staff ignored hypoglycemia in elderly woman

[dtrinlaw]

 RANT-- I am new to this forum, but glad to have found it.  My MIL has been recieving hemodialysis since October, it has been a struggle and seems I am always standing up for her rights, she is 81 so is seen as too old and is often not given all the facts by the staff. They seem to think she is senile, which she certainly is not. She was living alone and driving her car up to October. For her safety she is living in a nursing home, hence the attitude from the staff.   She is diabetic on insulin and has had many struggles with nausea and being able to eat enough for her renal diet and to avoid hypo's.  We work so cant go with her to her D.  We see her daily, thougj. Monday eve she told me she passed out from hypoglycemia at DaVita. I asked her what they did about it, "nothing,  I just woke up".    She has a driver who brings her the 10 miles back to her NH, and on arrival there her BG was 61. I called DaVita to ask about the incident.  I was told "They are supposed to bring their own meters and treat their own hypo's, we don't have anything here for that."  I asked what she did for my MIL that day, she said she gave saline, which would be for low BP, right?  It would do nothing for BG.  This is the FIRST we knew anything about her needing to take her glucometer, she can't do it herself now due to nerve damage in her hand from a failed AV fistula, do you suppose the staff even knows how to check a BG???    Aren't many many people on dialysis diabetic??  I am a nurse and am appalled and embarrassed because I thought they were taking care of her better.     Thanks for listening.  I am packing her a care package with meter and carbs to take.

[Lisa]

Hi dtrinlaw

Saline will raise the BP.

I am not diabetic but it seems to me a place where there are RN's they should be able to handle hypoglycemic patients. I cannot imagine they would have to try to check their BG on a meter while dializing then give themselves the insulin, and certainly not an elderly patient.

I would make sure they allow her to snack while on the machine without incident...that seems to be an issue with some clinics due to the BP dropping and patients may either pass out or vomit causing an entire group of different problems.

[jbeany]

My center didn't check glucose, either.  I had good staff, so if I checked mine and it was low, they always offered to go get me juice or candy if I needed anything.  One of my techs even gave me part of her own lunch once.  But that was done out of the goodness of their hearts, not because the center requires it, or because of a standing medical order.  Check with MIL's doc to see if he can make an order for them to check it, even if she still needs to bring her own meter for them to do it.

Saline is, indeed, only a treatment for low bp.  Hopefully, if your MIL brings her own meter, even without a doc's order, the staff will help her check her sugar if she needs to.  I had to check mine frequently, since it was difficult for me to tell the difference between a drop in glucose and a drop in bp.

On the other hand, once your MIL gets more used to dialysis, she should get more of an appetite, and her lows will not happen as often.  The dialysis itself doesn't actually affect blood glucose, but the nausea and the stress it causes certainly can.

[Romona]

I would hope that they would be prepared to handle the low blood sugar. If there such a policy for diabetics, shouldn't the nursing home be aware and make sure everything is with her when she leaves for dialysis.

[Rerun]

Dtrnlaw great post, but please go introduce yourself to us.  You may say the same thing, but at least it will be in the right place.  Just housekeeping rules.  BTW it is good to go read those also.

                 

Rerun, Moderator

[sullidog]

Our techs take care of all of that, now as far as bringing your own stuff, I'm not sure on how that works at our center as I'm not diabetic, I just know the techs watch that stuff.
Troy

[texasstyle]

 I would have to think that you should be able to call the center and speak to someone who will take the time to let you know what is going on and how the center operates. Don't be afraid to call them with your questions even if you have to a couple times. Another suggestion is to talk to her Neph. about these concerns or at least someone at his office. The Neph.'s office of you MIL is most likely back and forth with the center for many different reasons. I hope things get straightend out  so this never happens again.

[kitkatz]

That staff needs to get with it.