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Today I accidentally gave mom four times the amount of iron she was supposed to start. The poison center said it wasn’t a toxic amount and she isn’t showing symptoms, for which I am incredibly grateful.


How do I ever forgive myself for making such a stupid, yet potentially deadly mistake? How do I go forward and be confident in my caregiving abilities ever again? I feel I have completely failed her and am heartbroken.

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Know that you are doing your best. When you are wanting to do your very best by your loved one, it feels terrible to realize you made a mistake. The day before Thanksgiving I realized I probably made a big mistake in applying for rent assistance for my brother—he may not be eligible for the program I applied for. I think much of caregiving is about crisis management. If there’s a slip up I’ve created I feel awful. There’ve been lots of great suggestions about medication boxes here—those should help out!
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Reply to katepaints
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Show me a person who claims they've never made a mistake and I will show you a liar!!! Mistakes happen. In your case it didn't really cause any issues. Be grateful it wasn't a more toxic medication! Since it was an honest and innocent mistake, take it as a learning lesson, not as a bull whip. If you have been doing this for several years and this is the first oopsie, consider yourself lucky!

One way to reduce medication errors is to get one of those monthly dispensers. If all medications are taken at the same time and they all fit in the compartment, you can set it up for the entire month. If there are medications taken at different times of the day, or too many to fit in the compartment, you will get fewer weeks, but should be able to get at least one week's worth in it. Generally they are locked and have alarm(s) - could be audio and/or visual. By using one of these, you can fill it at a time when you have no distractions or need to rush. Then, even if you can't be there or are running late, she can still get her medications.

Even professionals make mistakes. While hospitalized and not allowed to eat, they set up a "feed bag". I could tell without weighing myself that I was losing weight, but I checked a scale anyway. Sure enough! So when I asked about calories (bag listed lots of stuff, but not that), I practically had to drag it out of the nutritionist. 1200!!! I asked her if she was nuts. She said they weighed me in at 102 and were targeting 110. So I told her you are NEVER going to get to 110. She had the nurse get the scale. It was either 90 or 91 lbs. Without even looking it up, I KNOW 1200 is not enough, AND I could tell by looking at my legs that I was losing weight! Here's what I found online today:

health.gov chart shows est cal by age, gender and activity. For sedentary age 41-45 1,800 cal - actually from age 14 to about 50, with a little increase in the 20s, it's 1800 cal!

healthline.com says "A 1,200-calorie diet is much too low for most people and can result in negative side effects..." they have examples, but not really weight loss!!

Keep in mind this was NOT a young, still wet-behind-the-ears nutritionist AND was at a well known hospital in a large metro area (aka not a bumpkin!) She had it raised to 1500, but I still had to contact her after I went home with it. I wasn't losing anymore, but neither was I gaining. She finally got it to 1800, but shortly after I was given the okay to eat again!

So, even though it is different than a "mistake", it still could have had serious repercussions had I not taken her on! Technically I WOULD consider it a mistake. WHO would suggest 1200 cal for an adult?
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Reply to disgustedtoo
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Please stop beating yourself up. These types of mistakes are pretty common. Most medication mistakes do not cause the person harm, but it is always a good idea to check with the pharmacist or poison control if there is an overdose.

Chalk this up to being a new medication.

As an RN, we are always told to slow down, be focused (distractions lead to most mistakes), read the label for patient name, dosage, time to administer medication, method to administer medication (most of the time it will oral medications), and any information about interactions or side effects to look out for. If this medication is in pill form, pill boxes can come in handy. If it is in liquid form, use a medicine cup or syringe and mark the level the amount of liquid on the syringe or cup. When you get a refill of the medication, always double check make sure that the amount of medication hasn't changed (which can happen more often with generic medications).

