Who can administer insulin?

[Henry's Cat]

Hi all, my first post here.

TLR - if you don't administer your own insulin, who does it for you?

My elderly father has been T2ID for a good few years. He lived independently other than us driving him around after he lost his licence 3 years ago due to out of control BS. He regularly had readings which just said "high" and rarely went below 20, despite increasing insulin, guidance on diet etc. At the end of November he suddenly went totally blind in both eyes & ended up in hospital for 25 days & by the time he came out his BS were constantly 7-11 even with a lowered dose of insulin. He was hardly eating (because he couldn't feed himself) and not having his evening beer or having 'extras' etc. When he came out he needed 24 hour care to get established in his home and is back having a beer a couple of times a week, eating better and also having a few 'extras', however his BS are still well controlled and great levels. We think that with his Parkinsons (not very severe as yet) and a bit of cognitive difficulty etc, he perhaps hasn't been holding the pen in for long enough, which is PARTLY why his BS was so high for so many years. His carer isn't allowed to administer his insulin so the district nurse has been visiting twice daily. He is their only patient that has 2 doses and we are waiting (and waiting and waiting...) for the diabetic nurse to put him onto a single dose. When he came home from hospital, the nurses were very clear that they would only continue to administer the insulin until an alternative option could be found. The 24 hour care gets withdrawn next week but nobody has come up with an alternative to the nurses as yet. He definitely can't give it to himself anymore but apparently no carers are allowed to do it routinely either. I will be his main carer but I don't even know if I am allowed to do it. This can't be the first time this has come up but nobody seems to be able to give me an answer. Does anyone know - who is allowed to administer insulin on a routine basis?

 

[HSSS]

Have you discussed you being trained to administerthe insulin with his drs? This does seem the most obvious answer

 

[EllieM]

Parents give injections to their children all the time. You're in a similar situation. I agree, ask for training (or watch a video on youtube, it's not hard).

(Remembers being taught to inject in hospital age 8, I was very proud that the other kids were taught on oranges but I went straight to injecting myself.)

 

[Antje77]

I will be his main carer but I don't even know if I am allowed to do it. This can't be the first time this has come up but nobody seems to be able to give me an answer. Does anyone know - who is allowed to administer insulin on a routine basis?

I'm not completely sure about the rules in the UK, they might be slightly different from my country.

In the Netherlands, anyone injecting in a professional position needs to be licenced to do so. However, friends and family can legally inject without official training and a certificate. Often those people are parents of course, but they can also be parents of friends of a child, on a sleepover, my friends are allowed to give me my insulin when I'm driving (and do so, I hate having to pull over to inject).
Also, anyone is allowed to administer glucagon, which is often taught to co-workers or roommates in case of emergency.

I'd expect you are allowed to inject your father, but it makes sense for his carer to not be because of insurance risks.

 

[Jaylee]

Hi @Henry's Cat ,

Welcome to the forum.

Oddly, if was another young diabetic let loose with a syringe on myself after graduating from oranges in hospital..
The obvious choice would be yourself as a carer.
You could possibly organise a training session with your father's so that you are comfortable with the deed.

You didn't mention what insulin you father is prescribed? If he is doing well on 2 doses. It may not help switching to a single dose?

I can appreciate it's a massive undertaking as the roles reverse with parents. I still freak out over my mum's "stuff." & that's just a pill box.

 

[KK123]

aiting...) When he came home from hospital, the nurses were very clear that they would only continue to administer the insulin until an alternative option could be found.

Hi there, this is very similar to my Mum's circumstances when she was in her late 70s and became unable to administer her own insulin. Don't take ANY notice of what those Nurses are saying, every single person has the right in the UK to be assisted in remaining in their own homes. I'm not saying it's easy but never let them tell you that it can't be done simply because it is inconvenient to them.

They tried this with us and my Mum also had 3 injections a day and 3 visits. When they started bleating about how time consuming it was, we made an official complaint and we won! They had to keep coming in, have a read of the guidelines and it will tell you all you need to know, I will try to find a link for you when I have more time.

I would say also though, that a lot depends on how able your Dad is independently of his injections, it sounds like he can otherwise look after himself, if he were to become a 'danger' to himself (or others), eg, by having several hypos or hypers or becoming unconscious several times and so on, then they may try to use that as a reason for them to say 'We can't continue visiting like this, he needs round the clock care'. That happened to my Mum and she did eventually go into a care home but we understood why by that stage. I do think they were a little quicker than usual to declare this mind, just because it was a burden to them.

