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People living with diabetes resident in nursing homes : assessing levels of disability and nursing needs

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Gadsby, Roger, Barker, Peter and Sinclair, Alan (Alan J.). (2011) People living with diabetes resident in nursing homes : assessing levels of disability and nursing needs. Diabetic Medicine, Vol.28 (No.7). pp. 778-780. ISSN 0742-3071

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Official URL: http://dx.doi.org/10.1111/j.1464-5491.2011.03261.x

Abstract

Aims To describe the degree of disability and nursing need of people living with diabetes resident in nursing homes in one Primary Care Trust in the UK.

Methods A retrospective case notes review of 75 people with known diabetes who were resident in the 11 nursing homes in Coventry Teaching Primary Care Trust.

Results Very significant levels of disability and nursing need were documented in areas of continence, feeding, mobility and communication. Each individual had a mean of four co-morbidities (range 1-8), excluding diabetes. Using the definition of terminal illness based on a negative answer to the question 'would I be surprised if my patient were to die in the next 12 months' it is likely that the majority of individuals described in this study would be classified as being terminally ill.

Conclusion Using four practical clinical measures, this study has shown very significant levels of disability and nursing care need in this population of mainly elderly people resident in nursing homes in Coventry. In addition, it has demonstrated that a large proportion of nursing home residents with diabetes can be considered to be in the terminal phase of life, a period where many other factors interplay in how care should be delivered and what outcomes are appropriate. In fact, residents in this category may well be candidates for a considered withdrawal of treatments, but not of care.

Item Type:

Journal Article

Subjects:

R Medicine > RC Internal medicine

Divisions:

Faculty of Medicine > Warwick Medical School

Library of Congress Subject Headings (LCSH):

Diabetes -- Patients -- England -- Coventry, Nursing home patients -- England -- Coventry

Journal or Publication Title:

Diabetic Medicine

Publisher:

Blackwell

ISSN:

0742-3071

Official Date:

July 2011

Dates:

Date	Event
July 2011	Published

Volume:

Vol.28

Number:

No.7

Page Range:

pp. 778-780

Identification Number:

10.1111/j.1464-5491.2011.03261.x

Status:

Peer Reviewed

Publication Status:

Published

Access rights to Published version:

Restricted or Subscription Access

Funder:

Novo Nordisk, Takeda UK (Firm)

References:

1 Benbow SJ, Walsh A, Gill GV Diabetes in institutionalised elderly people: a forgotten population?
MBY 1997 314:1868-1870
2 Sinclair A, Gadsby R, Penfold S et al Prevalence of Diabetes in Care Home Residents Diabetes Care 2001 24:1066-1068
3 Aspray TJ, Nesbit K, Cassidy TP et al Diabetes in British Nursing and Residential homes Diabetes Care 2006 29: 707 – 708
4 Shah A, Bruce M, Willson C et al The care of people with diabetes within a primary care trust Journal of Diabetes Nursing 2006 10: 289-296
5 Breslin E The standard of diabetes care in Nursing homes in South and East Belfast Journal of Diabetes Nursing 2009 13: 109-117
6 Diabetes UK Good Clinical Practice Guidelines for Care Home Residents with Diabetes
London Jan 2010 www.diabetes.org.uk
7 Black SA, Ray LA, Markides KS. The prevalence and health burden of self-reported diabetes in older Mexican Americans: findings from the Hispanic established populations for epidemiologic studies of the elderly. Am J Public Health 1999 April;89(4):546-52.
8 Gregg EW, Beckles GL, Williamson DF, Leveille SG, Langlois JA, Engelgau MM et al. Diabetes and physical disability among older U.S. adults. Diabetes Care 2000 October;23(9):1272-7
9 Sinclair AJ, Allard I, Bayer A. . . Observations of diabetes care in long-term institutional settings with measures of cognitive function and dependency. Diabetes Care. 1997 May;20(5):778-84.
10 Murray SA, Boyd K, Sheikh A Palliative Care in chronic illness BMJ 2005 330:611-612
11 Fahey T, Montgomery AA, Barnes J, Protheroe J Quality of care for elderly residents in Nursing Homes and elderly people living at home: controlled observational study BMJ 326: 580-585

URI:

http://wrap.warwick.ac.uk/id/eprint/38794

Data sourced from Thomson Reuters' Web of Knowledge

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