Is the Nursing Home Over-Medicating Your Elderly Parent?

My mother is not in a nursing home. She lives with me and my husband. She has Alzheimer's disease and she gets very combative and hard to deal with at times. If I didn't have the anti-psychotic drugs to help her, I couldn't keep her with me, so how could I expect a nursing home to deal with her without that help. Often when people put their folks in a home, they don't realize how difficult things can become, because they haven't had to deal with it one on one. Without the help of these drugs, everyone would be upset and out of sorts, including the patient. I would much rather have her a little sedated than so upset and agitated. Dealing with that situation is not good for anyone.

Speaking from personal experience about my mother, who has Parkinson's Disease and, a few months ago, required in-patient rehabilitation for three weeks at a nursing facility following unrelated surgery subsequent to a fall, even reputable nursing facilities drug patients to subdue them merely for the convenience of their own nursing staff. My mother was not an unruly patient; she merely insisted on being given her PD medications at the required times (as did we when we were there with her) and required assistance with going to the bathroom and with picking something up off the floor that she may have dropped when my father and I were no longer visiting her.

Although we stayed by my mother's side for 10+ hours per day during the first week, I had to return to my city and my father had to shorten his visiting hours so as to have time to prepare the house for my mother's return. Therefore, neither my father or I were at my mother's bedside in the evenings. However, when I called to say good night between 7:30 and 8:00 p.m. each night, my mother sounded utterly drugged; she was confused, incoherent, and totally groggy. The nurses assured us that this was common for patients new to a facility environment, etc., but I didn't believe it. My mother was unaware of being given any additional drugs but the ones she normally took for PD at 7:00 p.m. plus the pain pill, but it was just too odd that my mother would be such a different person shortly after 7:00 p.m. each night during those remaining two weeks during her hospital stay. Something that was a "red flag" for me was what my father told me about a conversation that my mother had had with one of the night nurses, namely, that during a conversation that my mother had with that nurse about her PD medications, the nurse disagreed with my mother, stating that she (the nurse) knew better than the doctor. Anyway, I was there for my mother's return home and, from that evening on, she never again exhibited such signs of having been drugged. That's when we knew that our suspicion had been accurate. To our frustration, there is little we could do since, as so often happens in nursing facility situations, we have no proof. The only thing that is doable is to not only not return there but also to spread the word among friends and acquaintances so that others know what we wish we had known in time.

I'll go one step further than Carol Bradley Bursack did when she said, "The old practice of over-medicating just to keep people 'manageable' so that they didn’t need so much staff attention is, in my opinion, dead wrong." and say that it is ILLEGAL to dispense unprescribed medication and ethically and morally wrong to dispense any medications to a conscious and alert patient without the patient's consent.

Yup I understand the choice between sedating elderly patients or not sedating them. As always, there's something that has to give... Now that it's very expensive to hire additional staff, I am sure, the only triage option is to sedate unruly demanding patients. It's the most civil and possible way to keep things manageable without causing anyone too much tension to build up and explode. I know well based on my experience after my mom was hospitalized. I cherished the days when it was all quiet and peaceful at home, I can do whatever I want, while she was in the hospital. My daughter & I liked the feeling that we don't have a cantankerous grouchy old person at home. We can watch whatever channel on TV we like, eat whenever we want and let the dirty dishes stay at the sink longer unwashed, etc. We know the staff at the hospital kept my mom sedated strongly so they can handle other patients.

One size doesn't fit all. I just found out that my Mom was on a psychotropic drug. I had wondered why her behavior was getting worse. Seems the home was giving her the drug as needed I found out. You would have thought they would know better since it was making her behavior WORSE. I was NOT notified of this, and I have her power of attorney. They are now weaning her away from this drug. If Mom needs something to calm her then we can discuss this after she is weaned from this horrible drug. BTW Mom has a very low tolerance for meds to begin with.I had told them many,many times Mom has mild/moderate dementia and other medical issues..still ..she was never ,ever a problem. Yes I totally,agree the elderly are at times over medicated and one size doesn't fit all.

Good article, thank you, Carol.

It reminds me of the time my Dad was in a nursing home.. with last stages of Alzheimer's - dreaded place to be. The family was leery of the drug issue.. it seems my Dad was more distant each day. We also leery of other "staff behaviors" so we all pitched in and visited Dad every day. My sisters did most of the work during the week and I helped out on weekends... we were there everyday for lunches and dinners and of course breakfast too when we could make it. I spent hours with Dad on weekends during the day to make sure he was cared for properly.

In my opinion, this is what it takes... lots of dedicated effort by family to ensure your loved ones are safe and well cared for when they are living in a nursing home.

