Can I demand the nursing home to give my Mom a supplement?

Although it can vary a bit from state to state, to the best of my knowledge, this is pretty much how it works:

If someone is in residential care or assisted living, which is a form of residential care, it is considered very much like your own home: your choices in almost all circumstances.

If, however, it's necessary that the patient be in a nursing home or a long term care facility which is structured like a nursing home, ie: with the doctor in charge and overseeing the patient (read that as: RESPONSIBLE for the patient), you will only be able to give what a doctor prescribes, and it will generally need to be available through their pharmacy on blister pack cards, which is the way most nursing homes are currently choosing to dispense their medications. The cards come already pre packaged each patient's medical requirements, the day count during the month is right on there, the nursing staff doesn't have to handle and count bottles and bottles of medication, it is supposed to be safer because it eliminates which of the chance of human error.

According to recent research. So many people are vitamin D deficient that you are finding doctors who will prescribe it. consequently, pharmacies make it available as a drug, not a vitamin. Rather then being a vitamin D3 from a source you might prefer, it's going to be a USP form of chemical vitamin D from the absolute least expensive source, while dispensing it at the highest possible cost, of course.

I am a nutritionist. At home, I had my dad on a slew of "industrial strength supplements" from 1985 till 1994. He was a big man, and my mom was small. When his behavior became uncontrollably violent, we could no longer keep him at home. The only type of place available to us was a nursing home, yes, with a doctor. So no more supplements.

Within a few days of admission, they did a cursory examination as required by law. They didn't get to a serious evaluation for 10 days. By that time, he was off his supplements and the doctor there had "adjusted" his medications. His mental and emotional condition deteriorated very rapidly. The comment they made to my mother and me was that they were surprised from his behavior that he was in as good a physical shape as he was. Well, of course IMO, that's what the supplement did, although you'll never convince any medical personnel that don't believe in supplements that that was the case.

He was in the final stages of Alzheimer's; his mind was already was already gone, his mental faculties did not work, we had kept his physical body healthy. Withdrawing the supplements took care of that. My dad was a strong, booming 6 foot 3 inches. He went in to the nursing home at 219 pounds. He crossed over 16 months later weighing 147. I don't know if you can even imagine a person of that height weighing so little.

It's a sad reality for all of us, but Alzheimer's and other dementias are death sentences diseases. There is absolutely nothing you can do you totally prevent the progression. It's admirable that you have given supplements. You have no doubt extended not only the length of time but the quality of life. But once you reach the nursing home stage, you are on the slippery slope.

Frankly, I was trying to help my mother, because she wasn't ready to let go. But the caretaking was killing her. Because my dad had become violent, we could have continued with him at home longer by giving him antipsychotics such as Haldol, but we would have been dealing with a pendulum swinging between violence and zombification.

If it had been up to me, alone, I would have withdrawn the supplements and allowed his physical self to deteriorate in line with his mental health and emotional self. When they are in a residential situation, you have control over this. When things have digressed to a nursing home situation, the control is removed from your choice he was very large degree, something you will have to adjust to.

To be sure, there are facilities that are licensed for memory care which are residential and not skilled nursing or long term care with doctors in attendance. We had one of those in our area, but it was private pay. We needed to place my dad nearly an hour away from home, and it was a nursing home.

I don't mean to be depressing or bleak but everyone responsible for taking care of dementia patients needs to be realistic about the progress of the disease. I will mention this, just for the irony of it all: after we placed my dad, my mom started serious, deep cleaning for the first time in 10 years. Behind couches, lamp tables and my mom's electric organ, as well as under the beds of all three bedrooms, we found little piles of supplements. Certainly not everything we had given him, by a long shot, but enough to realize that the very taking of them irritated him. Hahahaha...

ANDREAAG
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I believe that you, being her son, and possibly having "POA" can give you mom anything in the way of food and supplements that are "non" medicinal!

I gave my wife the attached supplement for 3 years including 3 months at her nursing home. It is a very high calorie, nutritional drink that cannot be bought in the store; however, you can purchase it via the internet from many sources. I bought it through Amazon and it shipped for free. It comes in vanilla and chocolate and has a nice flavor and texture. It has 530 calories per 8oz...This is more than double the amount found in "over the counter" boost drinks. It kept my wife from losing weight and gave her many vitamins that she needed. Check out the ingredients on "google".

Talk to the dietitian about this and "not" to a nurse or doctor! It isn't a medicine and you have a perfect right to give it to her

Lots of luck, Sonny

BOOST® VHC-Flavor Vanilla Calories 530/ 237 mL Packaging 8 fl oz carton - Each 1
by Nestle Nutritional

The nurses who administer meds in a nursing home can only give what the Dr has ordered. Those medications are dispensed sperately for each patient and placed in the drug cart by the pharmacy.
Most nursing homes have their own Dr on staff who oversees all patient treatment unless they need to go outside for specialized treatment for such things as dialysis.
I do not know how dental treatment is provided but in my opinion a filling would be more palliative than an extraction.
Nursing homes vary in quality as many have observed so once again due diligence will get the best care for your loved ones. Visit at many different times of the day so you can see how your loved one is truly treated.
the whole subject of suppliments is a very thorny

To continue as it posted by itself. Suppliments vary in their quality and may even not contain any of the ingredient they claim to have. if you actually call the company you will recieve a very evasive answer such as "It is a therapeutic amount" so you may well be buying sugar pills.

