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July 5, 2001

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Question from Joplin, Missouri, USA:

My 46 year old sister, diagnosed with type 1 diabetes at about the age of 12, has a very brittle history of blood sugar control, has lost one leg, has had part of her other foot removed, is threatening the loss of her other leg, is losing her eyesight, has urinary tract problems, has been diagnosed with neuropathy, and is bedfast, no longer having the strength to reposition herself in her bed. Approximately three to four years ago, when her condition worsened to the point where it was decided that she no longer could live alone and care for herself sufficiently, the decision was made and agreed to by her that she be admitted to a nursing home where she would be provided "proper care". As you can imagine, this is when all the infections leading to her amputation and the overall worsening began to take place. She has been in and out of hospitals over the last few years and released back to the nursing home. It seems to me we made a mistake admitting her to such a facility. After the amputation of her leg, she was admitted to a therapy center to learn to use her prosthesis and do the required exercises and other practices necessary for recovery. After the Medicare and Medicaid allotted time expired, she was again sent back to a nursing home. My family and I are heartbroken and feeling like we did her a major injustice by convincing her she needed 24 hour care and getting her to agree to live in a nursing home. However, we didn't know what else to do, all of us having full-time jobs and not being able to provide the care she required, or being able to afford the high cost of specialized facilities. It is obvious to me that the atmosphere of a non-specialized nursing home facility is adding to her depression and loss of hope and motivation. She is now at the point at which she thinks she will never get better and is just more or less waiting to expire, as, even though it sounds cold and heartless, are the majority of patients in such a facility are. Yesterday we received a call from the nursing home telling us that her oxygen level was low, that she was having trouble breathing and was shaking continuously. They said they had called an ambulance and were sending her to the hospital. We immediately went to the hospital. After several hours of blood tests and other tests we were told that she has a blockage of some kind of in her urinary tract, contributing to an infection, her blood sugar level was 49 mg/dl [mmol/L]. She has been admitted and is awaiting more tests and diagnosis. This same scenario happened about a month ago. She was treated and sent back to the nursing home. I can't help but feel that if she is sent back to the nursing home this will all happen again and again, ending in God knows what. My family and I are desperate to find some facility which can provide the necessary care needed for our sister and daughter. I was hoping that your organization could offer some information or point us in the direction of finding some help for her. Is there such a facility for diabetes that is covered by Medicare and/or Medicaid?


The University of Oklahoma College of Medicine Health Science Center in Tulsa has a number of clinics at which she could be served. They accept Medicaid and Medicare and are highly regarded.