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My diabetic mother needs help with the finger prick test. She gives herself the insulin injections (4 per day) but may need to have it done for her in the future. We would like a template for a form to give her caregivers permission to administer the finger prick test and the insulin injections.

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Giving injections isn't that difficult, that's true, but, what is a little trickier, is the amount of work, calculations, monitoring, etc. that goes along with taking insulin. I'm type I and take multiple injections. (Fast acting and slow acting.) You have to also take multiple blood sticks to check blood sugar levels, count carbs to determine the amount to take to cover them with insulin, check urine for ketones if blood sugar is high, and other duties, including taking juice and eating appropriate snack if blood sugar drops suddenly. Even now that I wear a continuous glucose monitor, there's still loads to do, so, I can see how a senior with mobility and cognitive challenges may be overwhelmed with diabetic care. Often the actual injection is only part of the diabetes management.
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I know this was a while ago but in case others have the same question. Rules seem to differ by state to a large degree but we got around this to some degree by switching my mom to the pen, she was able to stab herself with it when instructed after her stroke but not able to dial up the number of units or remember the sequence. A non RN caregiver was able to put the new needle tip on and dial in the number of units and then help her put her thumb on the end and tell her to administer the pen. Mom has been giving herself injections for so long the process of sticking herself with a needle wasn't a problem. The technical issue is actually injecting someone with a medication so everything short of inserting the needle in a persons body and releasing the medication is fine. Does seem odd that any family member or friend, neighbor can give them an injection but not a trained care giver that isn't licensed for it...insurance and lawyers. ;)
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My mother is a diabetic also and I have to take her to daycare while I work where she is given her insulin by nurses (LPN). She is in a medical daycare. I get asked all the time why I do not hire aides for her to stay at home since the daycare is 40 minutes away. The reason is because home health aides are not allow to administer any type of meds or injections. I am employed as a home health aide and although I know how---I cannot perform this task on a patient---doing so would get you fired and yank your license! There is no way an agency will send a nurse out 3 times a day for insulin injections (given with each meal), so difficult for diabetics unless you can train and pay a neighbor or someone else. My mom was independent and did this all on her own until she had a 3rd stroke and now completely dependent on me. I wish you the best for a solution:)
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Going awry is a risk you take. All I am saying is that people learn to give themselves insulin everyday. They don't need an RN to give it to them. Family members are trained to give their children or elderly parents insulin; no special degree needed. The problem is lawsuits for ridiculous reasons. A credentialed caregiver can also go awry and make a mistake. It happens all of the time in hospitals and SNF. All I am saying is having to go to a nursing home just to get insulin is absurd and it should not cost your life savings to hire someone to give a person their injections.
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Reno55: You say "you can do whatever you want to in your home." True that, but what happens if something goes awry in this specific case?
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You can do whatever you want in your own home. You will not get home health to come in 4 times a day just to administer insulin. If you use an agency, it is possible that a home health aid working for the agency cannot give the shots. Why not teach a neighbor how to do it and pay them to come over 4 times a day. Testing blood sugar and giving insulin is not rocket science. Your only worry is hypoglycemia. If your mom is old with poor life expectancy, tight blood sugar control is not as important. Does your mom have type 1 or type 2 diabetes?
Depending on her age and life expectancy, I would not impose a bunch of dietary rules that have little scientific backing. She is not 40. Give her insulin to cover her food and let her enjoy the time she has.
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Just need to say, in some states LPNs can give injections. Delaware is one of them.
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The correct answer to "who can give an insulin injection?" is that is varies from state to state.
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Not so fast. As a nurse, all I can tell you is the caregiver must possess a license or some other medical education, otherwise you are opening yourself and the caregiver (and agency if there is one) to a lawsuit should anything untoward happen to your mother or the caregiver.
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Not an unlicensed caregiver unless it's your own immediate family (in Florida). You will need homehealth and a visiting LPN and it's NOT cheap.
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Take Everything out of your house that has HFCS in it. Read the labels and you will be amazed. It's in a lot of things today.
Buy Coconut Oil, Quinoa, Coconut milk. We make a breakfast cereal (weekly or twice weekly, heat daily, easier getting to work on time, and you feel Great, plus mom stays more regular with everything and she is healthier)
Quinoa, Steel Cut Oats, another ancient grain optional (amaranth, wheat berries, farro etc) Cook Beginning with Longest cooking grain first. Add to liquid that is equal parts Water, Coconut Water & Coconut Milk (I add the coco milk later with the Steel Cut Oats or Quinoa, if using Long cooking grain like spelt, farro, barley, wheat berries) Make sure you add up to enough liquid total versus grain part.
Also chop apples (washed & cored, leave peeling on for fiber) Raisins, Craisins, Dates, Prunes, any other dried fruit you like, I add fruit half way to avoid mushing it. Cinnamon (great to stabilize sugar, you will hardly taste it, so be generous) Vanilla, and it's Delicious!
Remember liquids drank cold, take a While to absorb due to body temp being way higher... Try to drink more of your water/liquids room temp or warmed.
This simple list of healthy lifestyle habits, along with a Good steady Routine, so you Both know what to expect and feel comforted, will Really Help. A Lot.