Thank you,

Carol
Carebuzz

This is why I am doing everything humanly possible to keep my mother out of these places.
Even the most reputable care facilities will never treat your parents like "family" so, therefore, they do not view overmedication as a problem.
Can you imagine how horrible it would be to be stuck in a bed, drugged out of your mind, and you cannot even express it to anyone?
I think that this practice is all too common and nh staff has no right to be medicating w/o both doctor's orders and family notification.
I think we need to install "granny" cams in all patient's rooms.

My mother was over medicated in an attempt to save money and it nearly cost her life. She has epilepsy and takes a very specific dose of dilantin every 8 hours. She had to go to a rehab center to recouperate from hip replacement. She was fine but in a few days was completely out of it. I asked to SEE - physically LOOK AT - the pills they were giving her and noticed that the dilantin tablet was wrong. Come to find out, that they got a "deal" on a bunch of dilantin and substituted it for her prescribed pill. Though the active ingredient was only slightly more than her normal pill, it was enough to put her over the edge. After some screaming and yelling on my part - they sent someone to the pharmacy to purchase the correct pills and did blood work immediately. Her dilantin level was double what it should be - any more and it would have killed her. It took a week of tweaking and regular blood tests to get her back to normal. I took emergency leave from my job and be there daily to ensure they towed the line. Needless to say, I wrote letters of complaint to the state dept of healthy, Better Business Bureau, the state attorney general, and the local district attorney. Several years later Mom moved into assisted living and the director remembered me - she was employed at the rehab center during this fiasco. She made sure that everyone had training in dealing with seizures & seizure meds and they had a policy that they used EXACTLY what the physician described - no generics or substitutions without doctors permission. At least Mom's close call had a positive outcome for some one.

Medicating with mind altering drugs can also happen in the home. My mother, who still lives alone in her home, was prescribed a medication for "depression" at the request of my brother. The Pharmacist called her doctor and was given a prescription without a doctors visit. Even though I don't live near her I call her every day to see how she is. She has mild dementia so is confused but for months she was telling me about people in her home who were stealing her things. I asked my brother if she was on any new medication and he said no that she was making up stories to get attention. I became even more concerned when she expressed feelings of being harmed. I found out that she had been on a medication for Alzheimer's for 6 months and what I thought was real were really hallucinations. She has been taken off this mind altering drug but it has been 2 weeks and the hallucinations persist. Mother experienced hallucinations when she was put on an anti-depressant years ago but they subsided after the drug was removed.

Physicians will not take the time to explain the side effect or adverse effects of these drugs. Caregivers need to be vigilant and informed so our elderly are not robbed of what little memory they have left and end up in Nursing Homes and on more drugs.

My mother came to visit us in CA 81 days in the last 15 months. Then mom had eye surgery and couldn't drive so my sister had to do more. She resented it and talked my brothers into putting mom into a home against her wishes. Mom wanted an attorney to protect her and I called one. Unfortunately she fell and went to the hospital. Her doctor put her on a morphine patch PLUS pills and she went off her rocker. My sister falsified a power of attorney when mom was still hospitalized and they put her in a home. The longer mom got off the meds the clearer thinking she got. She terminated the power of attorney and wanted me come live with us in CA. My hateful siblings lied and went to court when I was in CA and told the court I stole $200K, I falsified a POA, not giving mom her meds, and I brought her against her will to CA. They came and forced her to return against her will to Texas. Now we are in a court battle and the doctor is over sedating her. He states in his report she suffers from hallucinations, memory loss and instability walking YET these are all listed as side effects of the drugs. On behalf of my siblings he is advising mom not to attend court because it will upset her (when she sees me) and they don't want the truth to come out. My phone number was listed on mom's pharmacy and they called that the new prescription her doctor order is approved and ready. So what else are they drugging her with? I also learned that my sister is telling mom's friends they will never get to see mom again. They also, based on lies, got the judge to rule against me - can't believe a 77 yr old judge would issue a permanent restraining order on the youngest daughter of her 83 year old mom. It's been heartbreaking for us. My son will never get to see his grandma and his daughter, my mom's great-granddaughter will never get to see her either. There is light at the end of this tunnel - we filed an appeal because I was violated my due process to defend myself. We have 11 affidavits and 3 testimonies and a doctor's report that argues my sister becoming mom's Guardian. I pray it becomes obvious to the court. However, the time clock is ticking and my mother is locked away for no one to see.

My mother is sedated by the nursing home and it breaks my heart. They just don't want to deal with her requests so they drug her. We have found that some days she is still almost comotose by noon due to being heavily sedated. I do not understand why our states allow for this to go on. My mother doesn't deserve this and it makes me angry and sad.