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My elderly mother suffers from dementia and is currently being treated at the hospital for a urinary tract infection and low blood pressure. She is receiving antibiotics and fluids intravenously for those conditions and she is improving.

However, she has a history of non-compliance with medications. She is on thyroid and kidney meds which she takes on and off whenever she feels like it. Today, I learned that the doctors at the hospital are planning to put her on psych meds because when they insist that she take her medicine she becomes agitated. I told the doctor that I would get agitated too if he kept insisting that I do something that I didn't want to do. She has been on several different psych meds in the past and has suffered through troublesome side effects like tremors, apathy, suicidal thoughts, anxiety, facial paralysis, restlessness and more.

The doctors are not consulting me or her private physicians regarding the psych medications they plan to prescribe. Can they do this? Is this legal or ethical? Should I consult a lawyer?

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The next closest hospital is far off and it is owned by the same medical organization as this one. On a positive note, the doctor's said that she should be ready for discharge in about a week. They are just waiting for some lab results to come back. Thank you.
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If you are not happy with her treatment there, perhaps you can have a transported to another hospital in the area. Is there another hospital nearby?
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I have spoken to my mother's doctors at length about the anti-psychotic medications that have been tried in the past, including zyprexa. They gave her zyprexa, anyway. Zyprexa is not approved for use in conditions related to dementia.

My mother is not combative or abusive to me or to the staff at the hospital. As I said in my previous posts, she only becomes agitated when they insist on giving her meds that she doesn't want. She is not agitated at any other time.

My mother does not pull IV lines. The doctor that gave my mother the zyprexa did not speak to me about that proposed treatment before it was given. Another doctor that I had not heard of or spoken to before told me that she heard that doctors were planning on putting my mother mood stabilizers. I told her that I was not informed about that plan and had made it clear upon my mother's admission to the hospital that no anti-psychotics were to be prescribed to my mother without our informed consent.

Thank you for your comments.
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I suspect their plans to use the Zyprexa may have to do with the IV lines. Agitated patients and IVs don't mix well. Has she been pulling at the lines? If they haven't started the medication yet and you currently know about it, it sounds like you became informed in some way. As the nurse told you, if your mother and family oppose the treatment, then it won't be done. They will look for other ways to help.
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If your mother is problematic/combative while in the hospital, they will give her the meds to try and make her cooperative. This is not a measure which I would fight. When she gets home you can tolerate whatever bad behavior you wish to but please do not expect the staff at the hospital to subject themselves to it.
I spent years begging doctors to add meds to stop my mom's abuse of me - her primary caregiver and whipping post. Why would you want her agitated?
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The doctors prescribed olanzapine. I spoke to the doctor this morning and she told me that they wouldn't continue to administer the medication if the patient and the family are opposed to it. The things is, they already knew we were opposed to it before it was administered.

I find that both disturbing and unethical. In the Patient Bill of Rights, it clearly states that we have the right to "receive all the information that we need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment." And, the right to "participate in all decisions about treatment."

I mean, why let a little thing like patient rights get in the way?
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Well evidently the doctors believe the benefits from taking the medications outweigh the possible side effects they might cause. That statement of benefit/risks is on every prescription I fill for my mom.

If it was me, instead of talk about consulting an attorney, I'd clue the docs in on what medications have been tried in the past that caused her the distress you've outlined. I imagine they'd find that information beneficial to her care.
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The doctors can administer without consulting the family first, but they can't continue the medication if the patient or the healthcare proxy requests that it should not be given. What type of psychotropic medication did the doctor prescribe?
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Thank you for your comments. As we all know, each situation is different and what works for some people does not work for everyone.

All anti-psychotic medications have a black box warning that specifically state that they are not indicated for the treatment of dementia related and/or disturbed behavior, especially in the elderly. The magnitude of risk of stroke is sufficient to outweigh likely benefits in the treatment of behavioral disturbances associated with dementia. The risk of stroke, heart attack and death is three times higher with anti-psychotics vs. a placebo.

My mother's non-compliance is a behavioral problem. She only becomes agitated when someone insists she take her medicine when she has already stated that she doesn't want to take it. Imagine what you would do if someone kept trying to get you to do something that you are vehemently opposed to. Exposing her to higher health and mortality risks, not to mention the effects of medication induced impairment, will only tip the scales from vulnerability to death.

This is a very complicated topic and I appreciate that you all took the time to respond. My question was "Can doctors in a hospital administer psych medications to an elderly dementia patient without consulting her family?" I don't expect the doctors to call me every time her meds need adjusting, however, I do expect them to consult with me if they are planning on adding medicines that will increase her risks.
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6Beta; what the doctors are insisting that your mom do is take medications that will save her life (kidney and thyroid meds). I doubt you would become agitated if someone tried to get you to take lifesaving drugs. The agitation is part of the dementia and there are drugs that can help with that. Overall, your mother will have better quality of life if she is compliant with the medications that treat her physical symptoms. The demented mind is not rational. It's very hard, I know.
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At the age of 78, my dad was on a lot of medications. When he would go into the hospital they often added new meds or adjusted the current ones. I didn't expect the Dr. to call me every time they adjusted his meds.

Let the Dr.'s do their job. Often several meds have to be tried before finding one that works.
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The hospital is the right place to try to get her behaviors stabilized. The docs are trying different meds to see if they will help. She will be happier that way and so will you. My Mom is taking Seroquel and it has done wonders for her.
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No, you should let them give her the medications that calm her down. If she remains in her current state, her only option is a rubber room.
Our mom was non-compliant when living on her own, but in Assisted Living, where the meds are dispensed on a schedule, her paranoia and agitation were dissipated. The crying jags and wanting to die went away. Mental pain is every bit as real as physical pain, let them alleviate it.
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