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She has orders for sugar free and low carb meals selected, but they are completely ignored. At every meal she is given sugar sweetened lemonade and tea and desserts and tons of carbs. Then the staff gives her a hard time for refusing to eat those items. I am having to pay out of pocket to buy her food that won't destroy her health further and I am already strapped. I'm guessing their food budget is tiny. I worked at a facility like this as a chef and the budget was $5.00 per resident per day for all meals combined not for each meal, but for all meals total. They gave me a menu designed by a dietitian I had to follow but the budget wasn't even enough to order what I needed to follow the menu. I left after 3 months. I don't understand why they would have standing orders where my mom is staying for nutrition if they are unable to meet them. Can anyone give me some advice?


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I guarantee your mom is not the only diabetic in there. Contact the adminstrator in charge of the whole place and request a meeting with them, the director of nursing, and the dietician. Make it REALLY clear that it is their job to meet dietary requirements, and you expect your mother to be given the proper diet. Ask to see a week's worth of menus for the diabetic patients, too, to ensure they even have such a menu.

My mother's nursing home gave her soups and other salty items when she was on a low-salt diet and had severe edema. Because she had dementia and was basically blind, she couldn't order from theiI put a sign on her door that said LOW SALT DIET ONLY, and had the meeting I described above, and you'd better believe they cleaned up their act.
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Snfs are regulated by Medicaid and Medicare. The last thing they want is for you to initiate a complaint with the ombudsman over doctor ordered meals.

I would request one last meet with the top cats and say, look, my mom needs to be fed her doctor prescribed diet and there shouldn’t be any reason to escalate things. Hopefully they see what you mean.
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You need to contact the Ombudsman if you have already had a meeting with the Executive Director and the Director of Nursing.
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anonymous1732518 Nov 11, 2023
Dietitian should be doing this
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Not really. I mean, this isn't something WE can take up with them.
Are you certain that you are correct?
This would be exceptionally unusual, because as you can imagine it would/could cause diabetic crisis, more staff needs, hospitalizations and absolute chaos.

You have, I am assuming, spoken with the administration?
What do they say to you about this negligent behavior?
It may be time to call an ombudsman.
A facility could literally lose their licensure over such a thing.
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cebswood Nov 11, 2023
Yes, I'm certain. I've been there when they served the meals, and taken pictures of what they served, as well as tried the food and drinks. My mom has a cell phone and has taken pictures and sent them to me, as well. They also would never give the residents there insulin at the correct times so it was less effective. My mom pushed back for months until they finally started doing it correctly. I do need to speak to the administration l. My mom fears harassment from the staff of she complains too much because it's happened several times. She's been yelled at for things completely out of her control. However, she was at a previous facility that was much worse and she is worried if she leaves were she is she could end up someplace like that again. We did speak to the ombudsman about the previous place but we have no idea if anything was done. It certainly didn't improve anything for her.
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This is horrible! Obviously this will/is negatively improving your mom's health. If your mom's A1C is increasing under their care, then they are being quite negligent and it really should be fixed.

The easiest fix would be on the drinks. Nothing but water and plain coffee or plain hot tea.

Meals - I would think/hope that there are ingredients in their kitchen that could make a diabetic friendly low carb meal. For example, there are often meat, carbs and veggies at most meals. So, ditch the carbs and give her more veggies? I am probably being overly simplistic but seems like something MUST be done. How about sandwiches? Without the bread? My mom's AL offers sandwiches as an option at lunch and dinner so I would have her just get the meat and cheese.

I would be talking to someone there ASAP. This would make me crazy!! So negligent!
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I understand. We had to let the staff and dietician know several times that my MIL didn't like sweet tea to begin with, and she would not drink it if it was on her tray. After a few months of letting them know what she could eat and drink, they finally settled into a routine of bringing her better food. She still preferred the food that we brought in, but then again, who wouldn't? The food there was not that appealing to the senses, unfortunately.
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anonymous1732518 Nov 11, 2023
Sounds like the food here.

They serve whole milk or 2 percent milk. The very rare time they had skin or non fat, the skin had spoiled. Non fat was there one day gone the next; they have even served chocolate milk at dinner.
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Is your mom insulin dependent? On other diabetes medication, such as metFormin? Is she getting routine blood work done to monitor her A1C?

Is she under a doctor/endocrinologist's care for her diabetes? Because if she is, that's where I would start if I were you.

I read your mom is in her 60's with "age related decline"; does that mean she is having cognitive issues? Was her diabetes well under control before she entered the facility?

When you have diabetes, the older you get, the more "leeway" a doctor will give a patient regarding diet. Mostly because hyPOglycemia - low blood sugar - is a much greater risk as you get older than hyPERglycemia - high blood sugar - is, especially if the patient has had good control over their diabetes in the long term. Since most diabetic complications come from ***long-term*** uncontrolled glucose levels, and many older people, especially those with cognitive issues, have a hard time recognizing the symptoms of low blood sugar (which is an immediate medical crisis), the ADA recommends a higher A1C level for elderly diabetic patients, particularly those who have cognitive decline and/or are in facilities such as SNF's.

As long as mom has given her doctors' permission to talk to you, I would call her PCP/endocrinologist first and discuss this with him/her. If need be, arrange for an A1C test to see where mom is, and if those levels are acceptable for mom, her age and her particular health issues.

Not that a sugar-laden, carb heavy diet is particularly healthy for anyone, but it might not be affecting your mom's diabetes as much as you fear it is.

Good luck!
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cebswood Nov 11, 2023
Thank you for your response, btw!
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Your profile says that your mom is only 64 years old(my age)and doesn't have(from what you've listed)any major health issues that she should be living in a skilled nursing facility at such a young age.
Can you explain better why this is the only option for your mom? Why is she not able to live on her own, or is she just in it for some type of rehab?
And if it's just for rehab be grateful that she'll be out soon. But if this is now her permanent home(again I'm not understanding why)I guess you'll just have to continue to talk to the director and the person in charge of the kitchen to try to get her some more healthy food options.
And please don't be spending your own money for her food. Your mom should be paying for her own food if she wants/needs something different from what she's getting at the facility.
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anonymous1732518 Nov 11, 2023
I was with you until your last sentence. Mom and/ or her insurance is paying for this. She should have a choice what she wants to and not want to eat, with a healthier choice being available.

The dietitian is the one who should have met with mom to set up her meal plan.

The lack of change falls on him or her.
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Yeah they did that to me when I was in the hospital. They are clueless or lazy. I just ate the least offensive foods. I told them many times I was diabetic but they ignored me.
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Deb555 Nov 18, 2023
In the hospital (and nursing homes), staff are required to follow the diet that the doctor ordered. Some Doctors use standard orders so everyone goes on the doctor's preferred diet. Next time have the nurse contact the doctor to have the diet changed.
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Be with her at meal time, take a pic of the meals and show them to administrators. The meals don't match her nutritional orders that should be on file. There should be no problem with preparation of food that meets her needs - short handed or not. My guess would be nearly half the folks who live there are diabetic.
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TouchMatters Nov 16, 2023
Everything needs to (also) be in writing.
There needs to be a paper trail.
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