Call to action issued over diabetes in care homes
Diabetes care in care homes still remains “fragmented” and “sub‐optimal” and action is needed to improve standards, leading experts have said.
That was the assessment of a review called Failing to meet the needs of generations of care home residents with diabetes: a review of the literature and a call for action.
The review published by Diabetic Medicine, examines the literature relating to care home diabetes over the last 25 years to assess what has been achieved in characterising residents with diabetes and also covers the “various but limited” intervention studies carried out internationally.
Action is required since diabetes care still remains fragmented, sub‐optimal, and in need of investment, otherwise care home residents with diabetes will continue to have their needs unfulfilled
The guidance and guidelines that have been published to assist clinicians in planning effective and safe care for this rather vulnerable group of people with diabetes were also reviewed.
The review was authored by Professor Alan Sinclair, from Foundation for Diabetes Research in Older People and University of Aston, Professor Roger Gadsby, of Warwick Medical School, Dr Ahmed Abdelhafiz, from Rotherham General Hospital, and Dr Mark Kennedy, from Corio Medical Clinic, Australia.
They said that between one in three and one in four residents may have diabetes in residential care homes and aged‐care facilities globally and that the condition in older people can lead to frailty, dependency, disability and reduced life expectancy.
Residents with diabetes also have a high risk of hypoglycaemia, avoidable hospital admissions, and represent one of the “most difficult challenges” to health professionals and care staff in optimising their diabetes and medical care, the article said.
Actions to improve care
Commenting on the practical measures needed to ensure change, the authors said: “Sustainable effective diabetes care within care homes and similar settings requires additional resources (both public and private) including trained staff, equipment, modification of facilities to allow for implementing new interventions, and new audit programmes. A call to action is therefore proposed to address these requirements to bring about a global improvement in the care of residents with diabetes.”
The call to action includes the following:
- A greater prominence to be given by health professionals to older people with diabetes living in care home environments.
- All residents with diabetes should be named on a local diabetes register to increase their opportunity to be involved in clinical audits.
- Health professionals, researchers and research funding bodies should do more to overcoming the barriers to effective diabetes audit and research in the care home.
- International bodies should include diabetes in care homes in their policies and guidelines.
The authors concluded: “The review presents the first diagrammatic representation of a likely physiological cascade depicting the mainly irreversible functional decline a resident with diabetes might experience, provides modern principles of care for each resident with diabetes, and identifies what priority recommendations are required to be implemented if diabetes care is to improve.
“The review concludes that action is required since diabetes care still remains fragmented, sub‐optimal, and in need of investment, otherwise care home residents with diabetes will continue to have their needs unfulfilled.”
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