Which housing option is best for someone with diabetes?

Smiles asked...

My mother is 83 and has been diagnosed with dementia. She also has type 2 diabetes. I recently placed her in a board and care home and found out after wards they cannot check her blood sugar - what other options do I have?

Expert Answer

Theresa Garnero is clinical nurse manager of Diabetes Services at California Pacific Medical Center in San Francisco.

You have a few options to help your mother get the care she needs. Start by speaking to the Director of the board and care facility about your concern. Is it in their policy to not perform glucose monitoring? What were you told when your mother was being admitted to the facility? Ultimately, board and care facilities make their own rules.

You can also discuss this issue with her physician. Depending upon which diabetes medications your mother takes, her doctor might opt for an every three month glucose average blood test (the A1C) in lieu of daily monitoring. This is a common approach for people who cannot check their own glucose and who are not at risk for hypoglycemia (blood glucose less than 70 mg/dl caused by insulin or certain diabetes pills like Glucotrol or Amaryl). Certainly, ongoing monitoring is important, but in some situations checking the A1C may be the best way to measure diabetes health.

Another consideration is home care. If your mother has an acute or recent health issue, she may qualify for that service which includes visiting nurses who could also check her glucose. You can discuss this with her physician as well. If she does not qualify and you have the financial resources, hiring a home health aide a few times a week may be a possibility.

If staying at this board and care presents a safety issue for your mother, you may need to work with your local Ombudsman office (check your local directory or call information) to help with your advocacy efforts. You may need to consider other facilities that provide a higher level of care. If you contact your local hospital and ask to speak to a medical social worker, they can help point you in the right direction.

I wish the best for your mother. She's fortunate to have you there to help.