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My Mom lives in Texas. She’s 84 and has Alzheimer’s and high blood pressure and a few other health issues. Over the last year she has developed a terrible nervous habit of scratching herself. Her arms and thighs are literally covered in horrible open sores and bruises and scars. She often gets infections. We know for sure it’s not a rash or skin condition. She’s been on many meds and lotions including for OCD. None worked and all made her like a zombie. Mom’s Doctor is very open to giving her CBD oil. He feels it has great potential and has no side effects. I searched and studied and found one that is very reputable. My husband and I both have been taking it and have had amazing results with relief from aches and pains, anxiety and sleep issues. So, I feel very comfortable giving it to my Mother, however the Med nurses where she lives aren’t allowed to dispense it. The CBD oil has no THC in it and is legal in Texas but the corporate office refuses to consider it. We have to have their help. It needs to be taken a couple of times a day consistently to work. Alzheimer’s is just heart breaking anyway but it really pains me to see my Mom literally tearing herself apart. You can buy CBD oil in the mall and shops are popping up everywhere. Last year her Doctors prescribed B12 vitamins and she also has a standing order for Tylenol if needed. Both are purchased at local stores and are dispensed by the Med nurses. What legal rights do we have?

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You are going to have trouble getting her anything that isn't on the med chart, get the doctor to prescribe it.
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Since there are federal regulations that figure in the licensing of extended care facilities you are dealing with their refusal due to federal law in all likelihood. I doubt you will get far getting the oil approved..
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I agree with the person who suggested that the doctor write a standing order for it like the Tylenol. I take a ton of homeopathic supplements...B12, D3, flax seed oil, pumpkin seed oil, Lutein, sage, hemp oil, turmeric ...and I would be pretty mad if a care facility refused to administer those supplements to me. ..or to my husband! They are all legal substances that I choose to take and all help me stay healthy. See what her doctor can do. Good luck!
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Even for OTC meds you need a doctor's order. Have him call it in to the RN. If she then says no, ask why since it is legal.
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worriedinCali Jun 2019
It’s probably because the facility doesnt know for sure that it’s absolutely THC-free. If it’s not, then....it’s not legal. It’s a felony in the state of Texas. It’s a slippery slope. My husband would have used it for his back issues when the doctors were refusing to give him pain meds a few years back but.....it’s hard to be absolutely sure that there’s no THC in the CBD oil. He would lose his job if he failed a drug test even though weed is legal in this state.
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The OP's mother's doctor is already in favour, it's the faceless corporate office laying down a blanket "no" that's the problem.

Is your mother's doctor up for a fight?

What exactly has the "office" said so far? You say it's a refusal to consider it. Okay, they can do that; but then they have to justify even that decision, the decision to refuse to consider it.

Your mother (not you) has legal rights. Whether or not the company is breaching its responsibility to her will depend on their justification for refusing to permit a therapy, which your mother's doctor has already approved, to be administered on their premises. It had better be good!
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Check for bedbugs or fleas.
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First thing we did last year when we started seeing sores is check for bedbugs, fleas. We wash everything in gentle soap for sensitive skin. Checked all her meds for side effects. It’s positively a purely nervous habit. The sores are on her left forearm, right thigh and left side of her neck. She is right handed. Every second of the day that right hand is digging and scratching. It NEVER stops.
The Doctor is willing to write the orders to give her the oil, just as he has for b12 and Tylenol. He can’t write a prescription for it only an “order” for the distribution of it. The particular oil I want to give her does not contain THC. It is purely CDB isolate. The company does 3rd party testing on every lot of oil. I can provide the corresponding test results to lot number on bottle. The residence corporate office tells me that it is against policy for the Med nurses to give her the oil. I believe the problem lies in an outdated policy. We can’t really afford to hire a lawyer. So frustrating that they are fine with her receiving drugs that make her so out of it that she can’t hold her eyes open but they won’t give her a perfectly legal, natural substance that has no side effects. Meanwhile she’s tearing holes in herself.
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Have the Doctor write an order for it.
Once it is a prescribed "medication" I would think that it is their obligation to administer it.
I think if it is a "suggestion" from the doctor to "try" it that is different than actually prescribing it.
Once it is "prescribed" and she has been using it for about 3 months if it works have the prescription continue if it does not show that there has been an improvement then it can be discontinued just like any other medication would be discontinued after it has show not to provide any positive results.
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worriedinCali Jun 2019
the doctor already said he can’t write a prescription. An order and a prescription are 2 different things.
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Thanks for your thoughts on this.
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You could contact the Texas Health and Human Services and ask them what the regulations are in regards to the administration of CDB oil by nurses or medication aides in an Assisted Living Facility.  If the Texas H&H tells you that it is okay for the CDB oil to be given to your Mom, then the ALF company should honor your request.

