Teaching the Developmentally Disabled to self-administer Insulin

[sherbearccrn]

Hi All

I was hoping to get some suggestions on teaching Developmentally Disabled Clients to give themselves Insulin injections. I'm only finding results of studies that have been done in the past. Any suggestions or references to sites I can explore would be much appreciated.

Thanks in advance:),

Sherbearccrn:nurse:

[Atl-Murse]

Sounds Like a bad idea

[OneDuckyRN]

Sounds Like a bad idea

I don't know about that...I think it probably depends on the degree of developmental delay. I think some might require reminders, while others would need supervision, and still others should probably not be self-administering.

OP...can you enlighten us at all?

[sherbearccrn]

Sounds like a bad idea to research it???

[KelRN215, BSN, RN]

Need more information. Developmental delay is a broad category.

[Been there,done that, ASN, RN]

What would be the point of teaching insulin administration.. if the client cannot comprehend the rationale of controlling blood sugar levels with insulin administration?

[TheCommuter, BSN, RN]

There are four levels of intellectual / developmental disability (IDD). Many persons with mild intellectual disabilities can be taught to self-administer insulin.

However, individuals with moderate, severe, and profound retardation cannot ever be taught to self-administer insulin.

[sherbearccrn]

I agree :)

[TheCommuter, BSN, RN]

Moved to the Nursing & Patient Medications forum for more feedback.

[quazar]

It's anecdotal, but maybe seek guidance from your local ARC or Autism Society? I personally don't know any DD insulin dependent diabetics, but I don't think it's totally out of the realm of possibility, depending on the client. My own child is DD, and I have found the best source for finding information like this is asking parents/caregivers and/or therapists. They have usually been very helpful in pointing me in the right direction.

[vintagemother, BSN, CNA, LVN, RN]

I had a client before whose care plan required s/he be taught to self administer insulin. S/He was not DD, if I recall. However, s/he had severe mental illness that interfered with his ability to appropriately manage his DM I.

S/He presented as slightly "slow", and s/he may have had some cognitive issues.

We started off by involving the client in his/her own care. Eg- where would you like your insulin administered? This helped us to determine that s/he knew appropriate sites to self inject.

We gave the client a written copy of the SS.

As time progressed, we asked the client to read the glucometer, and later, to tell us how many units were to be given.

As more time progressed, we allowed the client to self administer after we drew.

Later on, we allowed the client to draw up insulin and after the nurse verified the dose, s/he was allowed administer.

We also "quizzed" the client on s/s of hypo/hyperglycemia so that s/he could identify situations that warranted additional sugar/insulin.

The process took close to a year before the client was able to be "checked off" on his/her ability to manage DM and subsequently be D/C-ed.

*** I apologize for the use of the phrase "we allowed" the client to do X,Y,Z. I feel that phrase flies in the face of pt rights to autonomy. However, it's a simple way for me to describe the step by step increases in the clients ability to manage his/her DM.

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