Diabetes care in nursing homes still remains “fragmented” and urgent steps need to be taken to restore the “health and dignity” of older people, leading experts have said.
A review of multiple studies carried out across 25 years involving service users with diabetes has slammed care home provision saying that care homes “often do not meet national standards” of diabetes care and staff training is “patchy”.
Lead author Professor Alan Sinclair, from the Foundation for Diabetes Research in Older People and University of Aston, said: “Our findings show the level of diabetes care remains fragmented which is quite worrying because figures suggest over a quarter of care home residents are believed to have the condition. Without proper management, it can lead to frailty, dependency, disability and reduced life expectancy.
“There is also the added strain on the NHS as frequent hospital admissions to treat diabetes-related complications are costly, not to mention unsettling for the patient.”
Declining diabetes health
Alongside Professor Sinclair, Professor Roger Gadsby, of Warwick Medical School, Dr Ahmed Abdelhafiz, from Rotherham General Hospital and Dr Mark Kennedy, from Corio Medical Clinic in Australia wanted to investigate what interventions had been introduced in a bd to improve care and what needed to be done to address the declining diabetes health of this vulnerable sector of people.
The findings also suggested that care homes often lack HbA1c monitoring, diabetes self-management programmes, regular exercise activities and most staff have very little knowledge of hypoglycaemia treatment.
Jenny Hirst, the co-chair of the Independent Diabetes Trust (IDDT), said: “It is thought around 27 per cent of residents in care homes have diabetes. With a growing number of older people developing the condition, the need is ever more pressing to ensure there is a good standard of care for this group of vulnerable people who have complex needs.
“Older people, particularly those with diabetes, are more likely to be admitted to hospital when they are unwell. This is because diabetes can have an additional effect on the illness and the illness can impact on their diabetes.
There is a need for much better training and support so that care homes are able to support people living with diabetes
Professor Martin Green OBE, chief executive of Care England
“However, this can be often be avoided if care home staff are trained properly in how to treat diabetes, checking blood sugar levels, identifying when a person is suffering from high or low blood sugar levels and taking the necessary action, quickly and also encouraging light exercise activities.”
To help counteract these problems, the researchers have made a series of recommendations for care home staff, health professionals, diabetes organisations and policy makers to undertake constituting a ‘Call for Action’.
Professor Martin Green OBE, chief executive of Care England, said: “There is a need for much better training and support so that care homes are able to support people living with diabetes. There needs to be a training programme put in place by Health Education England, much better access to primary care services and regular and proactive monitoring of residents so that they are able to live well with their condition.
“Currently, the NHS is poor at supporting care homes and we need them to understand the residents of care homes are part of the community and should be enabled to have all the resources that would be available to people living in their own homes.”
Professor Sinclair said: “We want to see older people with diabetes who are in care home settings being given greater prominence by healthcare professionals. In addition to this, we want more focus to be given to defending the rights, health and dignity of care home residents with diabetes.
“More training for staff, introducing better interventions and encouraging a change in attitude is all going to contribute towards improved health outcomes for those with diabetes.
“Furthermore, we want international health organisations to include diabetes in care homes within their policies and guidelines. This will ensure global collaboration at a high level of influence and pave the way for an International Best Practice statement in this area.”
This review of multiple studies carried out across 25 years involving service users with diabetes highlights the continual decline in provision to address the growing problem of service users with diabetes in care homes. A solution to the problem of diabetes will not be solved by care homes alone. They will need the support of NHS and Health Education England to ensure sufficient resources are made available and staff are properly trained.
The findings of the review, entitled Failing to meet the needs of generations of care home residents with diabetes: a review of the literature and a call for action, has been published recently in the Diabetic Medicine journal.
Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute
Bettal Quality Consultancy