Hospice diagnosis

tabshire1

In reference to the lady I care for. I have a concern with conflicting information. Medical records from hospice Dr states type 2 diabetes. Nurse from hospice stated she was not diabetic. I mentioned this to her son and he had zero knowledge of his mother being diabetic. Should I press her son to get answers or am I being overly protective? Please keep in mind this was not a recent diagnosis.

terei

I’m not sure whether it makes any difference to her care, frankly. Especially if she is on hospice

Quilting brings calm

lots of type 2 diabetics control their numbers solely through diet and exercise. Others through oral or shots depending on the numbers. So if she is not on medication for it, the nurse may not consider her a diabetic. Hospice will have evaluated her numbers and eliminated medications that are no longer needed for comfort. In my opinion, she’s not going to have long term complications at this point.

towhee

Sometimes when someone loses significant weight their numbers will drop back into the normal range. I would not be giving her undiluted fruit juice or coke or anything else that is pure sugar with no redeeming value, but at this point, on hospice, since you brought it up to her son, I think your responsibility is ended. It is between the family and the hospice team.

harshedbuzz

A couple of things could be in play here.

Firstly, by the time a PWD would qualify for hospice care, they'd likely be end-stages and losing weight. Dad had T2. By stage 6 was losing weight; in his last 15 months he lost close to 30% of his body weight and his A1C and fasting glucose were mostly in normal range.

Secondly, by the time a PWD is on hospice the focus is on comfort care rather than preventative treatments. Dad's geriatric doctor culled his daily medications in stage 6, well before he would has qualified for hospice. Among the drugs he stopped were metformin and a statin because the downside of side effects (stomach issues from the former and muscle pain from the latter) he couldn't report outweighed any benefit they would have had for someone who was reaching the end of a terminal disease. We prioritized his pulmonary and mood medications.

You were wise to share your concern with her son but it's his choice to act on the information or not.

HB