negligence or callousness.
I wonder why people think that the Social Services are all-powerful in these cases. More ofen than not their hands are tied.tThe privatisation of many residential institutions made them into profit making concerns and "they" were not too fussy about those who replaced them.
The Social Services could only visit after giving several weeks notice at one time although I think this has now changed.
The frightening thing I find is that many HCAs now employed in hospitals have gained their experience in this sort of culture.
A nurse in the hospital I attend told me how her colleagues tried to dissuade her from helping a very elderly man in A& E to eat . He had been there for many hours and needed assistance to eat. The others thought she shouldn't bother and that he would "manage"
I don't think anyone needs to fear being force-fed carbs or anything else in a hospital or nursing home
They should fear starving if they are too ill to feed themselves.
Type 2 diabees is not considered important in many places . Its only tablets. a few pieces of cake won't kill them , fruit juice is OK -well dilute it if it bothers you. T1s generally do beter as a trained nurse will normally deal with these patients but obviously , reading above , that is not always the case.
Those wih dementia are paricularly vunerable because even if they have caring relatives constantly visiting they forget what has happened to them. A friend of mine thought her mother was being well looked after as the Matron of the home she was in was a personal friend. Her mother had Alzheimers.
She was visited by the police ,much to her surprise , as a whistle blower had witnesssed her mother being abused on several occasions. The abuser got three years.
There was another horrific case last year {or the previous year} about an old lady visited daily by her three daughters, Her daughters thought she was damaging her own fingernails. One of tthe staff was pulling them out!
Horror stories yes, but not isolated by any means.
if such things can happen undetected how can anyone be confident that any chronic condition such as diabetes will be treated properly?
Something important and useful for a change! I wish them every success.
The last few posts struck many a chord with me but on the whole, it is difficult to explain the situation regarding residential care to those with no experience of it.
The scale of the problem is overwhelming and hospitals aren't much better. Well meaning staff members are powerless if the culture of the ward or establishment is entrenched in negligence or callousness.
I wonder why people think that the Social Services are all-powerful in these cases. More ofen than not their hands are tied.tThe privatisation of many residential institutions made them into profit making concerns and "they" were not too fussy about those who replaced them.
The Social Services could only visit after giving several weeks notice at one time although I think this has now changed.
The frightening thing I find is that many HCAs now employed in hospitals have gained their experience in this sort of culture.
A nurse in the hospital I attend told me how her colleagues tried to dissuade her from helping a very elderly man in A& E to eat . He had been there for many hours and needed assistance to eat. The others thought she shouldn't bother and that he would "manage"
I don't think anyone needs to fear being force-fed carbs or anything else in a hospital or nursing home
They should fear starving if they are too ill to feed themselves.
Type 2 diabees is not considered important in many places . Its only tablets. a few pieces of cake won't kill them , fruit juice is OK -well dilute it if it bothers you. T1s generally do beter as a trained nurse will normally deal with these patients but obviously , reading above , that is not always the case.
Those wih dementia are paricularly vunerable because even if they have caring relatives constantly visiting they forget what has happened to them. A friend of mine thought her mother was being well looked after as the Matron of the home she was in was a personal friend. Her mother had Alzheimers.
She was visited by the police ,much to her surprise , as a whistle blower had witnesssed her mother being abused on several occasions. The abuser got three years.
There was another horrific case last year {or the previous year} about an old lady visited daily by her three daughters, Her daughters thought she was damaging her own fingernails. One of tthe staff was pulling them out!
Horror stories yes, but not isolated by any means.
if such things can happen undetected how can anyone be confident that any chronic condition such as diabetes will be treated properly?
IanD
Well-Known Member
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- Type of diabetes
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When her mother was in hospital (transferred from care home) food was just put in front of them - & removed. She was blind & couldn't feed herself. One man did get himself a drink - he took the flowers out of a vase .....
When Mum got back to the home, the very caring staff worked hard to feed her & encourage to eat. That was near the infamous Midsomer where Barnaby has to deal with frequent murders, so perhaps the district isn't that bad after all....
TheSparkyPony said:
There are some guidelines that DUK commissioned for residents. It needs a copy in every Nursing Home.
http://www.diabetes.org.uk/Documents/Ab ... s-0110.pdf
It is not much better in the NHS either. I have worked on geriatric wards and you have to be a strong character and put your foot down for the proper care for diabetics. Look at the NHS menus for special dietary requirements, they are a farce.
Nice to see you postinng caherinecherub - often the voice of reason! I can well believe you about the NHS geriatric wards.
I suppose it is another facet of our relaionship with food . any restriction of diet is seen as a deprivation not as a necessary therapy. It also says much about our attitude to the elderly.
