Diabetes management in assisted living. Any advice?

I agree with Notgood and Alva. For one thing, unless a big AL, there is probably one RN and it most States an RN has to give the injection. Some States allow LPNs. At one time my State did not allow LPNs to give shots, not sure if that is still true. Across the Bridge that State allowed LPNs to give shots. Thats where my Daughter worked so she gave shots. CNAs can not give shots or medications. If a Medtech, can give meds.

Check out the pump.

If your mom is insulin dependent and can no longer manage her own insulin therapy, it might be time to have a discussion about an automatic insulin pump. It might also help with the high sugar numbers.

Has she or you spoken to her doctor/endocrinologist? It has been my understanding that once someone with diabetes reaches a certain age, the overall concern is more about low blood sugar rather than high, since high blood sugar leads to complications *in the long term*, but LOW blood sugar is an immediate medical emergency. Depending on your mom's age, her doctor may be somewhat less worried about high blood sugar now, especially if she's had good control of her diabetes throughout her course of the illness until recently.

I think I would take the print out of the dates and sugar readings and bring them to the attention of her doctor for his/her opinion. You might be worrying about nothing.

Good luck.

Call for a care conference with the nurse and executive director of the AL and raise your concern. If they can't manage mom's insulin, you'll need to move her to a SNF or another AL that administers meds properly, but still probably NOT at the exact same times daily.

Insulin should IDEALLY be given 15 to 20 minutes before a meal.

If it is given during or just after the meal the risk is for LOW blood sugars, not high (typically).

So the insulin titration itself here may be off and should be discussed with MD who I am certain is getting the same blood sugar read outs that you are.

Here's the problem, and this is the same problem whether nursing home, SNF or hospital (I was a nurse). You have, say 20 patients needing a.m. insulin. It is scheduled for the RN or med nurse for 7 a.m. But one cannot give 20 injections of insulin simultaneously, right? And there needs to be care in drawing up sterile, checking wrist bands, injecting correctly. And meals are not delivered according to insulin schedules.

This is a problem, there's no question about it. What do you think might be a good answer?

I am glad, by the way, that your facility is keeping you so well informed. I hope you will get back to us about what solutions you have after discussion with doc and with the facility. I surely do wish you the best. There are so many problems in elder care.