Moving home is an important decision at any time in life. If the person you care for, is an older person living with diabetes, there are some additional things to consider when choosing a residential or nursing care setting.
These tips can help you feel confident that the needs of the person you care for will be understood and supported.
On this page:
- Before you choose a care home
- Visiting a care home
- Questions to ask about diabetes care
- Adjusting your diabetes care
Before you choose a care home
Before you visit any care provider, it is always helpful if you, or someone you trust, can do some research. Take a look at things like:
- The Care Quality Commission report for the service.
- Whether the home is approved by your local council.
- Reviews or feedback from people living there or their families.
- What level of care service is provided, e.g. will the person you care for with diabetes need care from a nurse?
- The location, environment and outdoor spaces, to see if they feel right for the person you care for
- If the home can meet their cultural needs.
Visiting a care home
Visiting at different times of the day or staying for a few days to get the ’feel’ of the place, is always a good idea.
While you are there you may want to speak to different members of staff, other residents, and relatives - take notice of the decor and cleanliness, room sizes and facilities, food options, and mealtimes.
Look to see what activities are going on and how staff interact with residents and each other.
Ask about bringing personal furniture or possessions, whether guests can stay overnight or visit at any time, and how much choice and freedom the person you care for will have.
Questions to ask about diabetes care
Diabetes care can change as people get older, become more frail, or develop other health conditions. There are some questions you could ask which might help to give you a better idea of how the care home can meet the specific diabetes needs of the person you care for:
Training and staffing
- Are staff experienced in caring for people with diabetes, and what diabetes training have they had?
- Have staff had training in nutrition, exercise/activity benefits and mental health for older people with diabetes?
- Is there a member of staff who is responsible for diabetes care in the home?
- Does the care home have a written diabetes policy?
Monitoring and medication
- Are staff able to support with glucose monitoring or insulin administration, if this is something the person you care for requires or may require, in future?
- Is there a system to support accurate self-medication?
- Do residents with diabetes have written diabetes care plans?
- Do residents with diabetes have an annual diabetes review?
- How will food options fit with your likes, preferences and diabetes needs?
- Is there support to keep active and exercise?
- How are hypos managed?
- Is there a written policy for hypo management and prevention?
Access to other services
- Is there a GP responsible for the home or can you choose a GP or keep an existing GP?
- Is there access to a Diabetes Specialist Nurse?
- Is there a podiatrist/chiropodist who visits or access to a foot care team?
- Is there access to eye screening?
Food, routines and activity
- Is there access to a dietitian?
- Is there support to stay active, move more or join activities?
- How are changes in appetite, illness or new medications managed, given that these can affect blood sugar levels?
Diabetes care as needs change
Living in a care home doesn't mean someone is approaching the end of their life. Many people live in residential or nursing care for years while continuing to enjoy an active life.
As people get older or become more frail, however, their diabetes care may need to change. Care homes should regularly review diabetes care with the person, their family (where appropriate), and healthcare professionals to make sure it continues to meet their needs.
Towards the end of life, diabetes care usually focuses on keeping the person comfortable and avoiding symptoms such as low blood sugar (hypos), rather than aiming for strict blood sugar targets. Care should always be personalised and respect the person's wishes.
If you're choosing a care home, you may want to ask:
- how diabetes care is reviewed as someone's needs change
- how families are involved in decisions about care
- how the care home works with GPs, diabetes teams and other healthcare professionals
how the person's preferences and wishes are respected.
If you or someone you care for is approaching the end of life, more detailed guidance is available in the Trend Diabetes guidance on end-of-life care for diabetes.
