Your Guide to Senior Diabetes Care

A diabetes diagnosis is a life-altering scenario. For an older adult diagnosed with this serious and potentially fatal condition, managing blood sugars and insulin injection routines can quickly feel overwhelming. If you are an older adult newly diagnosed with diabetes, or if you have a senior loved one with this diagnosis, understanding diabetes’ impact on seniors’ health is essential.

Diabetes is a progressive disease with no cure. It is also very common, especially among seniors. Approximately 29.2% of Americans age 65 and older have diabetes, even if they are not diagnosed, and 1.4 million new cases get diagnosed every year. It is also the seventh leading cause of death in the United States, so this is a disease that you have to take seriously.

Diabetes directly impacts the health and wellness of those with the condition, and seniors are at the highest risk for disease complications. This guide takes a closer look at how diabetes affects seniors, what care options are available, and how seniors and their families can get financial help to manage this complex disease. Keep reading to learn how you can better care for a senior in your life who is battling diabetes.

When an older adult has diabetes, their body either does not make enough insulin or does not use insulin well. Because insulin is necessary to turn sugar, or glucose, into energy, lack of insulin or poor use of it will cause that glucose to stay in the blood. When blood sugar levels increase, a wide range of health problems can develop.

As someone ages, their body’s ability to fight off health problems lessens. High blood sugar levels can add to this problem. According to the National Institutes of Health, diabetes increases the risk of several serious health problems, including:

• Heart disease
• Stroke
• Kidney disease
• Eye problems
• Nerve damage
• Peripheral neuropathy
• Wounds that will not heal
• Amputations due to infections

It can also increase the risk of developing cancer and Alzheimer’s disease. Each of these conditions can turn fatal or create lifelong challenges, such as blindness or neuropathy in the feet, which means managing diabetes is essential to healthy retirement years.

Another reason diabetes is so challenging for seniors is because it often doesn’t have obvious signs and symptoms. For example, someone with high blood sugar may heal slowly from cuts and bruises, but this sign isn’t obvious. Other subtle symptoms that can be signs of diabetes yet also mask themselves as signs of aging include:

• Unexpected weight loss
• Frequent urination
• Blurring vision
• Exhaustion
• Increased hunger or thirst
• Skin infections
• Slow healing

In some patients, the disease causes no symptoms at all until it has progressed to a dangerous point.

These health concerns are a risk to someone with diabetes, and the only way to prevent it is proper disease management. When blood sugars are stable, the risk of serious health concerns is much lower.

To manage diabetes well, you must do the following:

• Track glucose levels multiple times a day
• Make healthy, carb-conscious food choices
• Stay active
• Take medications on time every day
• Monitor blood pressure and cholesterol
• Schedule yearly eye exams and kidney testing
• Protect the skin and feet
• Get screened for cancer

This list can feel overwhelming, but you can’t ignore any of these steps. Diabetes is too serious of an illness with long-term repercussions if it goes unchecked.

This creates a challenge when you’re caring for an older adult who may struggle to monitor blood sugar and take the right precautions to manage their disease. Also, when an older adult lives alone, blood sugar spikes or crashes can leave them incapacitated, which increases the risk for serious disease.

A senior living community can help make diabetes more manageable for an older adult. The staff can monitor the condition, ensuring that your loved one checks their sugar or takes their medication on time, and many seniors can lessen diabetes’ negative impact on their overall health.

As you consider your senior living community options while managing diabetes, it is important to note the differences between community types and how much help they can offer for diabetes management. These distinctions will help you choose the right community to meet your or your loved one’s needs.

The first type of community to consider is an independent living community. These are designed for seniors who need minimal help with their daily living needs.

Independent living communities provide an engaging community life with activities and events. These communities often help with small things such as home maintenance and may offer congregate meals for those who don’t feel like cooking. Classes, community outings, fitness programs and entertainment are woven into the daily lifestyle of an independent living community.

