Insulin, Diabetes Care & Home Sharing 

If the individual is unable to administer their own insulin, I would recommend involving their primary care provider, diabetes care team,  or the local community nursing/Home and Community Care service. If an unregulated care provider, such as a Home Sharing Provider, administers insulin to another person (e.g. by injection), they are performing an activity that BC legislation (i.e. the Health Professions and Occupations Act) classifies as a restricted activity. Restricted activities are higher-risk or invasive health activities that require specific legal authority to perform. 

This distinction is important in home sharing:

• Assisting with oral medication or helping someone with routine medication may not necessarily be a restricted activity simply because medication is involved.
• Some medications and methods of administration, particularly injections, fall within BC’s restricted activity framework and require additional assessment, authorization, training, or delegation.
• Delegating a task to an unregulated care provider, such as administering insulin, requires careful consideration of the applicable legal, health professional, organizational and situational requirements.
• A Home Sharing Provider is normally an unregulated care provider, so their employment or contractor status alone does not give them authority to perform any restricted activities.
• BCCNM specifically describes delegation as the mechanism through which a nurse can temporarily transfer authority to an unregulated care provider to perform a defined restricted activity. A delegation must be client-specific.
  • Completing a course (e.g. diabetes management and insulin administration) does not create independent legal authority for a Home Share provider to perform a restricted activity.

For a Home Sharing Provider, administering insulin should not simply be taken on as a regular medication-support task. Where there is consideration for an unregulated care provider (e.g. Home Sharing provider) to be delegated a restricted health-care activity, there is a formal delegation process that is required. This is client-specific and requires a health professional, typically a nurse, to assess the individual’s needs, determine whether delegation is appropriate, train the provider, confirm their competency, and establish a health care plan and ongoing supports.

The first step would be to connect with the individual’s primary care provider, diabetes team, or community health team to discuss the next steps. If none of these are available a referral to the local community nursing/Home and Community Care should be completed. The coordinating agency should complete a change in the individual’s health and support needs.

The health care team/responsible health professional can then determine what is required for this person’s diabetes management and insulin care.

If it is determined the task cannot safely be delegated, the health-care team would need to consider alternative arrangements for providing the required insulin support and diabetes management.

The key point is that the Home Sharing Provider should not independently assume responsibility for giving insulin until the appropriate health-care assessment, health care plan and, where identified, delegation and training have been completed.