Home Health Care and Diabetes Assessment, Care, and Education

Abstract

As hospitals, cognizant of the Diagnostic Related Groupings re-imbursement criteria, continue to shorten patients’ lengths of stay, home health care is increasingly relied upon to holistically address the needs of patients at home. From a more positive standpoint, health care in the home environment is more comfortable for patients, offers less risk of infection, saves health care dollars, and lends itself to the promotion of ongoing strategies to improve patients’ quality of life. Diabetes mellitus, whether type 1 or type 2, offers special challenges to home health care providers worldwide. A study funded by the American Diabetes Association (ADA) found that “diabetes is rarely a focus of care for patients with diabetes when they require hospitalization for other conditions.”1 The diagnosis of diabetes may not even be included in the hospital records of people who have diabetes. According to Jeffrey B. Halter, MD, a professor of internal medicine and director of the Geriatric Center at the University of Michigan in Ann Arbor, “Treatment of high blood glucose levels is often ignored in older people or relegated to secondary importance because of perceived barriers that often do not exist.”2 A recent epidemiological study found that 42% of the diabetic population in the United States is 65 years or older. This proportion is projected to increase to 53% by 2025 and to 58% by 2050.3 That is of concern because people with diabetes and hyperglycemia face a greater risk of major cognitive decline or physical disability than do those without diabetes. In addition, hyperglycemia in the elderly can cause poor sleep, nocturnal falls, incontinence, dehydration, impaired mobility, falls, and visual disturbances that interfere with self administration of insulin.4 Yet diabetes is often put on the back burner of elderly patient care. Experts estimate that, in caring for the …