My father is in his 70s and is hiding his insulin dosing from his caregivers. He’s giving himself too much insulin at times and sometimes forgetting the steps to use his insulin pump. He’s clearly trying to prove he can still be independent.
What suggestions/protocols do you suggest we put in place for insulin dosing and the caregivers?
Go with your father to his doctor.
A failure to make the decision for more care (if needed) could result in death.
He now cannot be trusted to manage his meds at all, so he either needs an appropriate person to do this for him (a qualified in-home aid and the meds not kept where he can find them) or he goes to AL and pays for meds management service (which often is an "a la carte" extra expense). IDK how it would all work with an insulin pump, maybe he doesn't use one any more so that he won't overdose himself.
Make his meds inaccessible and start administering them yourself or get homecare to come.
I can tell you what we did progressively with our mom. She was a type 2 so a little different but she managed her diabetics so poorly for years that she not only had other issues as a result but it became necessary for her to be treated as a type 1. When she first got the Dexicom our lives and her management got much better because we were able to see her blood sugar in real time as well and could set notifications for highs or lows while we could still contact her to correct them. For your dad it sounds like this would be more of a back up for now but it would be his children following his numbers and reminding him rather than a non related caregiver and if it got too far it sounds like there would be a caregiver with him who could give him glucose for example, at your direction, if he wasn’t able.
By the time Mom got an insulin pump she wasn’t able to get into her phone never mind figure out a bolus. The Omnipod, which is what she had, at least required a code to get into the app so that made it harder for her since she her dementia was such that she couldn’t remember the steps. The pump meant she needed someone with her even more of the time too which wasn’t a bad thing but because we had the Dexicom info all the time we could see things trending in the wrong way and that made it easier to work with caregivers for us as well. Her caregiver would always call (me mostly) when one of us wasn’t around to go over what she was eating and how many carbs or how much of a bolus to give her and she felt comfortable with the fact that we were overseeing it and making the decisions. Yes this required one of us to be available for inputs but it made all of us more comfortable and it allowed for multiple back ups, my brother and I often consulted on what to give her. Maybe you can start to work into consulting with your dad on it so he can “train” you for when he is no longer able to do it for himself. One thing that did sell Mom on the whole thing was not having to prick her finger and give herself shots (which started to often miss) anymore.
Good luck this push and pull between independence and letting go is never easy.
I don't know much about diabetes, but it sounds like dad's needs for help are changing. You or another responsible caring person needs to spend some time with him to bring his care up to a level that matches his changing needs.
I had a relatively minor wakeup call regarding med management with my husband this week. He has a "bad back" that flairs intermittently. One morning he told me he got up and took the "blue pill". That was Naproxsyn, which he is not supposed to take. Tylenol only per his doctor! And, I have no way of knowing for sure what or how much he took.
Thanks to this post, I am going to get a lock box for all of our meds.
AdVinn, there are so many benefits to forum members beyond direct problem solving or advice to the OP!