Dad can't handle mum's diabetes

Hi Andy, I put this question to a diabetes educator Sheree Rennie and posted her answer below. You can contact her via her website. These are some suggestions that may help. Depending on which state this question comes from - services that may be available are district nursing who can come into the house with the consent of both parents. This could be weekly or more often if needed. The district nurses could liaise with the nursing staff on site. Alternately, Andy's mum is eligible for an Enhanced Primary Care Plan as she has diabetes. This entitles her to 5 Allied Health visits per year and is completed by her GP under Medicare. There may be a private diabetes educator in the area that may do home visits that can be spread out over 3 monthly period for a year.   When a person with diabetes is managed with insulin, they usually see an Endocrinologist (diabetes specialist) every 3-6 months. If Andy's mother is seeing an Endo, contacting them may help to see if there is deterioration in diabetes management.    I think of primary concern is Andy's mothers dementia and confusion. This could be due to deterioration in dementia. A check of how often she is seeing her GP or having/needing an Aged Care Assessment to monitor memory function could be helpful. I feel blood glucose control and elevated BGLs could be causing confusion. If BGLs become elevated and fluctuate, it can cause temporary confusion, irritability, aggression, tiredness etc. This could be a result of poor insulin injection technique, missed insulin injections, poor dietary choices, inactivity and problems with other medications or if dose adjustment has not been attended in some time.   I feel Andy should make contact with the GP and liaise with the nursing staff onsite. Counselling may also be need for Andy's father to help with issues of caring for someone with a chronic illness, frustration and future living arrangements.   Temporarily, Andy could speak with the apartment manager and discuss setting up a communication book that she can write in when visiting and which nurses can use to report any changes in health. Many serviced apartments have a GP onsite. This may be a good idea on moving care onsite. I think Andy's dad may also benefit from a health check - If both parents are over the age of 75, they are eligible for a Health Assessment carried out by the GP and their practice nurse.   Andy may find it easier to sit with his parents and discuss health issues' and discuss that he would like to learn more about diabetes as it can be genetic. Andy could discuss with his parents that he would like to have a diabetes educator come in to the apartment to do an assessment and to educate himself about diabetes. This may help determine any issues in coping, deterioration in care and need for alternate living arrangements.   Sheree Rennie www.detadiabetes.com.au