By the way, iron is more easily absorbed into the system when taken with anything containing Vitamin C: orange juice, tomato juice...
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Reply to Taarna
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Caregiving is stressful and distracting, and makes it easier to forget things. You're not the first or last person who will do this. Heck, I can't even remember if I've taken my own vitamins in the morning sometimes! Perhaps alter your process?
I use a monthly pill dispenser for my Mom's meds that I bought on Amazon which holds 31 pill boxes in a tray. The date is printed on one end of each daily pill box, so the tray looks like a calendar when fully loaded. This allows you to pull out the pillbox for the day and put it back in the tray with the date hidden once the doses are taken. (On Amazon search for 'monthly pill box' with what you need-1, 2, or 3 x / day.) It's been a big help to me. I use this method for her prescription meds, and lay out her vitamins on her placemat each AM.
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Reply to ElizabethY
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Hopefully this experience will highten your awareness for her caregiving. You made a mistake so consider it a lesson learned. Keep on keeping on. You were wise to call the poison control center.
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Reply to sjplegacy
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Help me with something- if your mother is in an Assisted Living, why are you making yourself responsible for administering her medications? If this is a service available to her, it may be worth considering. My LO’s meds are administered daily for a small fee. I couldn’t POSSIBLY be responsible for administering them, based on her erratic schedule alone, much less all the other variables in her and my environments.

More important, just by your description you are putting an incredibly unmanageable burden of stress on your already overburdened list of responsibility if you are not even allowing for the possibility of making an innocent ERROR which was NOT “potentially deadly”.

Will it help you OR your mother by characterizing your actions with language like “completely failed her” and “heartbroken”? NOT ONE BIT.

You do what you do OUT OF LOVE for her, not out of being a Saint who is doomed if an innocent mistake occurs.

IF you cannot arrange for AL staff to administer medications (but her iron is actually a supplement, right?), then buy yourself the best organizer set-up you can find, and set aside a few minutes once a week to set it up. Having done this, YOU will be in better control of preventing accidents with dosage.

I’ve been a caregiver often throughout my life, and I’ve both observed AND LEARNED BY EXPERIENCE, that taking really good care of the CAREGIVER is JUST AS IMPORTANT as taking care of the patient. A weary, depressed, anxious, unnerved caregiver is MORE LIKELY to make an innocent goof than a comfortable, self nourishing one.

Be at peace with what’s happened as a blip in a long sequence of loving care.
It has made no difference in her life. Release your desire to make it too important in yours
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Reply to AnnReid
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caroli1 Nov 27, 2020
The OP's mother is in independent living,not assisted living, according to her profile. In general, people in independent living handle their own meds, although there are always some residents with caregivers who may handle their meds, except for actually administering them.
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You kick yourself all round the room, then you post what you've done here, and the good and lovely people will a) console you and b) recommend that you don't do it again!

That's what happened to me, anyway. I always set out my mother's early morning and lunchtime meds in two different egg cups. Then I put the a.m. ones on her breakfast tray and the lunchtime ones in the cupboard. Methodical, see?

And one morning the phone rang and I went to put the lunchtime eggcup in the cupboard, and it wasn't there, and where the heck had it gone, and ohmygod I must have left it on her tray -

Dash to her room. Too late.

Yup, she had taken both sets of meds. Bumetanide, Bisoprolol, Losartan...

😱

I called her GP, confessed, and was told to calm down and report any worrying signs but they didn't think there would be any.

Moral: whichever method you use can be improved by learning from mistakes.
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Reply to Countrymouse
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You are a human being. Humans make mistakes. Even doctors make mistakes, and so do nurses. The anxiety of caregiving often makes us so anxious we cannot stay mindful and stay in a headspace where you do something without thinking of the dozen other things on the "plate" at the same time. You made a mistake with something that luckily doesn't make a difference. It will help you going forward to know to keep you mind about you. Forgive yourself for human limitations. We all have them.
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Reply to AlvaDeer
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Meredith, you are human. Humans make mistakes. If iron is something you give her on a regular basis have you considered having the pharmacy have all your mom's medications in blister paks. It's so convenient. All her pills would be in their own little blister pak with the dates and times she needs to take them. I did this with my mom's medicine and it really helped.