In an independent living community, you will have few medical care services. Sometimes these communities offer healthy, balanced meals, which can help protect against blood sugar crashes. Also, they may include friendly visits, and the staff is usually trained on how to spot signs of problems, but not necessarily on how to treat problems related to diabetes. They also cannot usually administer injections or medications.

Independent living communities are for seniors who can live independently but may want to spend their time on tasks other than caring for their homes. They provide minimal personal care and no medical care. Seniors benefit from social activities and help with keeping a home in good repair.

Assisted living is the next step in care after an independent living community. They provide a little bit more assistance with daily living needs.

Assisted living communities assist seniors with daily care needs, such as bathing and dressing. They provide private or shared apartment homes, affording seniors maximum  independence with the security of healthcare monitoring when needed

Assisted living communities can monitor seniors more closely than independent living communities, but they may be unable to administer injections. Instead, they can ensure the senior gives themselves the injections they need to manage their diabetes. Assisted living communities may be able to manage dietary needs to assist with diabetes control, as they typically offer meals in a group setting with a managed diet.

Seniors who need a little extra help with day-to-day tasks but who are able to mostly manage their diabetes independently can find the right level of care in an assisted living community.

Nursing homes or skilled nursing communities provide the highest level of care available to seniors with diabetes.

Nursing homes provide round-the-clock skilled nursing care for older adults with advanced medical needs. They provide all the personal nursing care a senior needs.

In a nursing home, seniors receive all of their essential ongoing care, including diabetes management, from trained nurses. Nurses can monitor blood sugar, food intake and insulin injections. Should a senior have a diabetes-related medical emergency, nurses are available to intervene immediately.

Seniors with advanced stages of diabetes who can’t manage their own care or who have other health conditions that developed due to diabetes complications may need a skilled nursing center to ensure they stay healthy.

Continuing care retirement communities (CCRC) are also known as life plan communities. These communities provide different levels of care as a senior moves through the aging process.

CCRCs are all-in-one senior living communities. They often have different neighborhoods or units within the community that allow for different levels of care. Sometimes seniors can remain in their original apartment or home while changing the level of care. As a senior’s needs change, the type of care they receive also changes.

A CCRC has the same supports as the different types of senior living facilities. Seniors who enjoy a high level of independence benefit from fitness programs and meals, while those facing medical concerns benefit from skilled nursing care available in the same community.

CCRCs are ideal for seniors who want to stay in the same community throughout their older adult years. They can work well for seniors with diabetes because they provide the option to change the level of care should the diabetes progress result in complications. A CCRC affords seniors independence with disease management services when needed. Another benefit is a senior will stay within the community setting regardless of the level of care that is needed.

Whether the senior in your life chooses independent living, assisted living, nursing home care or CCRC care, you’ll find that there are specific ways senior living communities can assist with diabetes management. These amenities and services help a diabetic senior stay safer in an assisted living community compared to living independently at home.

If you’re considering a senior living community to help you care for an older adult in your life who has diabetes, you will need to know the basic cost of this type of care. These costs can vary quite a bit from one community to the next based on several factors, including:

• Where the community is located
• What types of amenities it offers
• The type of care it provides

You can use national averages as a baseline to estimate the cost, but always ask for detailed prices from the community you’re considering before signing any contracts. Also, keep in mind that diabetes care can sometimes add to the base cost because of the higher level of care this disease requires.

Per the 2021 Genworth Cost of Care Survey, the table below provides estimated costs for assisted living and nursing home communities. AARP offers an estimate for the cost of CCRCs.

Diabetes is a costly disease to manage. In the most recent study, researchers found that the estimated cost of diagnosed cases of diabetes in the United States was $327 billion a year. The monthly averages listed above are for basic care, and this doesn’t always include diabetes management. When you move to senior living, it passes some of that cost on to the senior and their family.

