SoAlone Asked March 2010

Can I have the nursing home inform me before they add medications to my father's daily regimen if I'm his Medical Power of Attorney?

Follow
Share

I noticed he was acting very different, no personality, not answering phone, completely different from 2 weeks before.
So I got a listing of his medications and they had added 2 alzheimers meds (he doesn't have alzheimers), a diuretic, an anti-histimine (which he is allergic to codeine and his body reacts badly to allergy meds), also they added an allergy med, (they were trying to dry up a chronic nose drip) they also added vicodin ( his body reacts badly to this). He already is on 20 medications! and now they added these within a 2 weak period. He is like a dead man.
Now I have to wait for them to get in contact with the doctor to remove the meds and they are fighting me on it.
It is like they are determined that he have alzheimers. He has some problems with thinking when he first wakes up and because he is on so many meds. Also he has problems when his sugar get really LOW. Otherwise he is as clear and sharp as I am.
I am not in denial. His mental problems are related to his medications and his depression over his now sucky life.

I could have kept him off all these latest meds if I had known they were being added. They did not tell me anything except
"your dad is a very sick man" (diabetes 77) as an excuse.

My dad is a resident in a VA Home.

This question has been closed for answers. Ask a New Question.
30

Answers

Show:
1 3
vstefans Nov 2016
Summer this is an old thread - you may want to start a new one.

You would think you can reliably get updates on all med changes by asking, but I found you actually need to get the updated lists every now and then. Sometimes you make the request to be notified, and they will call you if they add triple antibiotic for a scrape and not call you if they add Geodon or restart something they have reacted badly to in the recent past.

Seroiusly, thought it is not totally medically correct, if the facility uses only an "Allergy" list and not and ADR (adverse drug reaction) list it is not wrong to put the meds that have had bad reactions on the allergy list. Too often, otherwise, people add back a medication that does not agree with someone because their symptoms that occasioned using it in the first place are still there, most people do not get most side effects, and for some reason health care providers too often assume that no one already thought of the obvious and tried it already, without even asking the patient let alone a caregiver who may have been keeping track.
Helpful Answer (0)
Report

Summer1971 Nov 2016
My dad had a cardiac areast and triple heat bypass now left confused by brain damage he was in a reabitation centre for a year now medical records sent and he is on to many tablets of hospital to control his behaviour our gp says waiting on reports to come back it's so upsetting seeing my dad like this we need to get him on the right meds any thing we can do apart from phone doctors
Helpful Answer (0)
Report

SoAlone Apr 2010
helpingdad,
Your comment and information is really helpful to me.
Do you know if there is a name for this type of "condition or problem" when a person has a reaction of this type to drugs?
Something I can call it when I talk to my dad's doctor next week?
What you said (in quotes below) is what is happening when they put him on allergy, cold medicine. Does this toxic reaction have a name?
-Thank you

""If you look at the list of medications that can SIMULATE age related conditions, antihistimines and anticholenergics are the worst. They can cause agitation, anxiety, cardiac arrythmias, confusion, constipation, depression, dizziness, disorientation, depression,fatigue, hypotension, and restlessness, urinary dysfunction and visual disturbances. I am a licensed nursing home administrator and for the past 30 years I have been a geriatric nurse. So yes I have seen this many times. In a long term care environment """
Helpful Answer (0)
Report

with that many medications he surely needs a pharmacist consultation.?
Helpful Answer (1)
Report

vstefans Apr 2010
Helpingdad had a great comment, though there is one thing I disagree with - staff MUST take time to think about medication reactions. They are omitting a very important part of their job of coordinating and managing medical care, if they don't. I take care of rehab inpatients and that is a huge part of what I have to do, to try and determine if medications are contributing to any functional decline that we may observe (versus neurosurgical, psychological, or other complications for which medications may actually help, and/or more major intervnetions may be needed). Of course we are expecting all our patients to get better, so maybe that helps make sure alarms go off when something goes awry. We've seen everything from confusion on Motrin and hallucinations on Inderal, and at just ordinary or even low doses, which some people seem to believe can't possibly cause any problem. I've seen a Celexa reaction misdoagnosed as an MS exacerbation. I've seen insomnia caused by sleeping pills. You can NEVER stop thinking.
Helpful Answer (1)
Report

helpingdad Apr 2010
Cold and allergy medicine is designed to dry up mucus membranes in the head, This way you do not choke and cough, your nose does not run and so on. If you look at the list of medications that can SIMULATE age related conditions, antihistimines and anticholenergics are the worst. They can cause agitation, anxiety, cardiac arrythmias, confusion, constipation, depression, dizziness, disorientation, depression,fatigue, hypotension, and restlessness, urinary dysfunction and visual disturbances. I am a licensed nursing home administrator and for the past 30 years I have been a geriatric nurse. So yes I have seen this many times. In a long term care environment, staff usually do not have time to look for the underlying cause they just look for the next pill that will give them a quick fix. Your dad needs a medication vacation after about 2 weeks drug free re-assess what issues need to be treated.
Helpful Answer (1)
Report

SoAlone Apr 2010
Regarding my original post. The NH has said they will inform me of all my dads medication changes.

