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lchelsea Asked August 2011

What do I do when my mother's nursing home thinks she is depressed and needs medication?

The nursing home is telling my Mothers primary care doctor that she is depressed and needs depression meds. I can tell she is taking them because she is not herself and is very disoriented and can hardly talk at times. They have convinced her she is depressed and needs to take them even when she disagrees when them. I have tried talking to her doctor and the nursing home but they continue to tell me she needs them. I have also told her to tell them she doesn't want to take them, but they continue to talk her into it. Should I pursue this? Does anyone else have this problem with nursing home staff?

Here4her Aug 2011
You know mom also had a prescription for breathing treatments....albuterol. The script said 4 times a day. That was over kill for her as she shook violently. I wrote on the box only 1 time a day or 2 if needed. They never gave it to her the entire month. It is just whatever was easier for them. But they had no problem charging over $7,000 for 1 month + supplies. That is why I am keeping her as long as I can. I'm doing the job of several of them that can't seem to get it right. Just because a fasculity is beautiful and new doesn't mean they will care for your loved one any better.

jeannegibbs Aug 2011
golfbhard, it seems like "take as needed" drugs are an area of potential conflict in care facilities. One of the members of my local support group could not get the NH to give his wife a drug they had used successfully at home for certain symptoms. It was an off-label use (all drugs for Lewy Body Dementia are off-label; there have been no drugs specifically for that disease) and she didn't have the symptoms the drug was originally developed for, so they wouldn't give it to her. They held this position even though her doctor explained the symptoms that this drug relieved for her.

You thought "as needed" meant for panic attacks (probably because that is what the doctor intended) but the respite care place thought it meant for something else (probably anxiety).

grrrrr....

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jeannegibbs Aug 2011
Annette, if she is depressed, treating her for it is appropriate. The correct drug can make a world of difference. Depression doesn't always present itself as sadness. Symptoms can also include lack of interest in life, apathy, fatigue, etc. I would ask what symptoms your mother had that made them think she needed to be treated for depression?

The correct drug in the correct dose will not make her disoriented or unable to talk. Getting the correct drug/dose is often a trial-and-error adventure, not because the doctor is incompetent but because of the great variability from one person to the next.

Pursue this. Point out the side effects. Be polite but firm. Assume that the NH and the doctor both have the same goal you do: your mother's welfare. This medication does not seem to you to be contributing to that, so discussions are in order.

Here4her Aug 2011
My mother lives with me, but wen to respite care for a month so I could take a vacation to visit friends in Florida. She had a perscription for Xanax (not filled) to take as needed. This was in case she got a panic attack. I took her meds in and they used from her pill bottles
When I came back they had filled it and was giving her 3 a day. I told them I only use that for panic attacks (and she thinks she is having a heart attack) and they told me I should consider giving it to her daily as she "tolerates" it well. It makes her wacky if she doesn't need it. I told them she would not be taking it daily. I think some want to have them sleep all day so it is easier on them.

notrydoyoda Aug 2011
What meds is she on? I would look for any possible drug interactions between her antidepressant. If she can hardly talk and is disoriented, that might mean the dosage is too high. I hope you have medical POA for your mother for it is time to use it if you do.

NancyH Aug 2011
Annette, The nursing home doctors where my mother-in-law spent some time in (the rehab part), sat myself and my sister-in-law down once a week and discussed her care. BUT you have to have the legal rights to talk to her doctors and make decisions on her behalf. At one point in our case, my mil started getting a bed sore. I told them that this was unacceptable because she's just in there for a broken hip for crying out loud, she was supposed to be up doing physical therapy for her hip. My sister-in-law was a little shocked that I reacted so strongly, but my grandma died in a nursing home and had a bed sore that was clear to her tailbone, that's NOT right. So if you have the legal rights I mentioned, then ask to talk to her doctor/doctors and persist in your questions. Do some research on your own about the particular drugs she's taking and the side effects so you'll have some ammo when you talk to them. Be proactive. You are your mom's advocate, who cares what they think about you?

JoyceW Aug 2011
Is she being evaluated by a psychiatrist? Is there anything in her behavior that leads them to believe she is depressed? Sometimes antidepressants are given to stimulate appetitie. My Mom was definitely depressed, and even through it helps her mood swings a little, she is still the same angry and frustrated person she was before she started taking the meds. Drugs react differently on each individual and she should be monitored closely. I know it is difficult to get straight answers from staff, so you and your Mom are sometimes a better judge of how she is feeling and reacting to the medication. Keep a journal so you can document how she feels from day to day. Do you have the authority to make decisions regarding your Mom's care? I would continue to discuss your concerns with her doctor and don't quit until you are satisfied that your Mom is receiving the right medication for her mental condition (if there truly is one). Good luck.

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