Just found this information:

https://seniorslifestylemag.com/health-well-being/cbd-and-international-laws/

United States CBD Laws
USA has some interesting laws on CBD, especially as each state has differing laws on cannabis. There are now 10 states where marijuana is fully legal. There are also 33 states where marijuana is legal for medical use. This includes cannabis oils. What’s more, some states make exceptions for patients with certain conditions to use CBD Oil, providing the oil has low levels of THC and high levels of CBD.

While cannabis-based CBD Oil laws can vary from state-to-state, hemp-based CBD products are much more available. In the past, states such as Texas barred the use of CBD. However, recent changes to The Farm Bill make hemp products much more legally available. You can now use CBD in all 50 states, providing the product comes from hemp and has less than 0.3% THC.

This makes it legal to buy all kinds of hemp-derived CBD products. For instance, Just CBD Store sells a range of CBD products made with hemp. This includes CBD tinctures, gummies, vape cartridges, doobies, and a lot more. You can legally buy and use any of these in all 50 states.
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AT1234 Jun 2019
You can use yourself, patients residing in a facility different story. ALZ can not “give consent”. I know residents who are using CBD but they are cognitive and kids buy it for them and bring it. It’s not amazoned into facility.
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I wonder if you personally can give the oil. That way they are not doing it.

I'm totally new at working with an AL home. Lotta restrictions by law. Today they axt me for some liquid Tylenol which I happened to have. Well it was out of date. l could personally give it to my wife no problem but they could not.
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Can the doctor write a prescription and you purchase the oil to be given?

My dad was on non medical supplements and his doctor had to write a prescription that the care home copied for his file and implemented them in his daily meditations. The doctor had to write how much daily, the brand and strength. No changing vitamins without a new rx.
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worriedinCali Jun 2019
She said the doctor can’t write a prescription
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I would not give your mom CBD oil without her Dr knowing because of drug interaction. However, have you thought about CBD lotion or hemp lotion. Yes, it can cause drug interaction but most likely wouldn't. And you can play dumb if you need to.

Hemp lotion that you can buy at any tanning salon. It has no THC, but still will give mom that relax feeling. Helps with anxiety.

My mother was picking at her head and face and I do give her CBD oil and now her head and face are healing. But she lives at home and her Drs know how many mgs she is taking and what days.

The great thing about the lotion (I use for myself) it is long lasting.

Just a thought!
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Rabanette Jun 2019
If you re-read the question, you'll see that the doctor already okayed the use of CBD, but the facility refuses to dispense it.
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I'm sorry to hear you have to struggle with this, knowing there might be a remedy. B12 and Tylenol are both able to be regulated, so nurse or CNA would be assured of the amount their patient is getting. CBD may not quite be regulated yet.

In the meantime, is your mom wearing long sleeve shirts and long pants? Are her fingernails cut short enough so that she cannot scratch herself? Is there an anti-anxiety medication that might act similarly to the CBD?

What are the laws on CBD in Texas? I think you're going to be up against this no matter what. What about medical marijuana? Is that legal in Texas? If so, maybe that would be a way to help reduce her anxiety or whatever is causing the self harm by scratching.

As for legal rights, you would have to consult an Elder Care lawyer or possibly a Pro Bono lawyer who can assist you.