Hugs to you
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Of course, the complicated way ends up being also the easy way, but it takes a few weeks. You will see great results in just a week or two. Nurses visiting diabetics in our ALF have said, they get here and in two weeks sugar level is rock steady. The swings are what you want to avoid. They also cause mood swings, and everyone benefits from stabilization, caregivers I'd say even more so. Imagine how rare it is that a diabetic, having raised others, won't have fellow diabetics, even undiagnosed, in their family... True story as noted above. We just had a mother-daughter diabetic in our ALF for 2 years. Beyond the time when the large ALF without Individual Attention & care, said she had to go to Nursing Home. Two Years of Quality life is not a bad thing, and she Enjoyed her food steadily, Never asked for white bread or less protein or fiber. Her bowel movements became more regular, with fewer chemicals. Hydration & fiber are unbeatable for that. The medications they take don't have as many side effects, being effectively flushed through and eliminated, toxins don't build up as much... We also use melatonin, Vitamin D is Critical for kidney function that is hugely impaired by diabetes as well. Potassium & magnesium, the coconut products and the Quinoa take care of quite well...
I tried All of this for ME and it is Unbelievable. I leave a tall glass of water on the nightstand, and when I wake early to go pee, I drink half of it, being thirsty.
Next time I wake, my body is starting to actually Function, and it's Pleasant to wake up and begin to think of my day, and not feel exhausted already. I drink the other half, go pee again, and begin my day on a much brighter note. If we don't start That Early, how will we change bad habits where we begin with coffee and end with soda, hardly drinking what's best for us? Then the body craves water and we drink more of that & less poison. It's how we were Meant to live, not with chemicals and HFCS.
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To get back to the original question, a permission slip does not make it OK when the health law says the injection has to be given by an RN.
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Change diet, add hydration, exercise on a routine daily basis.
Add Fiber, so the sugar level doesn't Spike like that.
We do get nurses to give insulin at the ALF, when the resident can't do their own. We are not allowed to do it, unfortunately as others say.
At her Own home, the neighbor can do it - and a friend or family member can also come to our ALF and do it. But we can't unless we are a nurse, RN or LPN is also ok.
Medicare pays for Once a day, or twice, but that means getting the longer acting type of insulin. A1C levels change, and the goal of insulin treatment is to get them below 7. We got a lady, true story, whose diet was out of control. So was her daughter (out of control) hysterical, anytime the lady mentioned cookies, candy or other poison, she would have a fit if we didn't immediately give to mom. I took her outside to front porch, asked, "how long have You been diabetic?"
Her answer? "None of your Fu**ing business! and How'd you know?" Angry as heck over denying Anyone candy at breakfast table... Gave it to others, one of whom was diabetic.
Alzheimer's is generally getting to be known as "Diabetes Type 3", so strongly is it tied to blood sugar spikes and diabetes.
Bottom line, a gentle stroll after a meal lowers sugar 50 points - Hydration helps the Entire Body and Brain to Work Much Better. Our brain is like one of those thin, itty bitty advertising sponges, 1/8" thick, that you put in Water, and it's Half Inch Usable sponge... Think of the one by the sink if you don't use it for two days... Hard, Dry, Can't do Anything...
Using Whole Wheat bread, Brown Rice, Quinoa, Steel Cut Oats, Lots of Coconut Water, Coconut Milk & Coconut Oil, Engagement, and Exercise, along with all the above, Lowered this woman's insulin use from 21 units a day to 7. And the visits from 3 to One, so Medicare would pay for it.
True story and there are Others, where folks went from shots to pills, and from pills to Monitoring (which we still can't do, but we can "help" them do)
All ALFs are not alike, and most just do what the medical machine facilitates. That's what I call it. The machine only knows money and drugs. Not diet, love, water, exercise or self-empowerment. I show videos about the stuff residents are going through, and they Understand it. Many can still read, and they're amazed by reading Short (key to attention span) articles, and they Keep them and read them daily, it's a wonderful thing...
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If your mother lives at home she can ask whomever she wants to give her her meds. The state does not regulate what goes on in a persons own home. If you are using an agency for caregivers thats a different story as the agency may for libality reasons not have qualified staff. If your caregivers are private you could draw up an agreement outlining duties and include that in the agreement. However because of libality many caregivers may not feel comfortable doing it. Testing her sugar is one thing giving her the medication is another.
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Where is your Mom? At home? In a facility ? My Dad's is at home and his caregivers are not permitted to administer meds but can point them out. Are the caregivers through an agency? I would talk with the agency and find out what they can do for you. Your Mom certainly cannot be the only client who has this need.
Four times per day would be difficult to coordinate traveling nurses so I hope you can find an easier answer. It is good that you are thinking ahead and planning for this!
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Ask your doctor to put in a referral for a visiting nurse to come to your house to assess and determine, if your mom can be independent. Depending on your location, your mom and/or family can request a Visiting Nurse Association of your choice, or the Dr. can select one. Inform the Doctor that your mom needs to learn how to be independent with her diabetes management (Injections, etc). Some individuals with diabetes have decreased sensation, due to numbness/tingling in their fingers and lower extremities, Diabetes Retinopathy (vision impairment), etc. This can be compensated by using a talking glucometer, easy-to-open medication containers, etc. Your mother can also receive Occuaptional Therapy (OT) to reinforce the teaching aspect of Diabetes management. An OT cannot administer an injection. In addition, If your mom has a cognitive deficit, the OT can evaluate and teach strategies to help your mom remain at home, safe and independent, with minimal supports. The goal (if it is your mom's goal) is to keep your mom safe and independent, while decreasing her risk of being hospitalized or being placed in a long term facility. The nurse, OT, and PT (addressing safe transfers, walking, etc) can be important team members to help your mom achieve her goals.
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What state is she in? I think that in NC, they allow Med Aids sometimes called Med techs to administer insulin, in addition to other medications in an Assisted Living facility, but not nursing home. I'd check the laws in the state your mom is in.
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Check your state health laws or ask the MD. Usually a CNA cannot give injections, you need an RN. That is why diabetics end up in a skilled nursing facility.
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Her caregivers aren't allowed to check blood and administer insulin? Are your caregivers from an agency? If so, they should be allowed to check blood sugar and administer insulin.
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