Help needed for my Granny

[Dizzydi]

She is 80 and is struggling with her Diabetes.

She is on insulin - sorry cannot tell you which at the moment or how many units etc.

I saw her yesterday and asked her how her blood's are. She showed me her book and I am horrified at her results.

They are in the range of 20 to 30.2. She was hospitalised back in Sept last year as they were high then. She has been injecting in the same spot and the insulin is not getting in. She has only just realised she can alter her dose accordingly, but I don't think she is really with it or understands what she needs to do and started injecting in new places, but I suspect she has reverted back to her old ways. (She told me she is sick and tired of it all now and had enough). I suspect she has basically given up.

Can anyone please tell me - would she be a candidate for a pump? & If so how do I go about getting her sorted for me.

She is under a different NHS health care team to me and I'm going to go with her to see her diabetic nurse at he next appointment. The problem is her next appointment is not till late March and I'm worried this is to far away considering her results.

 

[Northerner]

I think you're right Di, that appointment really does need to be brought forward. It might give her the knowledge and encouragement she needs now to improve her situation - several weeks down the line and she is just going to get increasingly discouraged. Good for you for looking out for her - but her health care team should be more aware - give them a kick up the backside!

Best wishes to your grandma🙂

 

[Lizzie]

I am far from an expert on these matters. But I believe the pump also involves a lot of self management and maths calculations about what fraction of a unit to have, how many carbs etc, so if she is generally sick and tired of managing her diabetes maybe that is not right for her. I would imagine it is hard for diabetics at her age, my own granny is not diabetic but is always making remarks about how she is fed up with her life (she is a similar age), for a diabetic it must be even more difficult to muster the motivation to count carbs and inject and monitor themselves. If your blood sugars are high whatever your age it does make you feel ill and depressed, added to this the disheartening feeling of seeing yet another high blood sugar and the fact that it may be harder to exercise. I can understand why she would be fed up with things.

Does she live alone? If so, is there a friend or family member with some diabetic knowledge who could pop in on her regularly and help her with blood sugar checking and injections? Or is there some kind of provision on the NHS in her area for a nurse or someone to come and help her? Or could you afford to hire someone? I hesitate to mention some kind of sheltered accommodation, I know some people find this hard to think about but if your granny is having these kinds of problems with her self care I think she needs some sort of support especially in case she collapses, if it were my granny I would worry about her if she is on her own in fact I do worry about this with my own granny but she seems OK to manage for now and is also quite insistent that she won't be a burden on any of us, she recently was in hospital for a cataract op and I was quite concerned but she seems to have recovered OK.

Whatever you decide to do, I hope things get better for her. I agree with Northerner they should have given her more support especially after she came out of hospital.

 

[Copepod]

Given your Granny's age, I wonder if she has any other health problems? Under which team / consultant was she admitted to hospital? Often, Care of the Elderly consultants / teams (used to be called Geriatrics) are very good at looking at the whole person, including housing, social / medical / nursing support. Sheltered housing might suit her, but usually the support offered is just a daily "are you OK?" sometimes in person, sometimes by phone, with monitoring of an alarm system. The other area to consider is her age - realistically, if you're 80, you have fewer years ahead of you than if you're 40, say, and if she's had diabetes for many years, she will already have coped with many changes in diabetes management, and may, quite naturally not want any more changes. If she has other problems eg cataracts affecting her sight, then treating such problems would have a great benefit on her overall life - my grandmother had vitually given up sewing, but started again after having her cataracts operated on when she was about 90 years old.

However, more help from medical teams, and an earlier appointment with diabetes team would be a good start. Also, worth thinking about benefits - as she's over 65 years, she can only apply for Attendence Allowance at 2 rates of care (not Disability Living Allowance at 3 rates of care & 2 of mobility).

 

[Dizzydi]

Thanks Guys

Granny is already in sheltered accomodation. She is not very mobile for her age. She has people come into her everyday to help her dress and eat etc. But they are not specialist nurses etc,. The family go see her during the week (they alternate) and every weekend. I live a little further away and only get to see her once a month.

I always check her fridge and freezer etc and know she is probably not eating the best, but also does not really eat much. My Aunt shops for Granny and I've tried to advise her what is best for her to eat etc - but trying to get granny to have a healthoer diet is hard work - she love's her meat pie's🙂

Her healthcare team have really let her down with following up on her, but having said that they kept writing to her and she admitted to ignoring the letters. My mum is also Diabetic and constantly complain's about the lack of her health care and I have suggested she complain, insist on seeing someone etc, but again to no avail. They are both under the Oldham NHS trust (i'm under Stockport for my GP and South Manchester for my specialist.) Mum went with granny for her last appointment - and my granny bless her is a little tinker at times and played down her blood sugar levels etc to the nurse she saw at the GP's. The hospital when they discharged her last were supposed to set up appointments for her with the diabtetic team at the hospital and nothing was done, she was left to eat what she liked of the hospital menu - again considering she is diabtetic you would have thought they would monitor it and change it if she had picked un suitable meals.