Are you able to see your mother once a day? Are you sure that providing her with the CBD yourself even once a day might not be helpful?
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worriedinCali Jun 2019
Marijuana is illegal in Texas. CBD that tests positive for THC is illegal. In fact it is a felony in Texas.
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CBD oil, while legal, may cause adverse reaction with other meds. If there is a problem, if doc prescribed it, could endanger his license to practice medicine. CBD has not been tested so time for FDA to approve could be many years. There are many unknowns. When I had my golden retriever Macy, she was anxious and completely terrified of thunder and fireworks. I started giving her hemp treats, which seemed to help, for awhile. Then not so much. Is it an addiction that requires dosages to be increased? Who knows.

https://www.fda.gov/news-events/public-health-focus/warning-letters-and-test-results-cannabidiol-related-products

https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabis

https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-questions-and-answers
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It's probably too early for the facility to be ready to dispense CBD oil, even if it's legal or prescribed. There are very personal reactions & interactions with CBD, with elderly being a sensitive group. It's best to wait for medical protocol at the facility to catch up with very new laws. Liability worries for the facility? Check with an elder attorney.
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All good advice. I think the take away here is that there is still a lot of gray area while the states are trying to figure out the legalities of it and meanwhile big pharma is figuring a way to get their paws on it, and those that might benefit from it won’t. As many questions as there are about it, the bad side effects don’t come close to the meds that have already been prescribed and given to Mom with no concern whatsoever. So frustrating.
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Every healthcare facility has their own policy for medication administration. In my experience as a nurse in various settings, if a new med was introduced for whatever reason, facility educators in tandem with physicians then reviewed the literature & researched the proper dose, route of administration, etc. The new policy then needs to be approved by the facility. I am guessing if your mother’s facility is one of a chain, their corporate office probably writes and updates new policy & procedures for consistency.

CBD oil is fairly new to the medical community as far as ordering for patients; the issue is that not all CBD oil is the same so it would be impossible to write a policy to cover all of these unknowns.

If the corporate office is not willing to sort all that out, they can refuse, & rightfully so as the use of CBD is fairly new & they may just want to wait to see how state & federal regs pan out and cite patient safety as a concern. A valid concern as well, because there is just not enough scientific data and studies available about the use of the drug and I would bet minimal studies on CBD oil & effects on the elderly.

Have you discussed using benadryl or vistaril for relief from itching? Oatmeal baths? Is her renal function normal or does she have CKD (kidney disease)? If CKD have the docs check her phosphorus level as if elevated can cause severe itching, as well as itchy skin from kidney disease. Or have her evaluated by a dermatologist if you haven’t already.

Due to liability issues I would not bank on the facility allowing CBD anytime soon.
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Med aides can only give medications with prescription orders. Even if its an OTC med. A med aide needs an order. They are not nurses ( although we need orders as well) and they are employees of the facility not family so they carry the liability if anything were To happened. The only way I see it is you administer it yourself, not sure how close you live to the facility.
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Lostinva Jun 2019
And in turn the nurses are responsible for what the med techs do!! Cover yourself!!! Document, document!!
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I work in a NH and one of the Residents family member wanted her Mother to have this and they do give it the only thing different is they have to provide it.. You might ask them if you buy the CDB oil while they give it to her...This is in New Hampshire ...worth a try good Luck
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Would you mind sharing the brand of CBD oil you researched and use? I have been looking all over the internet for a trusted brand for my sleep. Thank you.
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Abby2018 Jun 2019
Buyer beware.....please make sure you buy from a legitimate dispensary. Many states now have legalized pot for medicinal purposes. They also sell CBD from trusted and reputable suppliers.... and will typically have a pharmacist to help guide you as there are many different potencies. Search Marijuana/Hemp dispensaries for one nearest you. Please don't trust online sources. Good luck.
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My mom is in memory care and uses the CBD patch. I go every three days to put a new one on. This plan works well.
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KELLYBRED Jun 2019
Interested on what type of CBD patch Name Brand, manufacturing from what state, dose that is used. My dad 90 yrs old, Memory care Thank you all information is appreciated Kelly B from PA.
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It's CBD-Cannabidiol. If necessary-sneak it to her. THC drops, (go low and slow) given at bedtime also works wonders.
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Surely you’ve been advised that you can administer. There are many diff strengths and methods some good - some junk. Have you seen improvement with your mom using it? A dr can prescribe but at least facilities I know of will not dispense.
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Shaner10 Jul 2019
I give it to her as often as I can but it needs to be consistent 2-3 x a day. I have to travel a lot so I can't always get it to her.
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Although I live in a state that permits medical marijuana, the nurning facility where Mom is, will not yet allow any form of CBD - whether it is the legal version made from hemp (the stalk of the plant), or the version (made from the flower of the plant) which needs state permission, as it carries a small amount of THC.

