Home Health Care and Diabetes Management
For patients with Diabetes, optimum control of blood glucose can make a significant contribution in preventing diabetes related complications. Failure to do that, can lead to serious health issues. Often, these patients are undertreated due to poor understanding of the disease process and non-adherence to treatment protocol. With improved control of their blood sugar level and more aggressive management of risk factors for other related complications like macro and microvascular diseases, these patients can benefit in abundance. Hence, to gain control of the disease, patients need an effective monitoring in place which could help with their self-care and adaptation to disease. In today’s setting, with changing lifestyle and rising costs, home monitoring and home health care are proving to be increasingly valuable tools for enhancing quality of care in diabetes management.
Home Health care for diabetic patients helps them and their families manage the patient’s complex medical needs, monitor blood sugar level patterns and insulin use, in addition to making them understand the medical regimen involved. The benefits for patients include better access, lesser visits to the doctors and labs, reduced episodes and duration of hospitalizations, reduced travel time and expenses. For hospitals, it offers continuum of care to their patients, better patient compliance to the treatment protocol and overall, better experience for the patients. With efficient home monitoring and communication processes, the physicians will be always be in the loop on patient status, thus helping them understand the his/her needs better. Thus, home health care provides an opportunity to offer a continuum of care that further improves health, wellness, and outcomes.
According to a recent clinic based survey called Screening India’s Twin Epidemic, one in every three adults living adults living in cities suffers from diabetes. 60% of those studied suffered from hypertension or diabetes or both. According to Dr. Shahshank Joshi, the principal investigator of the study, these numbers only show how uncontrolled the diseases are. He believes that this is due to people not monitoring their sugar or blood pressure regularly. Only 1.9% of those studies had control over these standards.
18.4%, of those tested had a condition called pre-diabetes. Extrapolations from the recent ICMR study say that India has approximately 75 million people suffering from diabetes. But it is estimated that double the number have pre-diabetes. These numbers only show the magnitude of this epidemic facing us.
How Can India Home Health Care Help?
Through it’s highly skilled and trained professionals, India Home Health Care offers the patient, a complete ranage of services that improve the quality of life.
1. Registered Nurses: Our Registered Nurses provide support by working closely with the physician and evaluating the patient’s needs related to Diabetes and any other co-morbid condition. This leads to the development of a cutomized care plan. The nursing care plan helps in gaining control of the disease by monitoring blood sugar levels, ensuring that the patient is taking the medication as prescribed and understanding the lifestyle changes that need to be made.
The nurse visits on a regular basis, depending on the patient requirement, and will also help with procuring the medication and other supplies for care. Through these visits, the nurse develops a good understanding of the patient’s health status and is be able to assess the progress of the disease condition accurately. This in turn helps him/her to review and revise the care plan as per patient’s needs.
The nurse will specifically assess vitals, blood glucose levels; monitor the development of diabetes related complications, including neuropathy, nephropathy, retinopathy, diabetic foot and other comorbid conditions.
2. Care Takers: Care Takers will provide basic personal care on a continuous basis and help the patient with activities of daily living, including bathing, dressing, grooming and mobilising. They can also check the patient’s vitals, monitor the glucose levels etc.
3. Wound Care Nurses: Our Registered nurses provide advanced care for those diabetic patients with diabetic foot, skin infections or other wounds. This specialized care provided by implementing international best practices helps in the patient recovering faster and preventing further complications.
4. Physiotherapist: Musculoskeletal manifestations of diabetes include frozen shoulder, back pain, carpal tunnel syndrome, sciatica or osteoarthritis. Diabetic amyotrophy is a type of neuropathy that involves muscle wasting and weakening, especially in the thighs. In all these conditions, daily physiotherapy can help in returning to normal levels of activity and wellbeing. Our physiotherapist visits you at home, does an assessment and develops an exercise regimen for you that are supervised by him/her on a daily basis.
Case Study 1
Mr. Aravind, (name changed), a 45 year old executive working for a MNC was diagnosed as a borderline diabetes in July 2009. However, he did not take the doctor’s advice to keep the disease in control, at that time, due to lack of time and stress related to work. In June 2011, he realized that he has gained 10 kg in the last two years and that he was not feeling fully fit. On consulting the physician again and after performing a battery of tests, he was diagnosed to have Type 2 Diabetes Mellitus, Hypertension and Hypercholesterolemia. This came as a shock to Mr. Aravind and he was not sure how he could manage his lifestyle and take control of his health, given his hectic lifestyle. The physician after prescribing medication for the conditions diagnosed and counselling him, thought it best to refer him to India Home Health Care (IHHC) to seek the partnership of a Registered Nurse to help Mr. Aravind and his wife on how they could tackle the issues at hand and take control. Together with the physician, THE nurse developed a care plan to manage the disease and the comorbidities. The first month, nurse visited them on a daily basis to understand their lifestyle, to educate them on healthy choices, to teach them how to use a glucometer and to record the readings, to ensure medication compliance, to provide constant feedback to the physician on the blood sugar levels in order to titrate the medicine against the levels. By the end of two months, the sugar levels, BP and cholesterol came within the acceptable range. The patient and his wife were much more confident to handle the situation and the nurse continues to visit them on a weekly basis to ensure that the care plan is followed and the blood sugar levels are in control.
Case Study 2
Mr. Ramakrishna, 80 year old man, living with his 75 year old wife has been a diabetic for the last twenty years. In November 2010, Mr. Ramakrishna met with a road traffic accident and was admitted to a hospital for severe lacerations in his right foot. His fasting blood sugar, at the time of admission, was 200 mg/dl and he was put on insulin to bring down the glucose levels. He had a series of complex surgeries to restore the functions of his foot. However, during the hospital stay, he had developed pressure ulcers and he was apprehensive about using the insulin syringe. Hence, he was discharged to the care of India Home Health Care. IHHC provided him with a 24 hour caretaker to help him with the activities of daily living, a Registered Nurse to visit every day to administer insulin, record his blood glucose levels, dress the pressure ulcers and to watch out for their complications and prevent them and a physiotherapist to visit to get his mobility and strength back. After three months, he was fully mobile and the ulcers were healed. The nurse still visits him every day to administer insulin and check the glucose levels.
Source – * The Times of India, Tuesday Nov 8th 2011