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My mom stays with me and is 92. she gets around well just using a walker, but her major downfall is the oxy codone pain killers and the tromodol pain killers plus she takes 3 Xanax a day also. She gets up at 3am thinking it is 8, gets her mind all mixed up, but says the pain killers are needed because her left hip is sore at night. She has had cortisone shots in an area of the back to help the hip and leg and that is the dr who prescribed the pain killers. I am wondering should I call that doctor and have him either call or write to my mom and say she should not take those pain killers? The Xanax has been ongoing over 20 years so I do not think I would get her to stop those. Any ideas? I have even considered asking her family dr. if he would prescribe some placebo pills for her.. thank you.

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The xanax at night will help her sleep if that's what she needs but you might ask the Dr about Buspar for daytime. It is an anxiolytic (anti-anxiety) medication and although dizziness or drowsiness COULD be a side effect, it usually isn't, and even if it does cause those symptoms, they are more minor than with xanax.
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Hi, Have not had a chance to get back on. She fell last week and had to be transported to a local hospital. She is now on their rehab floor and moving like a turtle. She broke nothing which is good but she is bruised up. I do think she slipped in the bathroom and went down on her butt. That is where she was when I heard her yell. sitting on her butt. She has very bad arthritis and osteoporosis. She insists on her 3 Xanax a day, each is .25 mg. The rehab floor wants her to not have any morning one of the Xanax as she just sleeps, st this point giving her age and all I am directing the doctor to give her the 3 Xanax a day as she has had for over 20 years and not let her have so much anxiety, she is totally stressed out about this so even though they mean well, in this case at age 92 she should have what she wants I think.
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Dear Lovinlife, As TTardis mentioned above, the repercussions of stopping pain meds all at once could have very serious repersussions. The withdrawal symptoms in an elderly person could be life threatening. From experience with my Mom when she was about 74, she was going to an anesthesiologist for anesthetic 'cocktail' shots in her back and spine (which did her little to no good) and then on top of that he put her on Oxycodone. Over the course of 4 months, I watched her body shrivel from approx 5'7" and 138 lbs, down to 5'4" and 110 lbs, skin and bones, and lost all muscle mass, and experienced confusion and anxiety. She is now 88 years old and never regained her former stature (not that we could expect her to grow, but the muscle mass never returned). I had a serious 'chat' with the anesthesiologist and he then weaned her off of the oxycodone, during which time we found an excellent pain management specialist, who started her on plain old morphine, both IR (immediate release) and ER (extended release). Over the course of several months, the dosages and frquency were gradually adjusted until the right combination was found to keep her free of pain. Eventually, as her condition deteriorated, he also had to put her on the Fentanyl patch - again adjusting until the right dosage and frequency was achieved. Ironically, a few years later, she broke her hip, and the brilliant idiots in the hospital, who God forbid should study her history before making judgements, took it upon themselves to change her meds because they didn't want her to be addicted! This for a woman who suffered from severe and chronic spinal pain with the ADDED pain of a broken hip - and they REDUCE her meds!! From that time forward, I have had to be like a pit bull with every hospitalist doctor and rehab doctor that has tried to to change her meds, by reminding them that her regimen of medications was under the strict supervsion of her pain management specialist. Even when she went to the NH last year, her meds were questioned and I refused to let them change a thing. Bottom line, she has been there 18 months and still free of pain. By the way, with proper management, Mom never became spaced out on any of this.
Don't listen to the naysayers spouting fears of "addiction" to pain meds for an elderly person - that is a load of BS! It's medically necessary, not a psychological addiction like some druggie out on the street. The objective of pain meds for the elderly is to keep them comfortable in their final years - surely they deserve NOT to suffer.
Also, it is true that pain meds can cause terrible constipation. I found that magnesium oxide tablets work wonders to keep the bowel soft and things moving along nicely. It is a natural muscle relaxer (including the bowel and sphincter muscles). Most people have magnesioum deficiencies anyway, so this is a good supplement. If diarreah starts to occur, then the dose is too high, and needs to be reduced. My Mom takes one 250mg a day which works for her.
I urge you to research and learn and question - and be your Mother's best advocate.
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I would consult with the dr who prescribed and voice your concerns. Then I would ask that he/she not renew any prescriptions without combining with mandatory physical therapy. Agree with others regarding a pain mgt. specialist -- but one who experienced with seniors because there needs are so much different and complex.

Good luck to you and a pray for your mom to not be so tortured by the pain and confusion.