I presented the request to her medical team: the doctor, the head of social work, and the head of nursing of the facility.

I was told that by policy, at this time, they cannot give her the CBD - even the widely accepted, legal version. I was told that if I want Mom to be given CBD, I would have to administer it daily myself. (Since I cannot go there each day, twice a day, that set-up does not work for me.)

This ignorant policy will continue until the federal laws are changed, and until there is a greater understanding of the difference between the legal CBD based on hemp, and the more effective CBD version which medical marijuana offers.

Eventually, this will change. For now, dosing rests as our responsibility once the doctor is informed.

Hope this helps.
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AlvaDeer Jun 2019
Not really an ignorant policy, but one that follows the Federal guidelines set at present. The problem is that this is not FDA tested. Some current testing is showing that most of the oils do contain TCH. There is also testing that suggests liver enzyme increases in approximately 10% of the populace. WebMD has info on administering, and google is full of info. I agree that this will soon be seen as merely a supplement. Even they can be very dangerous when given without great knowledge. If facilities ignore federal laws as they exist at present they will lose their license at once. We think that this is just a money making thing, these facilities, but the reams of regulations they must adhere to, the constant visits of ombudsmen and the loads of daily complaints would not be believed were you to try to run one. I was a hospital based RN for my career, but knew many involved in extended care, and it is NOT a picnic, to be sure.
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I was told they can't administer it because of Federal Law prohibiting it. The nurses want this to be legalized because they know the benefits will help dementia patients. I have not heard of the patch - I am going to see if I can do that for my brother.
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AlvaDeer Jun 2019
True. Most CBD oil has a trace at least of TCH in it, and it is federally prohibited. So if it is something that helps you do NOT bring it on an airplane.
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Problem with CBD oil (I am a fan, so don't hit me yet) is that it is not completely a benign "drug". There are studies that show that in 10% of the population, liver enzymes are raised. The claim that TCH is completely removed is almost always bogus, because when tested, CBD oil often shows up positive. Not advertising here, but I do have a link that shows which test positive for TCH and which negative. Given that the FDA has not tested (as with all supplements) and approved, I think it will be very very difficult for you to get it administered by someone in a care setting, but do wish you luck if it is helping. Do private message me if you would like to see a link I found on testing oils for cost, presence or not of TCH, etc. I will keep an eye peeled on my private messages. Good luck.
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The staff has to follow their "rules" or they will get fired. I had cancer and had to do Chemo once a week. If you want them to administer go to the top of the organization IE the CEO plead your case and see if you can get an exception.
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Read Alvadeer below. CBD may be legal in Texas, but if you are caught with it and it contains the THC, you can be charged. There are many, many sellers of CBD online and claim their product has no THC when, in fact, it does.

I know someone who was selling online and in bottles to sell directly. The bottle had absolutely no mfg name on it, no ingredients label, and simply said CBD - use 1/2 dropper for anxiety. These instructions were not even a typed or professional looking label. Just someone's handwriting. That has the hint of prescribing medicine without a license in my own opinion and there's no way I would take it or give it to someone or a pet.

You probably need to talk to her doctor about CBD or some sort of antianxiety med that will help with the scratching. That, or take her home and medicate however you choose.
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Please note that CBD oil is not FDA approved. Thus, it is buyer beware if one plans to use this oil.
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inneedindeed Jun 2019
yes it is FDA approved....they have in prescriptions. where do you get your info?
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