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In early spring my mom and I moved dad to a NH, thinking he would go anytime. For many many years he's had acute abdominal pain which could not be diagnosed. Quite a few doctors tried but couldn't find the answer. The NH along with hospice got him on a drug schedule of taking OxyContin every eight hours and another mes for breakthrough pain. He began to get much better. In the meantime, my mom who suffered from advanced COPD, began to quickly decline. After several trips to the ER and a few weeks in a NH, she passed away in a hospice house. We were all with her including my dad. Shortly after her death, dad moved into an assisted living facility. As long as he takes his pain meds he does great. We quickly realized that AL is nothing like the NH. While there is a DON, it seems as if the young women who man the nursing station know very little about nursing which has caused my dad to constantly stress and worry about not getting his pain meds. They have forgotten several times so I can't blame him for worrying. In the last day or so I've noticed him becoming confused and argumentative. He calls several times daily and at night claiming they've either forgot to give him his pain meds or they will forget him. He gets mad at us if we tell him to be patient. I'm an only child so no siblings to help out although I'm lucky to have a super husband who is always there. I'm wondering if we moved him too soon or maybe shouldn't have done so at all. He seems lost and confused all the time. I'd be grateful for any thoughts or opinions.

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1. If your father didn't have any dementia prior to your mother's death, it's a possibility that he has developed some emotional reactions to her death that mimic dementia. I'm sure it's been a traumatic few months for him. And to move to a new facility is like a double whammy - two major events to deal with and adjust to.

2. Before rejecting an AL entirely, check around for others. We've never had someone in anything but SNFs for rehab and one memory care unit, but with the exception of the latter, meds were always timely delivered and administered. Perhaps this AL isn't as diligent.

3. OTOH, perhaps you could spend some more time with him to confirm his statements. It might be true or it might be his imagination.

4. I don't know if the DON would allow it but you could ask to see his med chart administration to confirm whether or not the meds were in fact or not timely administered.

5. Others here will hopefully offer information on whether staff at the nursing stations need to be medically qualified. I don't know. But if they should be and aren't, I definitely would begin to look elsewhere.

6. However, you do mention that his drug regimen was worked out between a nursing home and hospice, so I'm wondering if his medical condition has worsened. When's the last time he saw his medical team? You might want to also have a nice chat with the doctors at the AL, if there are any on staff (as stated, I don't have much experience with AL facilities). But also see his regular treating physicians for an update - there might have been changes that the AL didn't diagnose.

Good luck; this can be so frustrating while you're trying to resolve problems that cause so much distress.
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Who is responsible for dispensing his meds? Clarify with the DON how and when meds are dispensed. Were his meds actually forgotten more than once? If that's the case, I'd say you are in the wrong facility for your dad. However, it may be his confusion and disorientation that is at the bottom of this. I would have him checked out by his physician and find out if this is the right level of care.
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Your dad's had a lot of change in a short amount of time and many elderly people don't do well with that much change. It can cause confusion and agitation, stress, depression, loss of confidence, plus your dad is dealing with the grief from losing your mom on top of everything else.

I don't think anyone can say if he'll settle down in time or not. Unfortunately you may just have to wait and see. Give him time to get acclimated to the AL. In the meantime try to make things as easy for your dad as you can. If he has complaints about the facility listen to him and then tell him with confidence, "Don't worry about it, dad. I'll take care of it." This is what I did with my dad when he started going downhill a bit. My #1 goal was to keep him calm and stress-free. It was a lot of work on my part but I didn't want my dad to have to worry about anything and from what you wrote I know you feel the same way about your dad. Be reassuring and calm with your dad. Be as patient as you can be (which can be very difficult) but in addition to caring for your dad make sure that you don't make yourself crazy.

And if you realize that your dad's anxiety isn't getting any better you may want to contact the Dr. and ask that your dad be given an antianxiety medication.
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Our mom began insisting she was not getting her meds. We checked the dispensing records with the Head Nurse aka DON. She was getting them and forgetting. Further on she thought she was missing meals. Dining hall records showed she consistently arrived late for dinner, but always got fed. We also found out she was refusing help with showering, always insisting she just took one, which was not true. So the nurses made sure she showered from then on.
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I agree with Pamstegma. I would confirm with the med tech that he is getting his meds. They keep a chart. I would consider that your dad may be forgetting that he gets them. I have seen Assisted Living residents get into heated arguments with staff when their memory fails them.
In our state, Assisted Living staff are required to administer the residents meds. It's not an option for them. The kind your dad is taking is highly guarded.

I would also consider that your dad may have grown accustomed to the med and it does not help as much as it did before. That's the problem with pain meds. He may benefit from seeing a pain specialist. Maybe there is another med that can help more.
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A lot of our problems wouldn't exist if the nursing home had told us we would need to find a doctor for my dad after moving him to AL. Tomorrow I'm taking him to a doctor who we hope will continue prescribing his meds. I'd really like to bring him home so he can live out whatever time he has left with people who love him. My husband is fine with this but dad doesn't want to be a burden. Or it could be my cooking. I appreciate all the suggestions. It's just nice to know we aren't alone on this journey.
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