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?

As POA you have the right to insist on approval on any medications. Speak to the Director of Nursing and insist on notificaation PRIOR to starting on any new meds, anti-histamines are notorious for causing lethargy and confusion in the elderly if his nose is running, give him a box of tissues. If he is on 20 meds that exceeds the CMS standard of 9 meds raising a red flag for polypharmacy, and his medication regime needs to be reviewed. Nursing home physicians visit the facility sporadically, they are required to assess a skilled resident every 30 days and a custodial resident every 60 days so trying to catch them on roundes is difficult. Ask the DON for the physicians office number and schedule an appointment either at his/her office or at the facility, but make it a scheduled appointment so they know you are going to meet. Also ask when your dad's care plan conference is they need to be quarterly and GO. Ask questions let them know you are concerned and want to be involved in his care. God Bless

Only a physician and some nurse practioners can "add" medications to your Dad's chart. If you have medical POA, then that physician should inform YOU. The staff at the nursing home is merely the caregiver. Many patients are over-medicated. You have the legal right to refuse any medication that you deem unnecessary or incorrect.

Contact the ombudsman at the facility

Yes, as tyour dad's POA, you definitely have the right to know what meds/care your father is receiving. Refer to 'Patient's Bill of Rights' to learn what you & your dad are intitled to be informed of. I do not know what state you are in but from my experience in caring for my mom, the doctor's in one state were very willing & cooperative to keep me in formed, however, the doctors in the state she now resides are less willing to tell me things or answer quesions. It's like they are intimidated if I ask about test results, meds or etc but i know that she & I are both entitled to know. And, I make it a point to be 'in the know' because that is my mom - & I only have one mom & dad. If you can not obtain info from the nurses or doctors, speak with the supervisor, director of nursing or owner of the facility. Sometimes, because we truly love & care about our parents, we have to make ourselves be seen & heard. Best of luck.

I'm also a doctor and a lot of my colleagues just seem like they don't believe anyone ever has side effects. I think I have learned diferently from 1. being a rehab doc and needing patients to function plus 2. needing to take a few pills myself!!
The only other excuse I see for making it into a hassle is its just easy and fast for them to Rx whatever they think should work and not worry about the consequences, and they are pretty well swamped and depend on overworked physician extenders to boot. A thoughtful discussion of effects and side effects takes a little time, as does an intelligent medications review. Both NEED to be done though, and we need to insist sometimes, our loved ones may do a whole lot better once it is straightened out and notes made of what does not agree with them. I think everyone should keep an ADR (adverse drug reaction) list as well as an allergies list. Sure, there are people who make mistakes about what really gave them problems and end up saying they are allergic to 30 different things, so this is not foolproof, but most people are pretty realistic.

It took me months to get them to give my mom a med I knew would give my own patient in a heartbeat for a specific condition she clearly had, and it finally worked when they did...the one doctor would not do it at all, another agreed but started a differnt med. There were somewhat good reasons at first to do that - needed a little antidepressant effect as well as pain relief - but in the long run, my pick was the better one for her adn would have avoided some hallucinations that she got as side effects. And I never did get my dad's headaches treated, though the doc was otherwise very good and took him off everything he did not really need. We should try very hard not to underestimate side efects - they may not be behind everything that is going wrong, but may be behind some very severe problems at times. I watched my mom end up with an ER trip when trying an Alzhemier med (she has vascular dementia, it was a long shot and I did not mind them giving it a try, since the increased irritability and resulting combative behavior was a very unusual turn of events, and they stopped it pronto after that. My dad got serotonergic syndrome when given the SSRI they usually use in this one ICU he was in, not adjusting the dose lower for geriatrics which they should have done. The nurse seemed to feel I was intruding to complain about his being beet red and miserable (no he wasn't on vanc) even though I have medical POA too. Maybe it was because my license was from out of state...but they did fix that one too after I insisted this could be serious and I wasn't leaving til I talked with someone. Just getting a list of meds can be a hassle - I had to literally get my POA papers out and point to the exact line that said I could get it from a nurse with a bad case of HIPAAphobia once!! That was at the same place they refused to treat her neuropathic pain - not suprisngly she did not do well in therapy there and we had to move her out shortly therafter.

SO ALONE:

This smells like malpractice to me. As his MPOA, they should consult with you about any medications and their side-effects before administering them. Make sure they know that.

Although you already have a listing of the medications added, ask them for the monographs you can "better understand how to cope with possible side effects" [how they're turning him into a vegetable to make things easier for them]. Heck, ask them for a copy of his chart in its entirety. Paper trail baby, paper trail. In our highly litigious society what you say and claim isn't nearly as important as what you can prove. If you don't have it down in black and white, it never happened and push comes to shove it's going to be your word against theirs.

Like Gilly said, contact the ombudsman and calmly raise your concerns. If you feel he/she isn't helping, take other calculated measures so you don't let your emotions cloud your judgment and do something stupid like slapping the taste out of someone's out just because you're overstressed. After you've exhausted every option, your last resort is the court system.

All of us here want you to be balanced and happy, so keep us posted on your progress. We're glad to help.

Always at your service,

-- ED

GUYS/GALS:

Took a 5mg Ambien last night, and am still having "senior moments." My eyes are open, but the brain's still napping and I feel run down. I'm going back to bed to "detox." Good night family.

-- ED

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.

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.

with that many medications he surely needs a pharmacist consultation.?