Planning your future care with type 1 diabetes

Planning ahead for your future care can make that transition smoother and give you confidence that your care will remain safe, consistent, and respectful of your wishes.

A diabetes care plan is one of the best ways to make sure your needs are clearly understood by family, carers, and healthcare professionals. It can cover things like:

• Your insulin routine
• How you use your type 1 technology
• What to do in an emergency

If you’re going into hospital or moving into a care home, a simple checklist of key information can help make sure your care continues without interruption. Keeping a printed copy of your care plan in your hospital bag or care home file ensures staff have immediate access to your routines and preferences, especially important if you’re unable to communicate them yourself.

Wherever you are, you should remain involved in your care and have access to the technology you choose.

“Thinking about the future can be difficult, but it is important so that those close to you know about your wishes. Having discussions with your diabetes team, your loved ones, and your carers about your wishes can help with planning for the future, and in selecting the right option for care that meets your priorities.” – Dr Jonathan Golding

Support from families and carers

If your family or carers help you, it’s important that they understand the specifics of T1D. They can support you with daily tasks like checking your glucose, giving insulin, and spotting signs of high or low blood sugar (hyper or hypo). Good communication helps everyone feel more confident and less stressed.

Carers should also know that T1D is different from type 2 and requires its own specialist knowledge and training. You may want your family to be part of decisions about your care or included in consultation meetings within care settings.

District nursing

District nurses can visit you at home to help with tasks such as insulin administration, wound care, and monitoring your overall health. They often work closely with your GP and diabetes team and are especially helpful if you’re recovering from illness or need temporary support.

When district nurses are needed for insulin administration, sometimes your insulin will need to be changed to a different type. This is normally to reduce the number of times insulin needs to be given.

Relying on district nurses for insulin administration can be challenging and often requires you to be available at home for several hours a day to wait for the nurse to arrive. It can be difficult for nurses to time visits with meals, and as a result glucose levels can become more variable.

Although timings can be challenging, support from District Nurses does allow you to stay in their own home, which might be your preference.

Residential care homes

Residential care homes offer 24-hour support in a community setting. They’re suitable for people who need help with daily living but don’t require intensive medical care. They have staff who can help with personal care such as washing, dressing, taking medication, and going to the toilet.

They might also offer social activities and day trips for residents. It’s important to check that staff are trained in T1D management and understand your insulin and technology needs.

Check with the individual care homes to find out how they could best support you.

Sheltered housing/assisted living

Supported living arrangements that allow you to live independently with access to help when needed. This is accommodation that you can purchase or rent and provides additional levels of assistance, beyond just a place to live.

This typically includes on-site staff, emergency call systems, and opportunities for social activities. It’s designed to help older adults live independently while having access to help if needed. It is important to check with them what specific support they would be able to offer for T1D.

Assisted living offers more support than sheltered housing but more independence than a care home. Unlike sheltered housing, assisted living is regulated by the Care Quality Commission (CQC).

Nursing homes

Nursing homes provide more complex medical care, including support for people with multiple health conditions. These offer personal care as well as qualified nurses on-site and can manage more advanced needs.

The constant presence of nurses means that insulin can usually be given with each meal, which can help with glucose management. You should be able to eat what you want in a nursing home and should not feel your choices are restricted by trying to manage your glucose levels.

Home care services

Home care services can help you to look after yourself and your home so that you can stay independent for longer. They can support you with daily routines like checking blood glucose, preparing meals, giving insulin, and helping with mobility. This option allows you to stay in your own home while receiving tailored support from trained carers.

Your voice matters

Whatever care setting you’re in, your voice matters. Share your routines, preferences, and concerns openly. When moving into a new setting, ask questions about:

• Staff training
• Emergency procedures
• How decisions will be made with you

Good care is about you. It should help you stay safe, independent and in control at every stage of life with T1D.