(I see Margaret already mentioned this but I guess it doesn't hurt to hear it twice) LOL
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Reply to Gershun
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Hi Meredith, find an improved medication routine. I forget within seconds whether I have had my morning tablets today, or am I remembering swallowing them yesterday. I now have a pill pack (aka webster pack) which runs for two weeks with the days of the week named, with all the doses sorted in advance. It’s very very common, and ought to help you too.

Just for your interest, I was in my mother’s hospital room when the nurse found that another nurse had mixed up doses big-time because she was not clear about exactly what metric milligrams meant. She was visiting from a country hospital, to get recent city experience – which she clearly needed. There was a sub-voice panic, but my mother wasn’t killed, thank heavens. If they can do it, you need to forgive yourself. Just work on ways to make it less likely to happen again!
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Reply to MargaretMcKen
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Merediths Nov 26, 2020
Goodness! So glad your mom is ok.

thank you. Through all the support here I am learning, being reminded that we as humans are not perfect. It is humbling and appreciated.

with gratitude,
m
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Your mom sounds lovely and so do you.

I am quite sure that your mom forgives you and would want you to forgive yourself.
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Reply to NeedHelpWithMom
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Merediths Nov 26, 2020
Agreed. We just cried about it together. Ugh. So much emotion in this caregiving world. The beauty and heartbreak go hand in hand it seems.

with gratitude,
m
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When the guilt is high about this. Tell yourself that you are human and that humans are fallible. I know if you were reading this story from someone else, you will tell them to keep forgiving themselves and to keep putting one foot in front of the other. All of us deal with self talk, which sadly a lot of times are out right lies and can be so self judging to the point of being a sadist on ourselves. It's common to all of us to hold ourselves to unreasonable expectations. One day you may be fine and then another day can roll around and there we are dredging it all up again. When that happens, you must be your own mental security guard and tell yourself, no this is not gonna be how this goes today. It's not that you did it on purpose. If you feel you need to, take extra measures like posting a chart on the wall or somewhere and when meds/vit etc are given mark it down, whoever is administering something. That might help you have confidence in the days ahead.
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Reply to eeyore12
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Merediths Nov 26, 2020
Oh my gosh. You are so right about self talk. Thank you for the reminder. Thank you for the image of being a mental security guard.

with gratitude,
m
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I think every caregiver eventually makes a similar mistake. We are human, and often trying to multitask or operating with suboptimal sleep, etc.

I accidentally gave my father too much of a painkiller medication for a few doses, and the mistake definitely contributed to the whole series of events surrounding the delay of the discovery of my dad’s spinal cord injury. Maybe the effects of the injury wouldn’t have been as bad ultimately if I hadn’t made that error. Sigh. Everyone (including me!) was doing their best.

My sweet dad said he didn’t blame me and I had to forgive myself and just keep on keepin’ on. Best to you and your mom.
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Reply to SnoopyLove
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Merediths Nov 26, 2020
First, I love your name Snoopy Love. Second, I am thankful you found peace with your situation and I appreciate you sharing your experience with me.

your dad sounds like my mom, as she said the same. You were doing your best, as was I. That’s all we can do right? Sigh.

with gratitude,
m
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Accidents happen. Please forgive yourself.

Obviously, you care. Or you wouldn’t be so upset.
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Reply to NeedHelpWithMom
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Merediths Nov 26, 2020
Thank you.

mom was such a fabulous caregiver to my sister, I just want to repay that. I appreciate your words.

with gratitude,
m
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When my son was an infant, one with many critical medical needs, we kept a running chart of his meds with dosages and times given. Once in all those doses my husband and I both gave him the same highly potent med, right on top of each other. Complete freak out! I was convinced we’d just killed him. A quick call to his doctor confirmed that he’d be fine, but that didn’t stop the guilt or the watching him like a hawk. Ultimately we’re all human, making human mistakes despite doing our best. Highly trained doctors make mistakes, that’s why it’s called “practicing medicine” Forgive yourself and move forward, you’re doing your best
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Reply to Daughterof1930
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Merediths Nov 26, 2020
Thank you for sharing your experience. I’m glad your son was ok.

It feels like a mountain to move right now, but I will work on forgiveness.

with gratitude,
m
m
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