I do know my mom was on lots of Vicodin along with her other prescriptions and I and she was 90...I was furious that they would renew prescrips without seeing her or coupling with PT. I threatened to sue if he continued to do so. That stopped the prescrips. Then her regular dr went back to weaning her to Tylenol, ice therapy, and exercise. Her mental state got better. She went off other anti anxiety meds too and has been off 9 mo and is more mentally sharp than in 18 mo prev though she still has dementia. IM NOT ADVOCATING without doctors knowledge and physician mgt because this has to be done carefully and under medical supervision, but from my experience! there were too many meds easily prescribed with little follow up and understanding of an elders needs and first hand knowledge of the drugs impact. Seniors also aren't always able to articulate or are afraid to articulate how they feel under the drug. They either like the numbness or believe whatever any dr tells them is right.
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When you say you are seeing a specialist for the elderly, are you referring to a gerontologist? If so, I hope that works for you but please be prepared. The "credentials" a doctor has don't always reflect their grasp of the reality of elder care.

As I previously posted, my mom was elderly (90s) AND in pain. She was switched from a PCP internist, who gave her great attentive care, to a board certified gerontologist, who was detached and nonplussed about everything, essentially providing no significant contributions to my mom's health and wellbeing over the last 2-1/2 years of her life. I was my moms live in caregiver but my sister was her conservator, so I had no say in the matter of the choice of doctors. Please believe me, it was hard to live with an even harder to watch.

There is nothing wrong with trying to interface with a gerontologist but if you are dealing with issues of pain, please, as suggested before, ALSO see a pain management specialist. You can probably find one who has gerontological experience and that would be ideal.
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Xanax comes in various strengths, for example 0.25 mg, 0.5 mg and 1.0 mg - of which strength is she taking 1 in the morning and 2 at bedtime?
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We will be seeing a specialist who deals with elderly. Many doctors seem to not understand one as old as her so we are going to see a specialist. I am hoping at least she will be able to cut down on the oxy for pain. The Xanax is 1 every morning and 2 at night to sleep
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The absolute best thing you can do is speak FIRST to your mother. Ask her if she is having pain, or if she is just worried about missing a dose the doctor told her to take. There may be other reasons she is wanting to take them, or she may feel that she *has* to do what the doctor says (Which is actually pretty common for that generation. They weren't really taught to question authority figures).

Second would be to talk to her doctor about it. **Do NOT try to just take her pills away or "give her sugar pills" as another member advised.** She could have some very, VERY nasty withdrawal symptoms that would leave her in a much worse position than the 'confusion' that the actual pills are causing. At her age the shock of doing something like that may very well be too much for her system to take, and I'm sure that's not what you wanted.
(As a side note, my mother thought it was 'ok' to just stop her Xanax after a year, because she felt better... I came home to find her wedged under her bed, screaming that "they were trying to eat her". She has permanent nerve damage caused by the incident, and a deathly fear of any long term medications now.)

As other members noted, there may be other reasons for the confusion, it could be dementia or it could just be frustration about other health issues that she is having a hard time communicating to you. Sit down with her and tell her why you are concerned, maybe she hasn't thought of that, or doesn't see it that way. You won't know until you actually speak with her!
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I don't think any of us can prescribe what your mother should be taking for her level of pain.

I don't you can cure her of an addiction (if she is addicted) to pain medications on your own.

Seek out a pain specialist and make sure that person knows EVERYTHING Mom is taking.

Good luck.
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My mom is 91. She broke her hip about 6 months ago and went 7 weeks to rehab and is now home. When she was in rehab the started her on tramadol.When she got home the dr perscribed lortab. Even with only one pill a day I watched my mother go from a sharp minded alert person, to being confused and delerious. I did some research and read that the elderly can't metabolize drugs as well as someone younger. I also read of many, many people (even younger ones) who had the same side effects as my mom from the tramadol. She was so bad I thought she had dementia.I cried every day when I saw her. She is now off all prescription pain killers. She takes a low dose celexa every day and is back to being herself. She still has pain in her hip, but only takes Tylenol and/or Motrin and Arnicare. She walks with a walker also.
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CarolLynn, I just attended a townhall meeting with the former Surgeon General of the U.S., president of Mayo Clinic, and president of Arizona State University and the resounding census in their discussion was the American population's addiction to medications, and their own bad health habits. I don't know where you live, but I live in America and have seen first hand addiction to pain meds in my nursing practice as well as dealing with drug-addicted parents in my social work practice with Child Protective Services. I did not mean to imply one would completely stop taking pain meds, as protocol requires a tapering off. It is not going to feel as good as the pain meds, but once off them the body can readapt and begin to heal itself. Pain is also mostly subjective.
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ps - generally, the only reason a narcotic pain medication would be prescribed at the same time as tramadol is because the doctor feels your mom has what is called "breakthrough pain" meaning bad even the oxycodone isn't completely overriding the pain, yet the doc doesn't want to give her more of that, hence the tramadol.