A recent experience undergoing a day procedure in the hospital - where a very well meaning nurse -describing herself as a "diabetic link nurse" would not accept my explanation that the toasted white bread given to me after the procedure accounted for the spike in my bg but insisted I must have smuggledin a chocolate bar or the like says it all.
She could not accept that a chocolate bar would not have had such an immediate effect.
Why can't they accept that they may be feeding POISON to their patients . One would think it was elementary.
I suppose it is another facet of our relaionship with food . any restriction of diet is seen as a deprivation not as a necessary therapy. It also says much about our attitude to the elderly.
A recent experience undergoing a day procedure in the hospital - where a very well meaning nurse -describing herself as a "diabetic link nurse" would not accept my explanation that the toasted white bread given to me after the procedure accounted for the spike in my bg but insisted I must have smuggledin a chocolate bar or the like says it all.
She could not accept that a chocolate bar would not have had such an immediate effect.
Why can't they accept that they may be feeding POISON to their patients . One would think it was elementary.
Hi all, excuse me for coming in on an already established thread but, after all these years of being an interested bystander on this forum, I felt the need to answer a post!
To answer Sparkypony, I don’t know if you can access this person’s care plan but are you certain that she is,in fact, a Type 1? Given the amazing amount of ignorance in some HCP’s who are not really acquainted with diabetes, a lot of them assume that someone on insulin is automatically a Type 1. She may well be a Type 2 on insulin who is now, because of age and maybe loss of body weight only requiring tablet control. You do not say which tablets she is on but if they are diabetic medication then I do have great difficulty believing that a doctor would prescribe them for a Type1!
If you are allowed to access her care plan, especially if you tell them it is for a case study, then check to see what sort of diet they advocate for her. The basic NHS type diet is not a good diet for any diabetics as most on this forum will testify to.
Staff in most nursing homes are up against a lot of different factors. Lack of staff and general apathy and empathy for the elderly are common.
Diabetes should be catered for through special diets but too often the information is wrong and they do not bother to find out anything new.
They are also up against the patients themselves unfortunately! Many patients with dementia will not eat everything that is put in front of them, especially something new They tend to like the sort of things they ate when they were younger, probably pre diabetic times.So staff are often forced to give them what they know they will eat to keep them well nourished rather than what they should eat for their treatment of their diabetes. That being said, they should always try! There are plenty of yogurts for instance that are lower than 13.8 carbs. I would suspect these are what is supplied from their supplier and they can’t be bothered to find other, lower ones.
Can you talk to the cook in the nursing home? Some are holy terrors BTW, ruling the roost and dictating the meals their way. It would be interesting to find out what her or his take of diabetes is. Maybe you could even throw in some suggestions seeing as you are a diabetic yourself.
To answer Sparkypony, I don’t know if you can access this person’s care plan but are you certain that she is,in fact, a Type 1? Given the amazing amount of ignorance in some HCP’s who are not really acquainted with diabetes, a lot of them assume that someone on insulin is automatically a Type 1. She may well be a Type 2 on insulin who is now, because of age and maybe loss of body weight only requiring tablet control. You do not say which tablets she is on but if they are diabetic medication then I do have great difficulty believing that a doctor would prescribe them for a Type1!
If you are allowed to access her care plan, especially if you tell them it is for a case study, then check to see what sort of diet they advocate for her. The basic NHS type diet is not a good diet for any diabetics as most on this forum will testify to.
Staff in most nursing homes are up against a lot of different factors. Lack of staff and general apathy and empathy for the elderly are common.
Diabetes should be catered for through special diets but too often the information is wrong and they do not bother to find out anything new.
They are also up against the patients themselves unfortunately! Many patients with dementia will not eat everything that is put in front of them, especially something new They tend to like the sort of things they ate when they were younger, probably pre diabetic times.So staff are often forced to give them what they know they will eat to keep them well nourished rather than what they should eat for their treatment of their diabetes. That being said, they should always try! There are plenty of yogurts for instance that are lower than 13.8 carbs. I would suspect these are what is supplied from their supplier and they can’t be bothered to find other, lower ones.
Can you talk to the cook in the nursing home? Some are holy terrors BTW, ruling the roost and dictating the meals their way. It would be interesting to find out what her or his take of diabetes is. Maybe you could even throw in some suggestions seeing as you are a diabetic yourself.
I have just glanced at a local[ish} newspaper and the first thing I read was " Diabetic residents were not being fed the special diets critical to thir conditions".
Another report about a ailing Nursing Home. The bad news is that it appears o be widespread , the good that there seems o be more awareness of the issue.
This was a home for dementia sufferers.
Another report about a ailing Nursing Home. The bad news is that it appears o be widespread , the good that there seems o be more awareness of the issue.
This was a home for dementia sufferers.
