Advice Required Please

[corbybear]

Hi

My father is an insulin dependant diabetic. He was moved to a nursing home about 11 weeks ago. We are extremely worried about his condition as it seems our concerns are not be listened too.
Last night after receiving a call from sister, I went to the home to see him, although I knew he would be sleeping.
3 days ago his readings were 38 & then off the scale where the equipment measuring just said HIGH!
He is also prescribed mertformin. Due to having vascular dementia with parkinsons now, he can longer swallow tablets so the metformin prescribed is a liquid form. The nursing home have this but after repeatedly telling the pharmacist who we cannot understand as not good at English, he keeps giving our dad tablet form which he will just spit out as he really cannot swallow most tablets these days.
His blood sugars have been a cause for concern for a long time. I won't go into detail as I could be here all day on this.

Last night when I seen him, he looks like we are losing him compared to last week where he could smile etc. He looks severely dehydrated to me. Can barely open his eyes, face has sunk in, voice so weak can barely hear him. Rapid weight loss. We honestly think he should be taken to hospital as he is not being cared for. I will re visit the home this morning to push this further.
I really am not informed enough about the effects of high or low readings and would really appreciate any help I can get please. Is having a reading as high as 38 dangerous? A normal high reading would be around 18
Thanks you for listening. I really do appreciate it.

 

[librarising]

With blood sugar levels that high,and yes they're too high, I would expect your father to be passing urine often. Without then drinking often, he will become dehydrated. I would expect him to be losing weight (as you report), sleeping badly, and tired all of the time. I have had my blood sugars hovering around the 30s (before going onto insulin) and had this without dehydration because I was drinking all of the time.
It sounds as if an in-house visit from the GP will help. I would push for that.
Geoff

 

[corbybear]

With blood sugar levels that high,and yes they're too high, I would expect your father to be passing urine often. Without then drinking often, he will become dehydrated. I would expect him to be losing weight (as you report), sleeping badly, and tired all of the time. I have had my blood sugars hovering around the 30s (before going onto insulin) and had this without dehydration because I was drinking all of the time.
It sounds as if an in-house visit from the GP will help. I would push for that.
Geoff

Thank you Geoff for your swift response. Passing excess urine is unfortunately another obstacle. Our dad is double incontinent & wears pads. Very prone to urinary tract infections as it's very difficult to obtain a sample to test. As you can probably gather he does have several conditions. He is 85. Our concern over the blood sugars are that its really hard for anyone to take notice. We must have been told at least a doze times he needs to see the diabetic nurse for a review. That review must have taken 8 months and that was also between 6 hospital admissions. Still waiting for the Parkinsons nurse for a review, that's now been over a year. Lately his sugars have dropped low. As mentioned earlier, they have through the night in particular went up & down but never to 38 & above. To re hydrate he gets water. I cannot believe that 2 or 3 tiny sips is doing anything really.

 

[Jaylee]

Hi @corbybear ,

Welcome to the forum..

What insulin regime is your father on?
Hi sugars like that would trigger urinary infections along with stuff like "thrush."
You are right focusing the primary concern on the blood sugars.
My T2 dad had vascular dementia. & didn't take enough fluid either.. I used to take the cup off him when he said he didn't want any more, then promptly return with it saying here's your drink dad. Until he'd finished it?

Tagging in @daisy1 with a help sheet..

 

[Snapsy]

@corbybear I'm so sorry to hear this. I would say that the very least he requires is an urgent visit from a clued-up (on diabetes) GP who would also be able to brief at least two nominated carers with information on how they can look after his diabetes properly. I appreciate that he is 85 and with other health issues, but it sounds as if he's really not very well at all specifically with the diabetes, with the associated dehydration and infections (which could be minimised/avoidable with better control) and things could improve for him and he would feel very very much better if the home is better equipped and educated to deal with this.

Is he robust enough for a hospital admission so that they can take a few days to stabilise his sugars?

Very very best wishes to your family.

 

[azure]

@corbybear It does sound like your dad's diabetes isn't getting the care it could. If it was me, I'd be asking for a doctor to,assess him. I'd also be making a complaint to the home. Surely they have some kind of care plan for him with advice about what to,do if he has high sugars?

Here's a helpful leaflet about treating diabetes in dementia patients:

https://www.diabetes.org.uk/Documen...urces/Diabetes_And_Dementia_Guidance_2013.pdf

38 is way too high and would certainly cause dehydration even if the person was drinking normally.

Don't be afraid of pushing and standing up for your dad. You know what's right and you've recognised he's become unwell. Don't rely on appointments to come through. I've found that often you need to push to get things done.