Also, I don't know where I got the idea that she was taking xanax 3 times a day. I must have mixed it up with some other post. Is she taking this annex at bedtime to help her sleep, as it does me? I have had either valium or xanax at night for sleep for over 20 years, so I don't find this unusual. Like many others, I tried melatonin years ago and got no results (you don't know me but I am a nutritionist with years of homeopathic background; my natural bias is toward alternative health products - the use of medical medication is never my first choice unless the condition is life or death). The Life Extension Institute recently published information that the many people who are not getting results from 1 to 3 milligrams of melatonin is because results for often not obtained until people had between 6 and 24 milligrams. I'm going to be trying this soon on an accelerated dosage and I'll let you know (the FORM of melatonin is important, never pills or quick dissolving, only sublingual liquid or tablets).
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Ferris I hope you enjoy your sugar pills when you break your hip.
The patient say she has pain so she is to be believed.
The Dr believes she has pain therefor he prescribed medications to relieve it.. Confused about the time so am I in the middle of the night, my eyesight is poor die to a cataract and mistake the long and short hands. maybe I should get clock with Mickey and Minnie on the hands. Oxycodone is a serious narcotic BUT it is better to be taking that than overusing Tylenol and damaging her kidneys.
Mom is 92 and pretty functional, so she gets a little confused - there are lots of reasons for that.
If it ain't broke don't fix it. Would you put her through a hip replacement?
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Have you been to a pain management specialist? Many are very good, not the caricature of the drug pushers you hear about. My mother was having similar problems and we switched to nyucenta (sp?). She is also having steroid injections every few months.

I think as you get older your ability to handle pain decreases.
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I SOOO completely disagree that you can diagnose this yourself and move forward in withdrawing her from pain medicine on your own. As a pain patient myself and having watched my mom with her drug-induced denentia, experience excruciating pain and not being able to do very much about it, this would be cruel and unusual punishment for a 92 year old who is truly in pain, which you have not really established one way or the other.

When it comes to pain, the American patient is woefully undermedicated due to the continual fear purported by the AMA and the DEA about addiction. That is how the specialty of pain management evolved. Studies have proven over and over again that pain medication given to the level of controlling true pain do not make a person high and that is generally a person feeling high and wanting more that leads to addiction. It would be very difficult for a 92 year old who is not managing her own medication to take "more".

While I agree that xanax 3 times a day should not be needed for sleeping and that melatonin could help her sleep, xanax is also used as an adjunct drug to pain control, particularly when the pain is exquisite. I personally use then accepted time for sleeping otherwise I don't go to sleep. When my mom had eye surgery which exposes the nerd on her cornea area, she was already taking vicodin but the ophthalmologist prescribed xanax in addition because he said the Vicodin on its own wouldn't be enough for this is your pain she was going to experience.

All I enable to do is share information about this based on years of personal experience in my own case, Jen in the care of others as well who had pain. And I can only reiterate to you that you (a) get her evaluated for dementia (b) seek the expertise of a pain management specialist and (c) in this case, don't do any adjusting on your own.
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Change the pills (all) to sugar pills (placebos), fire that doctor and get another. 20 yrs. on Xanax is way, way too long. With all these drugs I am surprised she is still alive, much less having such constipation she would be very uncomfortable. Give her some Melatonin at night so she will sleep (over the counter and non addicting 1.5 mg. - 3 mg.) and the other symptoms she will have to learn to cope with life like the rest of us do. Pain in her back can be helped with acupuncture, also non-addicting. At 92 yrs. though, I guess she can expect to be "high" because it must feel good. In any event, talk with the doctor who prescribed those meds and tell him/her she is addicted.
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Sorry ... a whole new SUB-SET of problems
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Your mom may have legitimate pain and, at her age, her confusion may actually be dementia. You should have her evaluated by a neuropsychiatrist. It may NOT be the pain meds at all or not entirely. If her pain is real and her pain meds are taken away, it may affect her sleep negatively and in such a way that a whole new set set of problems is created. Whether or not she is diagnosed with dementia, you should also consider consulting a pain management specialist, preferably one who also has geriatric experience.
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