Follow
Share

My mom has MS and is in care of a nursing home. The past three months her pain management has been great, the new doctor found a combination of meds that helped my moms pain and spasms. Just yesterday at 3pm my mom called in extreme pain with her legs spasming. I’ve called several times yesterday and the nurses say all they can do is give her ibuprofen on top of her meds, even after they called the nurse practitioner. My mom has been in extreme pain all night long and can’t take it. Is this treatment allowed at a nursing home? I feel it’s neglectful. FYI her meds are oxycodone 5, fentanyl patch (62.5), cymbalta 20 in the am, and neurotin 100 in the pm.

This question has been closed for answers. Ask a New Question.
Thank you for the responses. My mom's current meds are all scheduled, from talking to nurses no change in that. There was no plan for extreme pain, when I mentioned it to the Dr when she came up with the pain management plan she said we will cross that bridge when it comes. I will set up a care plan once this gets straightened out and have them make a plan with my mom and I and have them keep backup meds as necessary. She is still in bad pain. First the nurse practitioner prescribed 5 of baclofen and that didn't do anything so they switched to 5 of valium every 8 hours as needed. That helped for 3 hours and now she's in excruciating pain again and needs to wait 4 more hours. We found that she has not been getting her calcium, magnesium and zinc vitamins like normal and some nurses are wondering if that deficiency would cause this. It seems to extreme and sudden but who knows, it could be a bad MS attack.

She has been sent to the er for this in the past, she refuses scans because of the pain of transfers and laying in them, so they won't do anything for her at the hospital but send her back with a note saying the nursing home needs to provide her comfort care.

Reading your responses helped me take my emotions out of this a little and remember the nursing home is not a hospital. It just upsets me so much knowing she's in so much pain and I feel so helpless. But it's not necessarily the nursing homes fault. If I cared for her at home I'd be even more helpless trying to figure out what to do.
Helpful Answer (1)
Report

I would have told them to call the doctor who prescribed the meds and tell him she is in extreme pain.
Helpful Answer (0)
Report
EBeach Oct 10, 2018
I did... Her Dr actually came that evening for someone else, and when asked to look at my mom she told the nurse that my mom can wait for the nurse practitioner in the morning.
(0)
Report
I am sorry that your Mom and the nurses are having problems with getting your Mom's pain under control.  It can be SO frustrating to the nurses when a resident is in pain and the nursing home doesn't have the correct medications or if the medications prescribed are not relieving the resident's pain. 

You state "Just yesterday at 3pm my mom called in extreme pain with her legs spasming".  Did something happen to cause this sudden onset of pain?  Is the pain different from the pain that your Mom usually has due to MS?  Has your Mom had these spasms previously and did the routine medications prescribed help relieve the spasms or were additional pain medications required for the spasms to decrease?     

I agree with MargaretMcKen that the pain medications are "very strong pain killers".  Did the doctor's prescriptions allow for PRN Pain Medications to treat UNEXPECTED intense pain episodes as well as a routine scheduled pain medications?  All of these medications are usually given on a schedule, although the oxycodone sometimes is given routinely and PRN (As Needed). 

Please understand that the nurses are human too and that many of them will NOT leave your Mom in extreme pain ON PURPOSE.  They have certain rules and regulations that they have to follow and sometimes those rules and regulations hinder or prevent the nurses from doing their job of relieving pain because of the way the pain medications have been prescribed. 

Most nursing homes get their medications from a pharmaceutical company (which may be in a different city several miles away) who delivers the medications at a specific time of the day and rarely are willing and able to make an emergency trip to deliver medication to the nursing home.  Also nursing homes cannot legally stockpile routine medications nor can the nursing homes stockpile extra pain medication other than the 30 days worth of medications prescribed for the resident(s).

I hope that the nurse practitioner is able to prescribe medications to decrease or minimize the spasms.  Please keep in mind that sometimes it takes time to find the right combinations of routine pain medications and PRN pain medications to get the pain and spasms under control.
Helpful Answer (0)
Report

Those are very strong pain killers. Did the new doctor give the nursing home appropriate instructions for the new prescription combination? Did the doctor's instructions cover intense pain episodes as well as a base level of drugs? The issue is different if the staff wouldn't provide what had actually been prescribed, so it would be good to check with the doctor first.
Helpful Answer (0)
Report

How is your mom doing, EBeach? Is she getting adequate pain relief now?

We learn from each other here and I think that this is a question that is valuable to many folks here!

I struggled for a long time over the fact that my mom would complain only to family about her pain. I would call the Nursing Station, telling that my mom was in pain (because she had told me or SIL this on the phone); but when staff arrived, she'd say "no, I'm not in pain". (OY, dementia!!!!)

I got them to schedule all of her pain meds; many of them were PRN, i.e., if patients requests. It was clear that my mom was past the requesting stage, just not past the "weeping in pain" stage.
Helpful Answer (0)
Report
JoAnn29 Oct 10, 2018
All they have to do is take her BP and can determine if she is in pain.
(0)
Report
EBeach, staff at NHs can only give meds that are prescribed. And only the doctor or APRN can prescribe. Would getting her taken to the ER have been an option?

I certainly think you should address what to do in this situation at the next care meeting!
Helpful Answer (1)
Report

I wanted to add, it’s been 20 hours now and the nurse practitioner is just now looking at her.
Helpful Answer (0)
Report
JoAnn29 Oct 10, 2018
Nurse practioner's are not Doctor's. They can prescribe but I would request a doctor since this is all new.
(1)
Report
This question has been closed for answers. Ask a New Question.

Ask a Question

Subscribe to
Our Newsletter