Thank you for all your comments.

Looking thru all this paperwork and seeing what I think I see -makes me feel like I must be crazy to believe I know what I am talking about. How could the doctor & nurses not see it other than they have too many patients?

Can medication side effects even from cold and allergy type medications really affect the elderlies health and mind this badly?
Helpful Answer (0)
Report

SoAlone Apr 2010
I decided to go to the nursing home and get all of my dads medication records, nurses notes, and doctor notes to see if they did anything different leading up to his decline and hospital stay in Feb 2009.

In reading the 4 months prior he is doing great (other than not wanting to live there) he is walking, using the bathroom fine, they have to keep getting after him for walking to lunch and dinner without his walker (because he didn't need it), he is transporting himself in and out of bed okay etc....

They started giving him Robutissin DM on Feb 7th. (for cigarette related coughing (stupid))

Then Feb 10-12 they start sending him to the hospital for breathing problems, hallucinations, fatique, lack of response, talking about stuff that isn't happening, the 11th he stumbles and falls, etc... he makes 3 trips to the hospital but they decline each time to admit him since he seems to not have anything wrong (the E.R. doesn't know him and doesn't know his behavior is not like him) No one from the nursing home goes with him....

I visit him and tell the nursing home they MUST be messing up his medications, or he has had a stroke of SOMETHING. No no no nothing has changed his meds are the same.

Then on the 12th the hospital admits him and it all goes down hill from there and continues to be going downhill now. Since that time they have added anti-psych, alzheimers, anti-depressants etc... etc... and keep changing his meds. (which I never knew they could do without telling me)

ANYWAY, weve always known dad had exaggerated response to any tpe of cold, anti-histamine, allergy type medications,, he just cannot take them. We always thought because of his diabetes but....

I am reading all this stuff and I can see what has happened with each incident and I can see it all started on February 7th with that Robu DM and then the trip to the hospital - where who knows what they gave him.

After 3 days there he went completely out of his head. completely
gone and really, really bad scary scenes. then to mumbling. First time in his life he is incontinent and this is a horror to him.

Then he miraculously recovered (mostly) after the said they could do nothing for him, could find no infection, no cold, no pneumonia, there was nothing wrong with him..... so they quit all antibiotics quit all treatments (except the fluid) and he recovered but was never quite the same.... and it scared him and he got mad at the NH and so within a month
the NH doctor started prescribing anti-depressants and anti-psych to make him a happy boy.... risperadal and venlafaxine. (and he is now also on two alzheimers meds for the side effects of the above OR now we don't really know)

I can sit here and read the nurses notes about something really weird happening or a decline and then go look at the medicine chart for a day or two or three before and see a big medication change (added or dropped) and it is like they never even tried to make these connections.

I just am sick that I am too selfish to have my dad live with me. He must really have terrible toxic reactions to all kinds of medications... I wonder how many other older people are going thru this in nursing homes. and this is REALLY the best nursing home in this state,,, everyone says so. They just are not used to dealing with toxic reactions to drugs. AND I didn't have a clue!

I go back to talk to the head nurse again tomorrow.

I really have to get them to never give my dad these cold and allergy medications. EVER. Sometimes I feel like I must be nuts because how can they be wrong in what they are doing and I be right? But it is right there in these papers. I wanted to see if the dates of traumatic events correlated to medication changes and they mostly do.

but how do you get all that backed off .... will doing that hurt him?
Helpful Answer (0)
Report

LynnPO Apr 2010
Your father is on 20 medications?!!! Oh My GOD! Is it possible that there is some drug interaction going on? If it were my dad, I'd get a list of medications, the dosage and schedule then take it to a pharmacist and ask their opinion. Allergy meds alone can cause all kinds of problems with the elderly, then when you combine blood sugar issues and other meds, it's impossible to know what can happen. I've read that allergy meds are also not tested for interactions with the "new" drugs for alzheimer's treatment - which I find rather scary... Anyway - you're not likely to get much help from the ombudsman at the VA either so go up the chain of command. See if there's someone with the state dept of health that overseas long term treatment facilities. I've heard good and bad things about VA facilities. I don't feel right about commenting too much since you have not asked for advice on that matter but it if were my dad - I'd look into moving him. As a veteran he might still qualify for some financial benefits to help with his rent in assisted living. There should be a VA rep in your county or state that can help you understand what's possible. Good luck!
Helpful Answer (0)
Report

vstefans Apr 2010
I've had that happen more than once - it suddenly dawns on me that a symptom is really a side effect - I wonder why it takes so long? I've never had anything permanent, I hope yours clears up eventually! My other great hope is that someday we will have ways to predict more of these in advance - right now they only have it for a couple of cancer drugs. If they could tell you with a little more certainty you'd be OK on the muscle relaxer it might be worth trying it, but if it is a benzo in the same class as Ambien I don't blame you for steering clear.
Helpful Answer (0)
Report

1 3
This question has been closed for answers. Ask a New Question.

Related
Articles

Related
Questions