As for whether you can administer insulin, yes you can, get the Nurses to show you how as your Dad's carer. There are kids in schools with diabetes and the Teachers (after a bit of training) do the injections so there is nothing too medical about it.

 

[Henry's Cat]

Thanks everyone. I’ve ‘assumed’ I would be trained but I’m struggling to get my head around trained carers not being allowed but untrained non case workers being allowed! I’m also assuming the training is much like my dad had - wind the pen up, stick it in (different place each time) and press and hold for 10 seconds. I’ve seen what happens when someone has a massive overdose of insulin as I used to work in a mental hospital with a brain injury unit - it’s dangerous stuff!

Regarding the single dose, I’m hoping that whenever they get around to it that they’ll continue to administer for a while so they can see if it’s working okay without bringing my inexperience into the mix. Dad does take Linagliptin as well. He currently has medications 5 times a day (which is an issue because the council will only provide a carer 4 times a day - luckily we are not relying on them!) and we’re trying to establish a new meal routine that suits us as carers as well as Dad but we’re not sure how that fits with his new insulin. He currently has breakfast around 930, a main meal at 12 noon, sweet biscuits at 1.30 and a light snack at 6. His carer has been advised this isn’t ideal!! My brother and I would rather he had his main meal in the evening and this means we can manoeuvre his meds so that he’s not having to have someone visit at 8am (when he doesn’t get up till 9), and it gives capacity for a bigger break late afternoon so deuces the hours that someone has to be there just to give him a tablet. His Parkinson’s complicates things because the tablets can end up on the floor & he’s starting to get issues swallowing. It makes things very complicated!!

 

[lovinglife]

My dad became unable to administer his own insulin in the latter part of his life due to sight loss and early dementia, before he went into his care home he would get the district nurse visit twice a day to check his bloods and administer his insulin, they also checked on him for signs he wasn’t managing with other things and filled a record sheet in on each visit. I arranged this through his GP, carers are not permitted to administer drugs as they are here for personal care and cooking simple meals

 

[Henry's Cat]

The carers are allowed to administer drugs, well at least that's what we've been told & what has been happening! He has medication given to him 5 times a day (other than the insulin).

 

[lovinglife]

The carers are allowed to administer drugs, well at least that's what we've been told & what has been happening! He has medication given to him 5 times a day (other than the insulin).

That’s very surprising that carers are giving insulin (not other meds as I know nothing about that) It may be that it’s different for each health authority but where dad lived it was definitely a big no no. Even when he went into the care home it had to be a nursing home as only a nurse can administer insulin - not sure about other drugs. I apologise if I misunderstood your question I thought you were specifically asking about insulin

 

[lovinglife]

@Henry's Cat,
This is what the Care Quality Commission has to say on home carers administering medication. Hope you find it helpful

https://www.cqc.org.uk/guidance-providers/adult-social-care/managing-medicines-home-care-providers

 

[Henry's Cat]

Sorry, it is the insulin that’s the issue at the moment and we do have to have the district nurse in for those two slots in the day but they’re ‘not keen’ for it to continue (and I totally understand). The carer is giving him the rest of his meds though. That’s interesting about the care home issue & it needing to be a nursing home though as that changes things quite dramatically. Do you happen to know if that’s still the rule?

 

[lovinglife]

Sorry, it is the insulin that’s the issue at the moment and we do have to have the district nurse in for those two slots in the day but they’re ‘not keen’ for it to continue (and I totally understand). The carer is giving him the rest of his meds though. That’s interesting about the care home issue & it needing to be a nursing home though as that changes things quite dramatically. Do you happen to know if that’s still the rule?

That was in my area I’m not sure if it’s a national thing or not, I do remember though dad was in a care home temporarily for a couple of weeks until his room was ready in the place we chose for him and the district nurses would come in to do the injections. It’s worth knowing that if your dad goes into a care home in the future and he has to have stipulated nursing care and he is self funding he is entitled to an assessment to pay the part of the nursing care by the county council, it’s worth having as it’s a few hundred pounds a month depending on the level of care, only if he is totally self funding though

I hope you can get things sorted it’s so stressful and difficult having to fight for things that you are automatically entitled to

 

[lovinglife]

@Henry's Cat

Does your dad have a social worker? If not contact adult social services and ask for an assessment they have to do one. Also as a carer you are entitled to a carers assessment to make sure your needs are being met, contact your local carers association, they are a charity but they will do your assessment and also have lots of experts that can give you great advice, I know it’s a lot of “officialdom” and I appreciate than some don’t like to go down that sort of route but it can be invaluable in “setting up” a case for your dad. Like my mam used to say “the squeaky wheel gets the most oil”