 

[k9badger]

Hi @corbybear if you are concerned about the level of his care and it sounds as if you are right to then speak to the care staff and point out they have a duty of care and tell them you will apply for safeguarding. You can do this through your local social services team. To be fair they are probably out of their depth but safeguarding usually focuses the mind. Good luck

 

[corbybear]

many thanks for all your replies. Although I was told last night there was no need to call the paramedics, he has now been taken to hospital by the paramedics this morning. He is really unwell.
Nobody actually contacted us to tell us. On a visit this morning my sister found an ambulance at the door thinking it must be for somebody else but they were there for our dad. At least he will be in a place where they will monitor him & care for him.. The care at the nursing home has been absolutely shocking.

 

[Lazybones]

So sorry to read all about your diabetic problems that your father is experiencing at the new care home. I would point out that they are required in law to meet certain care standards, and if necesscairy administer medications to someone who is within their care if that individual is incapable of administering their own medications, as would seem to be the case here with your diabetic father who NEEDS insulin and with Dimentia would be unable to administer it for himself.
You aren't making trouble, your just looking after your father's best interests. Have a GOOD go at the care home and find out WHO is actually responsible for his care plan and WHO is responsible for his Insulin injections.
Also inform the social services about what is happening at this care home, and if necesscary threaten or contact the Care Commission yourself to make a complaint. In your circumstances you simply cannot sit back and do nothing, your father is indirectly relying on you to help him.
I would also suggest to you that you keep a dated record of everything that has so far transpired,, what you have done, who you have spoken with and what they are going to do to improve this situation. Hopefully you won't ever need to refer back to this record, but if you need to you will have everything to hand as statements can be denied or ammended in the future.
Good Luck with this.

 

[azure]

many thanks for all your replies. Although I was told last night there was no need to call the paramedics, he has now been taken to hospital by the paramedics this morning. He is really unwell.
Nobody actually contacted us to tell us. On a visit this morning my sister found an ambulance at the door thinking it must be for somebody else but they were there for our dad. At least he will be in a place where they will monitor him & care for him.. The care at the nursing home has been absolutely shocking.

Thank you for the update @corbybear

Sending you and your dad my best wishes. He should get the care he needs now he's in hospital. X

 

[Mark_1]

Can you get him moved? It sounds like he is not getting the care he should at the one he is at and is there someone you can complain to outside of the home?

 

[Robinredbreast]

Hi

My father is an insulin dependant diabetic. He was moved to a nursing home about 11 weeks ago. We are extremely worried about his condition as it seems our concerns are not be listened too.
Last night after receiving a call from sister, I went to the home to see him, although I knew he would be sleeping.
3 days ago his readings were 38 & then off the scale where the equipment measuring just said HIGH!
He is also prescribed mertformin. Due to having vascular dementia with parkinsons now, he can longer swallow tablets so the metformin prescribed is a liquid form. The nursing home have this but after repeatedly telling the pharmacist who we cannot understand as not good at English, he keeps giving our dad tablet form which he will just spit out as he really cannot swallow most tablets these days.
His blood sugars have been a cause for concern for a long time. I won't go into detail as I could be here all day on this.

Last night when I seen him, he looks like we are losing him compared to last week where he could smile etc. He looks severely dehydrated to me. Can barely open his eyes, face has sunk in, voice so weak can barely hear him. Rapid weight loss. We honestly think he should be taken to hospital as he is not being cared for. I will re visit the home this morning to push this further.
I really am not informed enough about the effects of high or low readings and would really appreciate any help I can get please. Is having a reading as high as 38 dangerous? A normal high reading would be around 18
Thanks you for listening. I really do appreciate it.

My father is also in a care home, he is 93, but doesn't have diabetes. Please speak to the nurse in charge, if not go straight to the manager of the home. His care, medication, food intake, fluids intake, regarding his condition must be addressed asap, it is obviously such a worry for you.
Take care.

 

[Robinredbreast]

many thanks for all your replies. Although I was told last night there was no need to call the paramedics, he has now been taken to hospital by the paramedics this morning. He is really unwell.
Nobody actually contacted us to tell us. On a visit this morning my sister found an ambulance at the door thinking it must be for somebody else but they were there for our dad. At least he will be in a place where they will monitor him & care for him.. The care at the nursing home has been absolutely shocking.

That is unacceptable, when things have calmed down a bit, speak to the company that own the home, I really feel for you. Sending my very best wishes to you and your dad and hoping he will get better very soon. x