Hi. My questions here are usually in reference to my Mom who has AD and is a NH. Tonight, however I have a question related to my Dad who I think might be starting to exhibit signs of dementia as well. He lives alone with alot of help from me (medication and medical management, chauffer to all destinations, groceries, light cooking and housekeeping). He is an insulin dependent diabetic.

Recently, my dad had to have two toes amputated due to osteomylitis. He has been in hosptials and rehabs for the past 4 months. His health has declined quite a bit due to repeated infections, but will hopefully return to his baseline in time. He will continue to need at least another 3 months of healing with skin grafts and weekly treatment with the Wound Clinic and his with his primary care doctor (which I take him to). He just came home this week. He will have visiting nurse and physical therpy services for a while and an aide to help with a shower. I am staying with him for 2 weeks to help him with the transition home, but can't stay longer as I have a family to care for too. He was invited to live with me, my husband and 3 yr. old daughter, but he really does not want to and maybe I am not pushing it as I know it will not be easy on any of us. Anyhow, he seems to have lost some abilities since he came home. One significant ability is preparing and giving himself insulin. He seems to forget that he needs to do this twice a day, the amount of insulin for each injection, and the proper procedure (such as using an alcohol swab to disinfect).

Does anyone know if Medicare offer any services to help with providing a nurse to come in twice a day to administer insulin? Honestly, I am burnt out. As is I am at my Dads house at least every other day to change a pain patch he wears, fill pill boxes, cooking, housework etc. and anything else he needs. I have no time for me and my little girl and feel tremendously guilty about it. I also visit my Mom everyday at the NH and need to be there to advocate for her. I can't add going to my Dad's house (20-30 minutes away) everyday at the right time for insulin injections. Even if he was living with me, I am not sure I could commit to being available day in and day out for injections or to actually give an injection. I am a bit squemish with needles.

What do other do in this situation?

Thanks

Maire,

I'm not sure about this specifically, since I haven't had to deal with anything like twice-a-day injections and Medicare. But if he is currently in a rehab program with a visiting nurse, that should be a Medicare-covered treatment. You need to talk with the nurse and ask about the injections. Or you could contact Medicare directly, either online or by phone. They will be able to tell you for sure.

Maybe someone else may have more direct experience with this.

When my father first became insulin dependant, Medicare paid for a nurse to come for a short period of time (I'm thinking only 2 or 3 times) to teach him how to do it himself. At the time, I was visiting and helping Mom with his care following heart surgery. Medicare would pay for home health visits by nurses and aides only for a short recovery period following his discharge from the hospital. They would not pay for long-term routine care services like what you are describing.

It really sounds it may be time for your father to no longer live alone. You'd be smart to start looking at your options, because you will run yourself ragged running over there twice a day to do injections.

Plus, if he is forgetting his insulin, what else is he forgetting? Is he eating a balanced diabetic appropriate diet? One of the things my Dad did was forget to eat after taking his medication, resulting in low blood sugar induced falls. Medication and diet management is the primary reason we had to move him to assisted living two weeks ago. He couldn't manage it, my sister could not continue to run over there several times each day, and her home is unsutable for him to live with her (only 2 BR and 12 steep steps to enter/leave the property).