the courses were complemented by bedside instructions by the RNs who signed the written delegation. the rural municipalities' education for HCAs was arranged within the assisted living facilities or on an individual basis. the main content focused on general knowledge about diabetes, blood glucose measurements and insulin injections. prevention of foot ulcers was not a central issue in the written material, but all HCAs were instructed not to cut the toenails and to report any changes in foot status to the RN.