VDBD calls for comprehensive diabetes training for long-term care residents and secure financing
26.09.2023 12:30
If people have a chronic illness, the amount of care required in old age is particularly high and complex. Already today, people with diabetes mellitus - especially type 1 diabetes - receive inadequate care and care in nursing homes, warns the Association of Diabetes Consulting and Training Professions in Germany. V. (VDBD).
Nursing staff are rarely trained in the latest therapies and patients therefore have to forego effective and safe forms of therapy. Relatives are also often overburdened by the increasing demands. If nothing changes in the situation, thousands of people with type 1 diabetes would be underserved in the future. The association therefore calls for comprehensive training courses for nursing staff in long-term care as well as relatives and uniformly secured financing and provision of diabetes training.
In Germany, it is estimated that over 100,000 people over the age of 70 have type 1 diabetes - and the trend is rising. If they can no longer manage their diabetes themselves, relatives, nursing services or nursing staff in nursing homes are required. “For older people, maintaining their independence is the primary therapeutic goal,” explains VDBD board member and diabetes consultant Yvonne Häusler. “Since geriatric illnesses such as loss of fine motor skills or dementia also play a role in many older people with type 1 diabetes, competent and reliable therapy support should be possible at all times.” However, neither maintaining independence nor providing appropriate support are possible The expert criticizes that the current supply situation in nursing homes is guaranteed. Family members are also often overwhelmed in their private lives.
Type 1 diabetes in old age requires intensive care
Older people with type 1 diabetes require specialized care and support to ensure that their health needs are adequately addressed and that life-threatening or life-limiting complications do not occur. This includes an individual care plan that precisely coordinates medication, meals and activities. In addition to regular monitoring of blood sugar levels and appropriate insulin doses, diabetes complications such as foot problems or eye and kidney diseases should also be kept in mind. “Nursing homes must ensure that appropriate testing equipment is available, that nursing staff are trained in diabetes, insulin administration and management and are able to recognize emergency situations such as impending hypoglycemia,” explains Häusler. Clear and careful documentation is also important in order to be able to adapt care plans in consultation with medical staff.
Too little time, too little knowledge
However, these complex procedures are rarely performed in retirement homes or in outpatient care services. “If anything, the attention is more on type 2 diabetes, which occurs much more frequently in older people and requires significantly less care,” explains VDBD board member and diabetes consultant Theresia Schoppe. “Our experience shows that nursing staff are unfortunately rarely given time off for appropriate diabetes training. They often have to do the training in their free time.”
Another problem is that as diabetes technology becomes more complex, the level of knowledge among carers decreases drastically. Currently, residents are usually forced to hand over their insulin pump and CGM meter at the nursing home gate in favor of conventional insulin syringes. “If we invested in appropriate education and training at this point, those affected could continue to benefit from safe and effective technological support in the future. At the same time, the nursing staff would be significantly relieved because meals, exercise and insulin administration can be coordinated and monitored digitally,” says Schoppe. The same applies to caring relatives.
The need for well-informed nursing staff and relatives is increasing
More and more people with type 1 diabetes are using new technologies, which also increase life expectancy. The need for competent care is therefore increasing. In addition to the training courses for carers, the VDBD also offers the “DiaLife” training program, which is explicitly aimed at relatives. However, training for relatives is currently not available in the health insurance provider's catalog of services and must be privately financed. “Those interested should seek advice from their treating diabetes team in this regard,” advises Schoppe.
The VDBD demands that training courses for carers, relatives and patients be uniformly regulated and financed. According to Häusler and Schoppe, it should not be a coincidence whether people with diabetes receive appropriate care. The diabetes consultants point out that the VDBD training program already provides a sufficient basis for this. Your appeal goes to those responsible for care facilities, health insurance companies, but also state politics to create a structured and secure financing and care framework.