My mother in law’s doctor provided a written statement that she needs a diabetic diet. Since moving to the facility her A1c has gone from 6.6-8.8 and has been placed on more medication. The facility said that they do not have to provide diabetic diets and they cannot tell her no if she requests sweets. My mother in law is not asking for sweets they offer them lemonade, sweet tea, cookies and then she accepts it. We are asking that they refrain from providing sweets. They also moved her from level 2 to level 3 after the medication increase and we do not know why. They said we would have a meeting before any increases and saw a draft for the increased amount today with no explanation. I have called the ombudsman and left a voice message but they said I am supposed to call department of public health. I left a message but feel that I will be going in circles. Does anyone know who I can contact? I am in SC and we have her in one of the best facilities. I am not sure if the problem is with the director or if I am expecting too much.
If you discussed that during admissions, they likely would have told you they are not able to accommodate her special diet needs. It's up to you to find a facility which will accommodate her diet, or just let go of that idea entirely and hope she enjoys her last years in a facility you say is one of the best.
Now, re-reading, if she is in an assisted living facility, she is fairly independent to do as she wishes. They are probably not preparing an individualized dinner plate and bringing it to her room.
I'm glad she is in a great facility. However, as some have suggested, you may have to let go of your expectations that her dietary needs will be met to your standards. You simply don't have much control over what happens there.
You could, if it is important to keep her A1C levels in check, place her in a skilled nursing facility - there are some good ones - and insist that she be given an appropriate diet for her health. A smaller, home care setting might be able to monitor what she eats and give individualized attention. This facility she is in has already stated that they can not accommodate a diabetic diet. You can make complaints to the ombudsman and the director, but I don't think it will change their policy.
Yes, they should contact the family for any changes in her status. It may have been an oversight, the staff can get pretty busy just taking care of residents.
I am not sure if an ombudsman will be of help since that person is for SNF.
I am so sorry you are dealing with the realities of facility care. It can be a shock.
When our loved ones are at home many of us have found ways to easily limit the things that are toxic to them. Some go into care seeking more help with meds only to find their LO will need even more meds to tolerate the system. Usually there are multiple reasons an elder needs facility care and poor food choices or not, the decision has been made.
Facilities will tell you that doctors orders are complied with but sadly our society still doesn’t accept that food is a drug.
We, the original caregivers, have a steep learning curve on just how many problems there are to contend with and what we must accept with the new regime.
It appears to have hit your MIL pretty hard and I expect she will require more care as her system deals with the effects of out of control blood sugar. I’m sure she is not alone.
You might find something to help her with her stress (anxiety) or perhaps even depression, which might help her make better choices if she is able to understand what is happening to her. Just a thought to consider.
I would hate to be in your MIL’s position of having to say no over and over to what she craves.
Would she be a candidate for a Dexcom to get alerts of her BS spikes? She’s in ALF so we know she has some limitations but perhaps still willing to try other devices to help her adjust.
Liquid sugar is the worst offender for a diabetic (teas, juices or like my DH does on a daily basis, honey in his coffee).
No digestion is needed before the body must take on the sugar rush.
Blood sugar is the highest 1 or 2 hours after eating and here comes the beverage cart with sweet ice tea and other sweet drinks. Not good for even one person.
But a glass of water with a slice of lemon or lime in a pretty glass and maybe a straw would be hydrating and helpful to all except those who are restricted from fluids.
Your MIL, I assume, is not yet deemed incompetent. She is expected to make her own decisions and it is really hard for some to make better decisions or push back at the inappropriate offerings. It’s truly cruel. It’s like offering a drug addict of any description their preferred drug when they are already freaked out with the new environment that are trying to adjust to. A lot for many to deal with.
Often we use “safety” as a criteria on when it’s time to place someone. I find “safety” not to be so easily defined.
I’m not telling you to give up on improving her diet. I’m just saying you will most likely have to find a workaround. Perhaps someone to accompany her to the dining room and help her make better choices or a standing diet order or predetermined meals delivered to her room?? All of this will mean increased cost but once YOU understand exactly what you are up against you might be able to find a way to make eating and hydrating safer for her.
Oh, and stress. The correlation between getting over stressed with worry and the numbers spiking is very clear.
I'm unable to place my mother into AL/MC because of her extremely specialized medically necessary diet. It goes way beyond diabetic or gluten free or vegan or..., so they won't take her as a client. Diets can make or break where someone can live.
Ask the administration if there is a compromise that can be reached to help her levels. The ones we've dealt with have been more than happy to communicate, even if not successful in placement due to diet.
Good luck.
Level of care is discussed with the resident him/herself unless there is a deficit in ability to understand that is present and known and part of entry contract. Discussion of their level of care can then be discussed by the resident and family as he or she chooses. If however he/she is currently unable to manage own life and is under the care of a POA it would be discussed with the POA who is also likely responsible for the cost in care.
When one comes down to being unhappy with the contracted care available at ALF or MC then it often comes down with management nicely suggesting they seek care and residency elsewhere with some statement such as "Your Mother may be unhappy with us; you might wish to seek other placement for her" and etc.
I would meet and discuss with administration what is available. The level of care in ALF is considered you are basically able to make your own decisions about sweet tea, happy hour, ice cream social, bingo game meets and etc. on your own. The family isn't involved. In my bro's place the residents could typically go on gambling meets. This would be up to the resident, not the family.
Just as an aside, A lC often has to do with MANY factors, not just sugary treats. Has to do a lot with carbohydrates over time, such as pastas and other like.
Good luck. Hope things can be arranged to the satisfaction of all.