Diabetes Care at Home

Care by condition

Diabetes is managed at home, every day, by the person who has it — which works well until something else changes. A stroke, failing eyesight, arthritic hands, dementia, or simply a very long time of doing it alone, and a routine that used to be automatic starts to slip.

Most of the harm from diabetes at home comes from small, boring lapses: a missed meal after an insulin dose, a foot nobody looked at, a repeat prescription nobody collected.

What actually changes at home

• Meals and medication have to line up. Insulin taken and then a meal skipped is the classic route to a hypoglycaemic episode.
• Feet need looking at, and older people frequently cannot see or reach their own. A small sore found late is how amputations begin.
• Eyesight and hands make drawing up insulin and reading a meter harder over time.
• Hypoglycaemia is frightening and fast, and everyone in the house should know what to do about it.
• Dementia and diabetes together is a difficult combination, because the person may not remember whether they have eaten or dosed.

How we help

• Regular meals at consistent times, cooked with diabetes in mind rather than to a joyless template
• Prompting blood glucose checks, recording results, and passing on a pattern that has shifted
• Medication reminders, and administration of insulin by an RN or RPN where the plan requires it
• Daily foot checks — between the toes, the heels, the soles — and same-day reporting of anything broken, red or not healing
• Recognizing hypoglycaemia early and treating it correctly, then telling the family and the prescriber
• Support to get to eye screening, chiropody and diabetes clinic appointments
• Support for children and young people with type 1 diabetes at home, alongside the family and the diabetes team
• Extra structure where diabetes sits alongside dementia and the routine can no longer be self-managed

Who provides the care

Personal support workers can prompt and support a person managing their own diabetes, prepare meals, and check feet. Administering insulin is a regulated act — that is nursing, and we place an RN or RPN where it is needed. If you are unsure which you need, tell us the situation and we will tell you honestly.

Common questions

Can your PSW give my mother her insulin?

No. Administering insulin is nursing work. A personal support worker can remind her, get everything ready, and be present while she does it herself. If she can no longer do it herself, you need a nurse and we will arrange one.

Nobody has looked at my father’s feet in months. Is that a problem?

Potentially a serious one, and it is one of the easiest things to put right. A daily look takes a minute and catches the small injuries that become dangerous when they are found late.

Do you support children with type 1 diabetes?

Yes, working alongside the family and the paediatric diabetes team. Support for a child is about routine, meals, recognizing a low, and giving parents some hours where they are not the only ones watching.

What does the carer do if she goes low?

Treat it immediately with fast-acting sugar following the plan you have given us, recheck, follow with something longer-acting, and then tell you and the prescriber. A repeated pattern of lows is information the doctor needs.

Is diabetes care publicly funded?

Nursing for insulin administration is one of the things Ontario Health atHome most commonly arranges, and it is worth asking about first. Ontario also has funding programmes for monitoring supplies and for foot care in some circumstances.

Where we provide this care

We provide this support across 146 communities in Ontario, from the Greater Toronto Area to Thunder Bay. If your town is not listed, call us — we will tell you honestly whether we can staff it properly rather than promising and then failing to turn up.

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• 24-hour home care
• All 146 communities we serve