I think I'm going to have to take the bull by the horn and try and get them both bettercare. Mum bless her has had a hard time of it lately as well, and I think she gets frustrated as I seem to get better care which I must say is not fair.

I can understand now why maybe a pump might not be good for granny - there is no way she will be able to work out carbs to insulin ratio. I really do feel for her.

My mum has also kinda given up on Granny which is very sad.

 

[diagonall]

Hello Dizzy,
Sorry to hear your gran is not doing so well at the moment.
Can you ring up the DSN's or consultant's sec and ask for an apt?
Ican't work out if you Gran is type 1 or 2 if a 2 then very little chance of a pump.
Pumps do all the working out for carbs/corrections etc. well all except the spirit pump.
But you do have to tell it hpw many carbs you are eating.
Your gran can eat what food she likes as long as the carbohydrates are covered by the insulin she is taking.
I am assuming she injects twice/day. If this is the case she is on a mixtard ie long and short acting in same vial.
If this is the case then she needs to have the same amount of carbs at each meal time.
It does sound to me as if some help is required by the community nurses.
Best wishes
Sue

 

[Dizzydi]

I Managed to Speak to Granny's GP

Granny is type 2. I called her GP Surgery yesterday afternoon and got booked in for a telephone consultation. Her GP called me back last night and he is going to go and see Granny today. He has told me considering how high her BS are again, they may have to admit her to hospital.

I have specifically asked if she can get more help i.e. can the diabetic team go and see her once a week etc. Her GP is going to call me again today to let me know what needs doing. So fingers crossed they can come up with a more suitable programme of help and assistance.

Thank you all for your kind words and advice.

 

[diagonall]

Granny is type 2. I called her GP Surgery yesterday afternoon and got booked in for a telephone consultation. Her GP called me back last night and he is going to go and see Granny today. He has told me considering how high her BS are again, they may have to admit her to hospital.

I have specifically asked if she can get more help i.e. can the diabetic team go and see her once a week etc. Her GP is going to call me again today to let me know what needs doing. So fingers crossed they can come up with a more suitable programme of help and assistance.

Thank you all for your kind words and advice.

Fantastic nice to hear someone is doing something for your Gran.
Best wishes
Sue

 

[carolyn]

Hi Dizzy. I am no medical person but I was offered the pump and all I had to do was put the needle in my tummy and that was it, there was NO counting of carbs etc but you do have to keep an eye on the insulin level daily as when that is empty you just put another one in. They tend to give the pumps to younger people (teenagers) or the older person so why not ask it wont hurt.
Good luck with granny and keep us up to date. 🙂
________
Justin bieber fans

 

[Caroline Wilson]

Granny may need more support. My neighbour from about the age of 80 needed lots of support. Luckily there were plenty of people around who could and did.

When you see the specialists/consultant/care team, make a list of questions you'd like answered, and a note of anything you'd like to say. It helps to know what you want to say before you get there, and make notes of any instructions you are given.

 

[Daisy]

Thank-goodness for you! And you are quite right to be horrified by your Granny's levels. Personally I do not think she is a candidate for a pump - Has her medication ever been altered - her tablets increased - is she even on tablets? Unfortunately the NHS do not lead you by the hand and a lot of diabetes management is about self mangement - which I beleive is the best way - look at all the knowledge oon here from self management and people taking responsibility for their diabetes! Unfortunately Granny did not help herself by ignoring letters - I hope you have pointed out the folliness of doing this. I think you should reassure her life won't change too much - just a wee bit extra care. Funny though - as she has not ignored it completely as she has obviously been monitoring! She may just not want to be bothered by more 'people' looking after her - as she obviously quite an independent lady - just stress to her they won't need to if she bucks her ideas up!

 

[Dizzydi]

Can you believe it the DR I spoke to did not turn up at Granny's yesterday - she had to chase them to find out when they were going to see her - I am so annoyed.

However they are going to her on Friday (should have been Thursday, but Granny has Thursday club...lol) and My Sister has arranged to be with her when they come to assess her. My Sister is not diabetic but she does know enough from mum and me and has now got a list of questions to ask for Granny - so hopefully we can get to the bottom of helping to get her bloods to a normal level and trying to keep them acceptable, with the help hopefully of weekly visits for her.

