Follow
Share

She's in a new memory care facility. Was walking, talking, bathing herself. Now after 3 weeks there she’s sedated all the time, in diapers, confined to a wheelchair “for her safety and comfort". I’ve asked them not to give any extra pain meds but can’t seem to stop it because they say she figits and hollers that she’s in pain. Hasn't had any serious injuries, does not have cancer, yet morphine is given frequently especially on night shift. Then they can’t feed her breakfast because she’s too “sleepy “ and remains that way all day. I’m at my wits end. Please advise.

This question has been closed for answers. Ask a New Question.
You say, "I will schedule a meeting with the facility director, who doubles as the facility nurse, and the Hospice nurse who works with her Doctor."  Your mother is on hospice care at her Memory Care ALF, and that is why they are medicating her for the pain she says she's experiencing. That's the purpose of hospice care: to prevent your mother from suffering now that she's approached her end of life care. If your mom is agitated to the point where she's 'breaking stuff in her room', that is likely why Ativan was prescribed; to calm her agitation and help prevent that agitation from occurring. Prescribing medication PRN is necessary so the nurse can administer the appropriate meds as your mother requires them, based on her symptoms and behavior at any given time, which is always subject to change.

Please speak with the doctor & the hospice care company so that you are fully aware of their services and what it's all about. Make sure you ask all the questions you need to ask so there are no surprises to encounter at this stage of her care regimen.

Wishing you the best of luck with a difficult situation.
Helpful Answer (6)
Report

Do you have POA for her medical needs?

My mother’s MC calls me every time there is a medication change.

If I say no to something, it’s NO.

If you have medical POA, can you ask for a list of her meds, and sit with the DON or her doc, and give explicit directions for each one?
Helpful Answer (3)
Report
Mommysgirl77 Sep 2021
Yes, I’m her POA. And they discuss changes with me but I was unaware the morphine and other things were PRN. They don’t check with me before they dose her up. I will schedule a meeting with the facility director, who doubles as the facility nurse, and the Hospice nurse who works with her Doctor. And I agree- I definitely need to be consulted on the PRN meds . Trouble is this often happens in the middle of the night.
(2)
Report
Are you sure she is being given Morphine?
Ask to see the medication logs and what has been prescribed.
If she has been medicated other than prescribed you can file a complaint.
You can also request that a different doctor see her to adjust medications as needed.
A side note here though.
A person with dementia often declines after a move.
That decline is usually the new "baseline". It is possible that the 3 weeks in this facility has resulted in the decline not exclusively due to the medications that have been given.

And if you are unhappy with the care that she is getting currently you can look for another facility just keep in mind that another move may cause another decline.
Helpful Answer (2)
Report

Yes it’s morphine. The Dr has ordered it PRN or “as needed” . She gets Adavan also 4x a day and that’s a decrease per my request. And Tramadol. She did great her first 3 weeks and then had an incident where she broke stuff in her room. That’s when this all started.
Helpful Answer (1)
Report

The thing is these kinds of meds really do need to be prescribed PRN so they are available when needed, the only alternatives would be scheduled dosing whether needed or not and not available at all unless the facility has the doctor on speed dial. Your mother must have some kind of terminal diagnosis since you have mentioned a Hospice nurse - if you do not agree that she is ready for palliative end of life care then that could be the root of your problem and what you need to focus on when speaking to the doctor and care team.
Helpful Answer (1)
Report

You need better communication with the hospice people so you understand what's going on. Morphine is not just for cancer, and it, combined with the sedative, helps to avoid the restlessness and anxiety that comes with the end of life.

Work WITH the hospice people, not against them. They appear to be going for comfort care for your mother.
Helpful Answer (1)
Report

Tramadol should not be given to the elderly. It gives them hallucinations. This may be the reason for her restlessness. If she is being given Morphine why Tramadol too? A nurse can tell when a patient is in pain, their BP goes up.

And why is Mom on Hospice to begin with? I think those suffering from a Dementia become like children. My Mom would cry in pain when a BP cuff was used on her. Like a child who has a scratch and you may think they were dying, I think its the same with those with Dementia.
Helpful Answer (1)
Report

Is this a "new memory care facility" as opposed to a previous one or newly build/opened?

