Nursing home residents suffering from diabetes face increased risk for a variety of health problems and complications, requiring additional caution and care.  However, there are no specific guidelines for providing proper care for nursing home residents suffering from diabetes.   Therefore, each facility must carefully determine the unique needs of each patient are successfully accommedated.

As the Baby Boomer generation ages, nursing homes will have to deal with increased numbers of residents and increased numbers of residents suffering from type 2 diabetes.  The 2004 National Nursing Home Survey revealed that 24.6% of nursing home residents had diabetes as a primary admission and/or current diagnosis, and one in four nursing home residents age 65 and older suffer from diabetes. 

A study, Diabetes Care in Extended-Care Facilities: Appropriate intensity of care?, published in the American Diabetes Association Journal, revealed that the care of elderly patients with type 1 insulin dependent and type 2 diabetes in extended care facilities fails to meet ADA Standards of Care. 

While 98% have their blood glucose monitored, only 38% meeting their short-term glucose goals.  While many nursing homes seem capable of regularly monitoring blood sugar, they may lack resources or knowledge for how to deal with the individual needs of diabetic residents.  This is especially true when dealing with elderly residents who might be unable to communicate to staff about low blood glucose levels or other dangerous conditions. 

A study conducted in a New York nursing home revealed that nursing home residents with diabetes are four times more likely to suffer from a dangerous fall than residents who are not diabetic.  This suggests that nursing home staff should consider diabetes as a risk factor for falls and take steps to reduce the risk for diabetic residents.  Diabetes can cause complications including a drop in blood pressure upon standing (orthostatic hypotension) and visual impairments; yet, researchers found that neither of these complications explained the increased risk of falling. 

One potential explanation for the increased risk of falls is that diabetics can experience problems with the peripheral nerves in their feet (peripheral neuropathy), which can affect sensation and cause pain and numbness. 

Peripheral neuropathy can cause additional complications for diabetic residents because they may be less likely to feel when their feet have become injured or are developing a pressure sore because of numbness.  Therefore, it is important for nursing home staff to regularly check the feet of diabetic patients so that minor injuries can be treated before they become infected.  This is especially important because diabetics tend to heal more slowly. 

The slower healing rate of diabetic residents is also concerning for residents who are recovering from pressure sores, injuries, or surgery.  Because of the prolonged recovery period, diabetic residents are more susceptible to infection.  Therefore, nursing home staff must take extra precautions to check on the injury or site that is healing to watch for infection or complications. 

Sources:

Diabetes Health: Nursing Home Care for People With Diabetes A Mixed Bag

MayoClinic: Type 2 Diabetes

CDC: National Nursing Home Survey (NNHS)

The Medical News: Study Shows That Nursing Homes Should Consider Diabetes A Significant Risk Factor For Falling

The Journals of Gerontology: Diabetes Mellitus Is Associated With An Increased Risk Of Falls In Elderly Residents Of A Long-Term Care Facility

Diabetes Care: Diabetes in Nursing Homes: United States 2004

Nursing Homes Abuse Blog: Nursing Homes Not Prepared To Handle Diabetic Residents