I'm pretty sure Granny will take a little bit more care with someone keeping there eye on her every week. I suspect she has gone back to injecting herself in the same place all the time, which she was doing before which has caused hardening and hence the insulin not getting in. She is a little tinker..lol

Thanks again for your all your kind wise words.

 

[bev]

Hi, i was just wondering how your granny was? Bev

 

[Dizzydi]

Hi Bev,

Granny seems ok, she is still getting very high readings. Someone from the family has been to see her everyday so far this week.

My sister Maz is going to be with her tomorrow when the dr goes to see her. I think she will be admitted to hospital, which is probably what she needs to be able to get BS back under control, which is a shame

I just wish I could get to her more, but it's difficult with work mon to fri - will defo see her on Sat though.

 

[Northerner]

Hi Bev,

Granny seems ok, she is still getting very high readings. Someone from the family has been to see her everyday so far this week.

My sister Maz is going to be with her tomorrow when the dr goes to see her. I think she will be admitted to hospital, which is probably what she needs to be able to get BS back under control, which is a shame

I just wish I could get to her more, but it's difficult with work mon to fri - will defo see her on Sat though.

Tell her she's got a crowd of 800+ people here cheering her on!🙂

 

[sofaraway]

If your granny needs supervision with her insulin, which is sounds like she does to ensure that she is gettign the correct doses and rotating her injection sites then she will need the district nurses to come and give the injections. In my area they will come in maximum of twice a day, so will not be able to give basal bolus insulin. they will give either a once daily long acting or a twice daily mixed insulin. See if you can find out what the DN's will do in your ganny's area.
typically older people will be advised to run higher blood sugars, due to the risk of hypo's, I agree that they are too high at the moment though and could benefit from reducing them somewhat.
she's lucky to have you advocating for her

 

[Dizzydi]

Finally some action from the GP

Granny's GP has just called me.

They are increasing her morning Insulin to 18 units and evening to 20 units. They are also getting the hospital diabetic care team involved who are going to monitor her every week and look at her diet. So thank fully no hospitalisation for her yeah!!

If the increase this way does not work, they are going to try her on injecting with meals ? I presume this will be the carb counting regime x units to x grams of carbs (sorry for sounding stupid I cannot remeber what terminology you use and is still a bit confusing to me as I'm on tablets).

I'm going to have to sit down with my aunt's again who do her shopping and try to get them to buy the right stuff. I did this in Sept last year and when I inspected her fridge/freezer on Sunday I noticed thay had gone back to Granny's bad ways.

So hopefully panic over - I'm going to be keeping my beedy eyes on Granny and her health care team to ensure things get better and stay that way this time.

On a funny note - & I really should not laught. My sister called to say she was at granny's and they had just brought her lunch and I'm presuming the Dr must have seen it as he arrived just after they called me - but Ganny was sat eating a Fish from the chip shop - when Maz told me what they bought her I said that aint gonna help & it was not Maz's fault really as she does not know the do & don't's unlike Granny. But it was what Granny wanted - she is a tinker.

Thanks again for your help and kind words xx

 

[Copepod]

What's so terrible about an 80 year old lady have a fish dinner with a visiting relative?!? It's one meal, not her entire diet - if she's not eating high fat at every meal, and eating some fruit & veg, plus beginning to get the hang of matching carbohydrate intake to insulin, sounds reasonable to me. I can see myself as an 80 year old having the odd fish supper.

 

[Dizzydi]

She has been eating whatever she has been bought and unfortunately pork pies, meat pies etc are not the best and your right the odd battered fish is ok, but it has not been the odd and I'm might sound horrible but I'm trying to get her and the rest of the family to get her to eat good most of the time. I don't want her to go to an early grave

 

[Lizzie]

Does your granny do much cooking? My gran makes chips by oven cooking rather than frying them which is a little healthier, maybe combine them with grilled fish, and frozen rather than mushy peas. She can have the foods she enjoys but find healthier ways of cooking them. Home cooked pies are also better and taste nicer than shop bought ones, I think you can get the pastry ready made. It might be a compromise between denying her what she enjoys eating and eating unhealthy foods. It is hard though with an older person living alone, they don't always have the motivation to cook and eat a healthy diet, especially with your gran's high sugar levels making her feel sluggish.

One thing I have been considering is to organise getting my granny's shopping online. It will mean she can pick and choose what she wants, you can suggest healthier alternatives, and she doesn't have to worry about getting it all home with her. And once you have decided on a shopping list I think you can log in and just order the same thing each time. Then the ingredients are there for her and with modern appliances the cooking shouldn't be too difficult. Would this help you at all?