If this is a different facility, why the change?

I would have SERIOUS concerns about a MC place that is just drugging up someone who was "walking, talking, bathing herself" 3 weeks ago. You mentioned an episode where she broke items in her room, which seems to have precipitated this drugging.

If she still has her own doctor, I would take her there for a good workup, MINUS the meds if possible, including blood work and urine test (culture is better than dip stick.)

UTIs and other infections are NOTORIOUS for causing sudden behavioral changes (being in depends and wheelchair is more likely because she's over-medicated - it's the "incident" that raises questions here!)

Those who work in the field (MC) and have half a brain should know this! My mother was also walking, talking, able to bathe, feed herself, etc. In her case, the UTI caused severe sun-downing, so she was demanding to get out, had guests coming, had to go home and set off every door alarm! Because this started on a Friday evening, we didn't get the test until Monday morning. Of course mornings she was fine, and she wouldn't remember it. This would only rear it's ugly head later afternoon. She had to take a small dose of anti-anxiety with the antibiotic, but it was MINIMAL and only enough to take the "edge" off. I'd been there when she'd get it (later in the day, before the "episodes" start) and she was fine. No rantings, not doped. The anti-anxiety was kept PRN but stopped. I maintained control over her medications (ordered and delivered them, much less expensive!), so I know the Rx was not renewed AND no other "drugs" were in use (otherwise they'd send a bill and I would raise holy-hell!)

If she has an infection, she quite possibly could be having pain, but can't express where or what it is. I would get her away from these drug peddlers, get her off those meds and then get her to a doc pronto for testing.

While it is possible she's nearing end of life, it doesn't make sense for things to change that abruptly. It's also NOT the goal in GOOD MC to keep residents doped up like that. Take her home long enough to "dry" her out and get her tested. If no regular doc, perhaps a clinic or an ER? IF she has a UTI or other infection, I'd move her out of that place permanently!
Helpful Answer (1)
Report

I was shocked when they just gave everyone anti-depressents in the nursing home where my Dad was a patient. Then in another nursing home they gave him haliperodol which killed him. I look it up on the company who makes it's web site and it said it was not to be given to the elderly! If the other suggestions here don't work I would look for another facility.
Helpful Answer (0)
Report

What diagnosis does your mom have? My heart goes out to you as this is unacceptable.

Are you saying she was not in depends and wheelchair bound when she went there?

During Covid my mom had a uti and had to go to the hospital by ambulance from my home as she has hemiplegia from her stroke and between UTI confusion and harder transport we chose to go by ambulance. I could not get in until the next morning where I found her out cold - eyes literally rolling and couldn’t respond. I was told she tild them her leg hurt (well after laying on a transport gurney for 18 hours before getting into a room- her body was sore - yes) so they gave her flexaril “so someone who takes zero pain meds and is sensitive to meds” was most likely anxious and had a uti which affects her - she was now unable to eat - feed herself - nor keep her eyes open or speak a sentence - it took 24 hours to wear off and her start to wake up from it.

There are many here who have had great care and trust but there are also many here that have lost all trust and I am one of them. I never want to see my mom agitated or uncomfortable nor do I want others receiving care around her to have to be anxious in moms UTI confusion moments - but I also will never allow her to be drugged to the point where it’s convenient because she fidgeted. I’m so sorry your mom was treated this way.

I would request a meeting immediately. But I would also try to take time off to spend some full days with her that may give you a better idea so that you can guide them - you know her best - you may see something they missed or a way to help her vs medicating her or even finding a lower level where you observe that it helps her to be less agitated but also able to function.

If mom was becoming worse that they gave her additional meds make sure they looked into what else could cause her more fidgeting or cognitive decline. For your mom to go from not wheelchair bound and using depends to now doing so she is either being given the incorrect medications or she has and infection or dehydration etc. Request a meeting ask for her current bloodwork - if urine sample was run etc.

Wishing you the best in finding answers for your mom.
Helpful Answer (0)
Report

See All Answers
This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter