By msann Latest Reply 2008-10-30 00:08:05 -0500
Started 2008-10-26 14:41:42 -0500

sorry, discussion i started earlier, i work in mentally changed residence have 12 clients, this one in particular weigh 400 lbs, have been not doing what she needs to do, bsl be over 200- 396 every day, she take about 5 pills for diabetic and 90 units of insulin a day, she doesnt seem to care, ideas please

4 replies

Pauline B
Pauline B 2008-10-30 00:06:36 -0500 Report

Having worked in a psych hospital and in several nursing homes, I know there is a care plan for each patient that must be followed, and that items on the care plan must be charted it was done, refused, not done, forgotten, etc. Do you have authority to read the Care Plan? If not, talk to your supervisor to see what you can do to enhance the client's quality of life.

The client has the right to refuse care. But the client really has to know that he is doing so. He can be a "mental case" and still be legally sane. It's a real "Catch 22."

Good luck dealing with this issue. It's not easy dealing with a non-compliant client when no-one seems to care.

Pauline B
Pauline B 2008-10-30 00:08:05 -0500 Report

I didn't read previous reply before composing my own; I was citing my own experiences from years of work.

Avera 2008-10-26 17:09:04 -0500 Report

In a care facility such as this and with a mentally challenged resident, certain foods can be eliminated from access. If a person is mentally challenged, then the caregiver has to limit the diet. The client will have no idea how to do it. A meeting of all caregivers working with this resident needs to be held and a plan of care can be devised to help. If the people who own and run this residence do not devise a plan for the client, then call Social Services. They will make sure one is done and like always, Social Services will not tell the owners who called.

John Crowley
John Crowley 2008-10-26 15:18:54 -0500 Report

That is really a frightening situation. Certainly those blood sugar numbers are wildly out of control. Something needs to be done. However, if you are not the doctor, it really puts you in an awkward position and possibly dangerous position. If you tried to give more insulin for instance, you might drop the blood sugar too low. How could you explain your choices if you are not authorized to prescribe.

However, your client must feel awful all the time. The headaches and sweats and everything that goes with high blood sugar. If you can help your client understand that he/she will feel so much better if they will start eating healthier, getting some exercise, and following their doc's orders on meds, then you can be a support in all those areas. You can encourage healthier eating. You can suggest appropriate exercises. And you can help him/her take meds at the prescribed times and doses.

If there is no progress, you can help document that your client has been following the prescribed treatments and isn't seeing good results. Your documentation can help the doc to design a more aggressive treatment.

I hope that helps some.


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