Status of Diabetes Management in the Nursing Home Setting

I am a diabetic.  I am also a lawyer who focuses on nursing home abuse and neglect cases, and in that context I have seen and brought to light through litigation numerous instances of diabetes in the elderly being mismanaged in a nursing home setting.  Diabetes is a complicated condition, and requires multifaceted approaches and techniques to treat properly.  These approaches assume that sufficient staff are present in the nursing home to implement the various orders of treating physicians and registered dieticians to insure that glucose levels are managed properly and elderly residents do not suffer.   Unfortunately, many nursing home operators choose to have less than sufficient staff to care for their residents.  This has a particular impact on those residents with diabetes.  A new study confirms that “numerous opportunities [exist] for improvement in the quality of care for nursing home residents with diabetes mellitus.”   The study further found that “only 15% of facilities studied had a policy for the use of treatment algorithms to manage residents with diabetes . . .”  Our elderly diabetics deserve better, and while the nursing home industry might choose not to believe my message with regard to the mistreatment of diabetic residents, they now have a message they cannot ignore, from the American medical Directors Association,  that should force them to take a look at this issue more closely.

JAMDA article (Diabetes) June 2009