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Managing T1D for my elderly mother

N

NB24

Newbie
Messages
3
Type of diabetes
Type 1
Treatment type
Insulin
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
 
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.
 
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?
 
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.
 
Jaylee said:
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?
Click to expand...
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...?
 
Thanks very much indeed - really helpful. I'll make those enquiries.
 
NB24 said:
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...?
Click to expand...
*MODERATOR EDITED Edited by mods to delete information that had been part of the post. The post had also been previously edited by the poster.


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**POSTER’S OWN EDIT PRIOR TO MOD INTERVENTION.


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.
 
Last edited by a moderator:
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…
 
NB24 said:
Thanks very much indeed - really helpful. I'll make those enquiries.
Click to expand...
As your mother is still in hospital, I suggest asking to see the therapies team before she is discharged. The team should have occupational therapists, in addition to physiotherapists. The OTs make sure that when a patient is medically discharged, they have all they need to manage in their home environment, or follow on care. They should have knowledge of any equipment, and or adaptations available, and liaise with medical and social care teams as well as the patient and any carer and family, to arrange the best sort of support.

Having been through similar situations with elderly relatives, I do understand how stressful this must be for you, too, @NB24 . Make sure you get some support for yourself, and if you feel you are not getting what is needed for your mother contact the hospital PALS team. You should find their info on the hospital website.
 
You can do it with dexcom as well.

I wouldn't personally be too concerned with highs, as they take time to result in serious illness, and she'll have people coming in twice a day. If she isn't cmpetent to do her own insulin I suspect that you'll have to accept that her control won't be as good as it was in her younger days.

Lows are more tricky, as they can come on quickly and without treatment can result in coma or completely irrational behaviour (I was found wandering the street in bare feet when pregnant and hypo thirty years ago, though I have no memory of this).

Luckily modern cgms mean that someone close to her could be alerted when she goes low, and I suspect her medical team will also work for her to have a regime that minimises such lows.
 
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