Q: My mother, who is a "brittle diabetic," has been sent to askilled nursing facility for two weeks of rehabilitation following aseven-week hospital stay. I am amazed and frightened at the lack ofconcern for and attention to her diabetes care at the nursing home.
Despite our repeated requests for a diabetic diet, she continues toreceive regular food trays. Often her insulin shots are missed. Herblood sugar has ranged between the mid-500s to as low as 38.Finally, one morning after her blood sugar dropped below fifty, Iput her monitor and some snacks by her bedside so that she can atleast partially manage her diabetes by herself.
Is there anyone out there to whom I can report this poor care? I'vetried nurses, doctors, and patient care technicians, but no oneseems to take this disease seriously. I'm afraid they're going tokill her.
A: Dear Ruth,
Your mother's blood sugar control during herhospitalization is possibly being affected by a number of factors,including the stress response and the use of pharmacological agents,as well as the hospital's practices. To address your concerns aboutyour mother's poor glycemic control, you could do the following:
- Request a diabetes consult to review and revise your mother's current diabetes plan.
- Schedule an appointment with the facility's nurse manager or director of nursing to discuss the issues impeding glycemic control, such as skipped insulin doses and the lack of a carbohydrate-controlled meal plan.
- Contact your local or state Long Term Care Ombudsman Program (at www.ltcombudsman.org). The federal Older Americans Act requires every state to create an ombudsman program to investigate and resolve complaints made by or on behalf of residents of long-term care facilities.
Mary M. Sullivan RN, APRN, BC, CDE
Diabetes Clinical Nurse Specialist/Nurse Practitioner