Here in NY, any adult home, ALF or NH must have written MD orders for any meds, including over-the-counter items like vitamins and topical creams and even cough medicines. No one can demand the staff give anything or hold anything back. Doctor's orders only, that's the law.

I am getting "nauseated" from hearing from so many caregivers that a personal caregiver such as a son, daughter or spouse should ask the doctor, nurse or an aid if a supplement is ok after a cognitent patient has been taking a nourishing and non medicinal supplement for some time with beneficial results and then told...no by a "professional" that he/she can't have one. That is ridiculous.

I believe that it would be best if at all possible, is to take your loved one home and have the nurse and therapist come to your home rather than have the person locked up in an institution. I believe my wife died unnecessarily because of the neglect and all of the pills that were given to her under "doctors" orders. Her personal doctor was not allowed to interfere with the "institutions" doctor!

No, it is not a payment issue. It has to do with the FDA NOT being able to regulate supplements which are mostly expensive pee, and the nursing home you are considering does not have to do anything they do not want to do based on their guidelines. It sounds to me like they want to keep all the money in house with meds only in their pharmacy. It is their right to do that. Try contacting other nursing homes to fit your needs and don't be surprised if the others want only FDA-approved drugs. Their are covering their as------ just in case of a lawsuit. Take them to her if you can if you want her to have them so much. Discuss the importance of taking the doctor prescribed meds, and if they will not make a difference (Nothing will help a person with dementia), then choose the nursing home based on your desires.

Christine if you mother is subject to abuse please notify your States health dept so they can investigate. Photograph anything you can.

Nursing homes do not give anything without a doctor's orders. My aunt was in for rehab for 22 days. They gave her a vitamin and Tylenol, but asked me to bring in her bottle of cranberry pills, which I gave her to prevent UTI's. BTW, they didn't, and shortly after discharge, she developed a bleeding problem. I discontinued most of the Tylenol and the cranberry pills. No more bleeding. But a lot of supplements interact with regular meds. I once heard a natural physician say that if they are strong enough to do good, then they are strong enough to have side effects and interact. My feeling is that when is person is ready for NH care, supplements do not do any good and may do more harm then good. The only type of supplement that may be good is a Boost type supplement if one is not eating properly. At my aunt's NH, a lot of the patients received their Boost shake at mealtime.I would think it would be hard to hide a supply in the room, so you'd have to carry a can in your purse when visiting.

If they are in a NH it is considered a skilled nursing facility and as such all aspects of care including medications has to be done by physician's orders. Usually this comes from / comes through the medical director of the NH with the DON (DIrector of Nursing) who places orders and staffing based on what the MD prescribes. SOmetimes the elders prior physician is involved but usually once they go into a NH, their old MD turns over care to the medical director of the NH.

All this is in the admissions agreement. You do not demand that they do xyz for your family member - all that does is cause problems. Once they are in a NH, there is a care plan meeting required to be done on a regular basis by CMS. For my mom in both of her NH, the first one was done within the first 30 days and then every 90 days thereafter. A letter was mailed as to the upcoming CPM and a # to call to set the exact time for the meeting. SOme I went to in person & some were done via CC. The CPM is where you can voice your concerns and request specific things be looked at -everybody front the various departments (dietary, activities, social work, nursing) will be there and will have a short report on your elders status for their department. CPM's are very insightful if you manage it right, and is very much a way to ensure what you want do is put into action. If something in serious, then the DON comes to the CPM otherwise the DON will send the RN who is the floor director or section manager for the unit your family member is in.

There is no reason why you cannot be totally prepared for the CPM with a list of items you want addressed and state why and what you suggest as a solution for them with documentation as to why (like a letter from their old MD that the specific supplements were given under their orders). When the CPM is done (takes under 30 minutes), you will be asked to sign off on having the meeting - at this point in time if you don';t agree then you add in what you want or you put clearly that the report you did and brought to the meeting was delivered and to be added to your elders chart. At my mom's first NH, the last CPM meeting I brought in a pretty scathing report with photos and wrote clearly on the CPM as per attached report and I would not leave the meeting till I got a copy of the CPM that had all the signatures of staff at the meeting. The DON was not happy, but this is totally within my rights as DPOA MPOA - I already had mom set up to move to a new NH later that month, so no blowback.I also filed a Stark complaint on this NH. If you have issues with a facility, you have to clearly document date & time on all this and then do the follow up in letters to CMS and your DHHS or whomever administers Medicaid for your state. All NH are state regulated and that body should also get your letter of concerns. Everything must be in writing with your authority indicated (DPOA, Guardian) and I would send all certified mail with return registered card (the green card @ USPO). Venting on this site is terrific but you have to do the follow up in writing and with a chain of verification to get things done.