Diabetes management depends on daily routine: meals at regular times, medicines taken as prescribed, blood sugar checked when the clinician says. For an older adult who lives alone or whose memory is changing, that routine can slip. A skipped lunch after a morning dose of insulin can lead to low blood sugar. A forgotten pill can push blood sugar high.
This guide is for families arranging support at home for a person with diabetes.
What daily support can include
Preparing meals and snacks that follow the clinician’s or dietitian’s plan, at regular times
Reminding the person to take medicines and check blood sugar
Writing down blood sugar readings, meals, and anything unusual
Helping with bathing and checking the feet for cuts, blisters, or color changes, then reporting what was seen
Driving to appointments and picking up supplies
A personal care aide does not give insulin or change doses. The person, a trained family member, or a nurse gives insulin, following the clinician’s plan. OPA offers skilled nursing at home.
Know the signs of low blood sugar
The CDC considers blood sugar below 70 mg/dL low (CDC). Low blood sugar can cause shakiness, sweating, fast heartbeat, hunger, irritability, confusion, or sleepiness.
The CDC describes the “15-15 rule” for a person who can swallow safely. Have 15 grams of fast carbohydrate, such as half a cup of juice or regular soda. Wait 15 minutes, check again, and repeat until blood sugar is 70 or higher. The CDC treats blood sugar below 55 mg/dL as severe, and it may need glucagon; ask the clinician whether to keep glucagon at home. Ask the person’s clinician whether this plan fits them, and write the plan down where any caregiver can find it.
Call 911 if the person cannot swallow safely, will not wake up, has a seizure, or does not improve after treatment.
Know when blood sugar is running high
Ask the clinician what readings should prompt a call, and keep those numbers next to the meter.
Keep the records in one place
A log of readings, meals, medicines, and symptoms helps the clinician adjust the plan. OPA’s free Observation Log and Medication Reconciliation worksheet work well for this. OPA’s guide to writing down what you see shows how.
A first step this week
Ask the clinician for a written low blood sugar plan and the readings that should prompt a call. Post both on the refrigerator.
To arrange help with meals, reminders, or nursing at home, see how care starts at OPA.
This is general information, not medical advice. Follow the person’s clinician’s diabetes plan, and call 911 for an immediate emergency. Rules on what aides and nurses may do are set by state law and provider policy. Confirm current requirements before acting.
Clinical guidance for the home plan
The NIDDK's diabetes-management guidance explains the role of an individual plan for glucose, medicines, and daily habits. Use this guidance to prepare questions for the treating team; the person's own clinical instructions determine the care plan.
The NIDDK's low-blood-glucose guidance describes the need to recognize and respond to low glucose. Use this guidance to prepare questions for the treating team; the person's own clinical instructions determine the care plan.
Turn the instructions into a shared home plan
Use the Care Coordination Grid from OPA's Knowledge Center to name who handles appointments, daily routines, and the next handoff. Keep the treating team's instructions and contact details alongside the schedule. Talk with OPA about personal care at home when the household needs another layer of help, and confirm the specific tasks and schedule before care starts.
