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what used to be second nature for this person to do the routine, has become less reliable. Difficulty putting new needle on the injection pen. Occasionally getting flustered.

These difficulties mean that she can no longer be left alone or live by herself. What happens: You notice the things you've noticed but have no idea what difficulties come up when you're not there. They will evidence themselves eventually - she hasn't done laundry in a while and you get curious and find it stuffed under the beds. Not life threatening, but it shows the level she's operating from, which could have serious consequences, such as she hides her pills under the bed too because she got flustered and confused, and she knew they should be gone, but she doesn't remember how to put them in her mouth or that they're medicine.

In my husband's case, there was 12" butcher knife under the couch cushions. He thought the vacuum cleaner was a hedge trimmer. That his toothbrush should be flushed down the toilet.

The signs you see indicate that facility care is on the horizon. Or in-home caregivers 24/7, but that soon becomes unsustainable.

My SIL is an R.N. who used to help elders with their meds. She'd visit their homes and lay out the meds in containers. But I'm telling you, that will only work for so long, and you need to prepare for the obvious next step.
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Suzy23 Aug 10, 2025
I totally agree and saw this type of progression with my dad big time.
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Quite honestly, this inability to remember and administer medications is one of the primary reasons that some people enter ALF.

I think, realistically, it will be impossible to get someone to stop daily and do medications. Taking on giving medications to someone is a lot to ask, especially when diabetes is involved. Payment would be massive because people cannot afford to have a job where they move home to home to home giving medications in the morning. Almost any caregiving agency has minimums of four hours a day and three days a week for their workers so that said workers can have a job that pays and sustains them.

This may be time to consider care.
Interestingly, in a recent memoir I read called The Marmalade Diaries by Ben Aitken I read that in England there is a "share-care" program in which Elders provide low cost rent to people in need of same who may be going to school and etc., in return for companionship and some agreed upon contractural duties. The program seems to be working quite well for many. I wish we here could more "think outside the box" but here it seems ultimately to all come down to following the almighty dollar.
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Reply to AlvaDeer
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She needs memory care with a tech to deliver meds. But many states will require the client to self inject. The tech would just set up the delivery device and dial in the number.
Another option varies state to state. Mom was in IL but needed assistance with baths and meds including daily insulin. Because she was in a facility with over 100 apartments, there was a visiting nurse group that had several clients and thus no need for a hired nurse to travel distances. They even had an office. Mom was charged in 15 min increments each day.
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Other than having a family member, friend or neighbor stop by daily to make sure this person is taking their medications and getting the insulin that they need, I see no other option if you're wanting this person to continue living in their home.
The other option of course is having them placed in the appropriate facility where all of that will be taken care of for them.
Hiring a home healthcare agency usually requires a 4 hour limit, so unless you would have other things for the aide to do in the 4 hours other than making sure this person takes their meds and insulin, it would be a costly venture.
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Reply to funkygrandma59
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I'm going to tell you straight that there are no free options for what you're looking for other than a volunteer. Talk to a homecare agency and hire a home/health aide to help this elder out.

A hired homecare worker will make sure the person takes their meds and is okay. Of course, the meds need to be laid out in advance in a pill organizer. A home/health aide from an agency cannot fill the pill box or administer meds. They can put them in a cup and hand them to the client to take though. If they are a CNA home/health worker, they can do blood sugar testing and put the needle on the insulin pen. Why doesn't the elder you're talking about have insulin pens that get thrown away after the doses finish? Then there's no need to fuss with it.

I think the others on the thread are right though. This elder should not be living alone anymore.
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MissesJ Aug 10, 2025
Insulin pen needles are screwed in prior to use and screwed out and disposed in a sharps container for each use. Needles are not reused.
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Does this person have a PoA? If so, the PoA needs to be informed of this problem so they can manage it.

If this person doesn’t at least have a local, trustworthy and willing relative to help move this forward and manage it, then report this person to APS so that they can be protected and get appropriate care.
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I had some agencies in Maryland that had a 3 hour minimum. The problem was that CNA's working for an agency in Maryland are legally not allowed to administer meds in a home setting.

We had to private pay CNA's to get around this rule. Expect a 3 hour minimum even if they just stop by to administer the meds.
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JoAnn29 Aug 11, 2025
Its this way in NJ unless they are medtechs. CNAs are not medically trained. They can remind they can't hand the meds to the person. They all can't give shots.
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Speaking as an R.N. who worked in Home Health -- medication management was one of our foremost responsibilities. Medication errors can cause a serious medical emergency, e.g., overdosing, hyperglycemia from skipping meds that are needed, like insulin. I can tell you that there is no way to "stop in and check on someone" to tell if they took their insulin injection at all, or took it correctly. Removing a pill from the pill minder does not prove that the client swallowed the pill, the correct dose at the correct time. The nurse would need to actually be present to give the injection or the pills, or stand by and observe while the client prepared and administered the injection and took oral meds. Like others responding to this query, your family member's safety may require closer in-person monitoring at this time.
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Reply to hmhollar
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Someone should be giving this person their meds. Unless a nurse can come to the house to do this, they should be staying in assisted living.
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con3ill Aug 14, 2025
Not all assisted living facilities have staff that can legally give meds. In my state, anyway. Staff can remind a resident to take meds, or cue the resident to take meds that are already laid out, but it stops there. So it works OK until it doesn't.
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Are there single shot diabetic meds? Or maybe ones that only need to be given once a week?

This person needs to see an endocrinologist to make sure they are on the best meds given their inability to change daily needles. my MIL lived for years w/o taking her meds. Of course she developed cancer. Connection? I don’t know. FIL no longer needed meds after years of taking because he lost weight.

I know that diet plays a huge role as well as exercise. Both things sometimes hard for a senior to change.

Home health for the homebound through original Medicare used to give insulin shots years ago but they no longer do.

I hired an aide for my aunt to come two hours a day to help with meds but it wasn’t a shot.

This is a game changing stage for the diabetic. Must be millions faced with the same problem.

Contact your Area Agency on Aging. There is an office for every county and see if they have suggestions.
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