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I repeatedly asked the owner of the facility to send me a list of and the schedule of my mom's medication list? After three times she did-and there are new psych meds on that list. I don’t know who ordered those meds-but there are a lot- and I question if the prior rehab facility ordered-my mom was very anxious and rang the call light a lot there. But is she now on these drugs for good? And can I request and expect to be notified when they are using them? The owner told me not to worry and to just let them handle it. This did not reassure me.
She’s on 10mg (highest dose) norco for pain scheduled every four hours (but they won’t wake her), Xanax, a mood balancing drug, and they ordered Ativan 3x a day as needed. My mom should not be experiencing intense pain anymore (she fall and had back pain), she is very frail -about 85lb prior to her rehab experience she was only on norco and they were advised by hospital discharge paperwork to wean her from norco. She doesn’t sound liked herself anymore And I question why she is on all.

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Who is her doctor? That is who should be dealing with her meds.

I would not kick up any fuss but I would get her in for an appointment with her doctor and get some clarification on the medications and side effects.

Some of these care home owners over step the medical boundaries and it is dangerous for the residents.
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That's a really high dose of Norco for an 85 lb lady. Every 4 hours would keep most people in a semi-coma! But, if her pain is controlled by that, who am I to guess?

Seeing elderly people in intractable pain and Drs withholding a opiate just makes me furious. Only your mom can say how much pain she's in...is she able to have a voice in this?

The Xanax and Ativan are in the same category of drugs--benzodiazepenes and are used for anxiety, primarily, and when a person is in Hospice. Or, sadly, sometimes to keep a 'trouble patient'--one who is ringing the call button constantly--from doing that. A judicious use of benzos makes life much more bearable--this comes from someone who has had to use them for many years.

If this were my mom, I would want to know who and why all this stuff is prescribed. It seems like EOL comfort--is she in Hospice?

Yes, a talk with the DOCTOR is needed. If he/she feels this is the appropriate way to handle her pain, anxiety, etc., then I would go along with it.

"just a fall" could have resulted in damage that cannot be seen on an xray or CT scan. Just b/c it's been a certain length of time and you feel she shouldn't be in pain now is not accurate--everyone feels pain differently. Some people can tolerate very high levels for long times, some can't handle the pain that comes with a blood draw.
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Do you have Power of Attorney? If you do or can have your mother appoint you as POA you will have a much easier time getting information. I’m not certain how it works in a small Care Home, but in a larger facility, the resident’s family is entitled to a Care Conference at the least every three months. If you can call a meeting, you certainly should. Also, when she was discharged from rehab, you should have gotten extensive paperwork on what her medications were and are now, the dosages and the prescribing doctor. Ask many questions and keep asking until you get answers.
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This is my opinion from experience, you are right to question these meds. And you have a right to talk to a doctor about Mom. I so hope you have Medical POA but even not, you can question. Tell the home you want to talk to the Doctor in charge. If you don't get a call, call Mom's doctor. Send him over the list for review and list your concerns. Maybe he can call the home and talk Dr. to Dr.

I realize in a hospital setting that those doctor's are in charge. In rehab you have their doctor's. But in an adult home do you have to use their's? Also, I would think any home caring for people is under the State when it comes to inspections and complaints. If you get nowhere, I would call your State Onmbudsman and ask what rights you have to protect Mom. If Mom is competent, have her sign Hippa paperwork saying you can talk to the staff.

I have found in caring for my Mom and the few times DH has been hospitalized, there is no communication between the doctor in the hospital and the patients PCP. I think a lot of mistakes and unnecessary tests would not be done if there was. My Mom was in a lot of pain from a fracture in her back so her BP meds were increased. The procedure took away the pain but the discharge papers and scripts said to continue with the higher dosage 2x her normal dose. I questioned it. Was told she had been in pain. But she wasn't now! She couldn't stay awake. The in home nurse checked her pause and said it was too low, called Moms PCP and he lowered her med to her normal amt. This happened to my DH who was not on BPmeds when he had an AFIB problem. Gave him BP meds while in AFIB and he was told to continue them even though his BP was normal. PCP took him off for same reason, he couldn't function.

So what I am trying to say is that what Mom was given in rehab may not apply to her now. I personally would not allow a GP to administer Physic drugs. If Mom has Dementia a neurologist would be the only doctor besides a Psychiatrist I would trust.
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MargaretMcKen Jul 2020
This is very similar to the problem that has caused the Fentanyl abuse - hospital sending people home with the drug and expectations that it will be continued after it's necessary. Good idea to check.
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Rebeccal-

Former RN, here.

It is VERY QUESTIONABLE and potentially dangerous whenever a narcotic like Norco is prescribed with not one but TWO benzodiazepines (Xanax and Ativan).

If they told you that Xanax is "mood stabilizer", they are lying to cover their buttocks.

People in my town have DIED because of dangerous combinations of such drugs. And these were relatively healthy people, not as old as your Mom.


Donyah
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Only a dr could order those meds, so you need to find out who the doctor is who cares for people at that facility. It's more than likely not going to be her own doctor. All those facilities have their own drs and they don't communicate to the regular family doctor, Talk to her old doctor and see if he will talk with the dr who wrote the prescriptions
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2 places to go for answers.
1 - Get a copy of mom's medical record at the hospital. Review how often she received these medications.

2 - Talk to her doctor about your concerns. Depending on the state you live in, mom may need to see a psychiatrist for the psych drugs and a pain management doctor for the pain meds.
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This is how they control elderly. If possible get guardian/Conservator before they do.
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my2cents Jul 2020
Exactly - it's about control and easing the workload. This woman is not asking questions, pushing the button to go to the bathroom, etc. Willing to bet a diaper was slapped on her upon arrival. -- Very little time spent on a patient who is out of it most of the time. Saves the facility from having to hire adequate number of employees.
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Xanax is getting attention for its side effects; check it out. 
https://www.rxlist.com/xanax-side-effects-drug-center.htm

To me she's on a "dope up the patient" regimen - someone overprescribed meds for her.

As others have suggested, raise these issues quickly with either her regular doctor, or someone other than the one who gave up a cursory answer.   There's no excuse for that kind of response. 

Chills run up and down my spine when I read about elders in "family homes".     Is this her desire, and how do you feel about it?
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MaryKathleen Jul 2020
I am 86, my family doctor told me not to take Xanax, because of my age. She put me on Buspar, generic Buspirone HCL.
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They are allowed to give medications as ordered by the MD. If you are POA for health care then they should be keeping records of the medications and they should allow you access to medications given. I believe you are suggesting that they may be drugging Mom to keep her quiet and controlled. You could be right. And if they are unable to keep Mom happy and well controlled they may not continue to care for her. So what you have is a dilemma here. I would say as POA for health care your first stop the the MD ordering these medications, with a list of how often they are being given in the week and for what symptoms. Do not take no for an answer. If you are POA you are responsible to know what is happening here.
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Donyah Jul 2020
Yes.
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