In a nursing home, diabetes management, along with the management of other conditions that can come with diabetes, is usually a covered type of care. However, in an assisted living community, you may need to pay extra for diabetes care, depending on how the community structures its fees. In a CCRC, adding diabetes management may mean moving up the care ladder within the community, such as transitioning from independent living to assisted living care, and that can change the monthly cost depending on how the community structures its fees.

According to U.S. News & World Report, seniors in senior living communities may pay more for a higher level of care. If your loved one’s diabetes is advanced or has created complications, then there may be added fees associated with their senior care community, especially if it is not a skilled nursing facility.

Because diabetes management costs will vary from one community to the next, you must ask about this when you’re evaluating communities for your loved one’s needs. Make sure you understand the costs associated with diabetes management before signing any care contract.

When you have a senior in your life managing a complex condition like diabetes, you’ll want to carefully consider the senior living community you choose. The right one can mean much better care and overall wellness, but the wrong one can add a lot of expense to an already costly condition. Below you’ll find a checklist that will help you understand exactly what to look for as you seek the right community to partner with in caring for your loved one.

Diabetes care can get expensive, and it’s not something you can ignore. The health risks associated with poorly managed diabetes are too severe. Thankfully, seniors and their caregivers will find several resources available to help them pay for diabetes care and medications so that they can control their blood sugar without overwhelming costs.

These resources include federal and state programs and nonprofit organizations, but most seniors will start with government programs to get help with their diabetes expenses. In fact, government-run insurance programs cover most of the diabetes care costs, approximately 67.3%. Other options exist to help cover the price beyond what these programs cover. Read on to see what options can help you with your diabetes costs.

Medicare is a federal health insurance program for adults over the age of 65. It includes three parts, Medicare Part A, which covers hospitalizations; Medicare Part B, which covers general medical insurance needs; and Medicare Part D, which covers medications.

Like most insurance plans, Medicare has some expenses that the recipient must pay. These include:

• Deductible: This is the amount someone pays out-of-pocket before the insurance pays for service or medication.
• Coinsurance: The recipient pays this amount to share the cost of services after meeting a deductible, usually a percentage of the service cost.
• Copayment: Someone pays this amount every time they purchase medication or see a doctor, usually a set dollar amount.

If you have Medicare, you have coverage for diabetes. In most instances, Medicare Part B covers diabetes care and preventative services for people with diabetes. Medicare Part D covers supplies and insulin for most diabetic patients.

The Social Security Administration manages Medicare applications. There are three ways to apply:

• Apply online at the Social Security Administration website
• Call 1-800-772-1213 to get help over the phone
• Contact the local Social Security office to apply in person or to get help with a mail application

Medicaid is a state-based health insurance plan for people who are considered low-income. Each state has its own eligibility requirements for Medicaid, but all state Medicaid programs must adhere to federal rules and regulations.

According to the American Diabetes Association, Medicaid does not have specific rules about diabetes coverage. However, federal rules do require it to cover:

• Doctor’s visits
• Inpatient and outpatient hospital care
• Laboratory services
• X-rays
• Long-term care services

Many of these services do apply to patients with diabetes.

To enroll in Medicaid, visit the website for your state’s Medicaid program. This is often part of the Health and Human Services department but will vary from state to state.

Seniors who served in the armed forces may qualify for medical coverage through the Veterans Administration (VA). Currently, the VA provides benefits to 1.45 million veterans with diabetes, and the number continues to increase.

The VA takes a modern approach to diabetes management. Through its health program, veterans not only receive testing and medications but also learn how to manage their disease through diet and exercise. This approach helps create better outcomes and overall blood sugar control for diabetic individuals. 

Under the current veteran’s benefit plan, diabetic veterans will receive the following coverage:

• Nutrition and exercise education
• Supplies for monitoring blood sugar
• Necessary diabetes medications
• Insulin, injection supplies and insulin pumps
• Screening for related diseases, including foot screening and vision screening

Qualified veterans will apply for veteran’s health coverage through their local VA office if they are not already enrolled in coverage.

In addition to these federal and state programs, seniors with diabetes may be able to get help from these organizations: