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Recently my dad had to be placed in a NH. We understood why the NH had to take over the meds for his extreme stomach pain but his face cream? He has excema on his face and scalp which he has always been able to treat with his cream. Within a few days of moving to the NH, they took the cream, saying they had to dispense all prescription medications. That would have been fine except they lost it or misplaced it. Now he's left with this itchy rash on his face. He obviously can't get out and go to his own doctor. Is there anything we can do?

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It's been my experience that, like hospitals, facilities insist on providing the medications. Part of this is quality control and I suspect that another part is contractual - they have their own suppliers and get medications for fixed prices. Beyond that, I can't guess what kinds of relationships might be established.

That's just a guess; I suspect there are others who'll post and provide more insight into this aspect.

If they removed the eczema cream, it should have been replaced ASAP. There's no excuse for that.

You can go directly to the Director of Nursing if you've already talked to the RNs and the issue hasn't been resolved. I wouldn't give them a lot of time to resolve it, as in: I want this resolved today! If the DON doesn't act, go directly to the Administrator.

If your father was placed on a script from a doctor, contact his/her office and see if they would be willing to contact the facility, or contact his dermatologist and explain the problem. If either of the doctors emphasize that this is an urgent situation, the nursing facility should act.

In the meantime, document all your contacts with them and efforts to get this resolved.

If you continue to have problems with the facility staff and admins, demand an immediate meeting to discuss resolution of the issue. It wouldn't hurt to bring family or friend reinforcements and politely emphasize how disappointed you are in the handling of this issue. That usually gets them moving if they think they'll lose a patient to another facility.

If you have any photos of your father's face when on the medicine, bring them, and if you have a camera (not everyone does), take photos of the breakout so you have evidence to present. That will also demonstrate to the facility staff that you're approaching this in a logical (and documentative) way.

Sometimes knowing that a family member is documenting shakes them up and gets them moving.

Good luck; please let us know how this works out. I know it can be very unsettling and fearful that your father isn't getting the treatment he expected.
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Inevitably, there are patients in nursing homes with different amounts of cognitive impairment.

Once you're there long enough, you will observe many of them roaming around the halls and entering other peoples' rooms without supervision.

These folks don't necessarily understand that they're not in their own room and, when they find something, they think it belongs to them, so they get into it.

Getting into another patient's foods, lotions, hair products, medicated creams, etc, is at the very least a potential mess for staff to clean up, and could be medically damaging, even deadly.

When it comes to confiscating a needed prescribed medicine, whether an Rx or OTC, you may need to be more on top of pushing them to bring it in from their own pharmacy. They may even require that it be prescribed by the doctor who is the medical director of the facility before they can even order it from their pharmacy.

If YOU still had it, you could take the responsibility of applying the cream, but if they've taken it and lost it, unless you can get a refill from his prior doctor, you're going to have to be a squeaky wheel.
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Call your fathers Dr and explain the situation. Have you talked to the nurse at the home? I don't know how it works there, but my mother has her own outside Dr. I call him if there is a situation. I keep in contact with the pharmacy and I know what meds she is taking and when she needs refills. And I pick them up and bring them to the home.
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Hi Marciad5,
This can seem like just one more frustration in the transition to nursing home care, but the three smart people who provided insight already gave a pretty complete picture of why this happens.

Since the skin cream seems to be the only medication issue, it's possible that the doctor in charge is not well versed about how necessary this is for you dad's comfort.

They do try to keep prescriptions to a minimum because of side effects (yes, skin creams are absorbed and can cause non-skin-realted side effects). I'd start with the floor nurse and move forward to having his previous doctor follow through if necessary. It may take some pushing on your part, but I think that they will follow through. The cream will likely be kept by the nurse to safeguard other patients.

Please keep us updated on this. Your question and the answers that follow will help others.
Take care,
Carol
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He needs an order from MD for any meds. Usually the "House Doctor" is in charge of orders for all residents. The nurses need to bring this to doc's attention. I do not think that a family could be in charge of pick up and delivery of nursung home residents meds! This is done in assisted living but unusual for nursing home.
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I have had this experience as well with my aunt placed in a nursing home...although she has severe senile dementia. ( used to think that was an old term, unfortunately, it still applies) She had some cream as well as other toiletries. She loved her nails done, so I left the nail polish in her bathroom cabinet, as well as polish remover. Well, one day she decided to pour the nail polish on her hands and rubbed it in ALL over....the nurses initially thought it was blood...what a mess!!! Then another time tried to eat her face cream...she was half way through eating it before they found her...ugh...And then came the drinking of nail polish remover...she thought it was mouthwash. Soooo, I would imagine that may be why they took it away..but it should have been locked up along with his other medications so he could use it when needed. I would definitely talk to the head nurse and if you don't get anywhere with that, take it directly to the administrator. I've been an advocate for the past 14 years in caring for family members that aren't able to speak on their own behalf. It can be a struggle, but so worth it and gratifying. God bless you and good luck...
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The doctor on staff should be able to write another prescription based on his medical records. Have you asked them to contact the first prescribing doctor to communicate with the nursing home doctor? Try that.
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The answer to many questions about frustrating and perplexing policies in ALs and SNFs is "Dementia." staying one step ahead of the hijinx (and dangerous situations) that residents with dementia can get into is a 24/7 job for all senior care workers.
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Request the nurse in charge, or the DAY SHIFT HEAD NURSE to dall the facility doctor to ORDER your dad's ointment. The facility then will contact their pharmacy to supply the ointment. make shure you ask the nurse to inform the doctor of frequency of application, strength of it and locations to apply to.
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State Health Laws mandate written orders for all medications. During flu season this becomes a real nightmare when families bring in various cough syrups but fail to get written orders from the MD. In summer, bring in topicals for allergies or foot fungus, all a big no-no and the facility must confiscate and destroy this stuff. Ask the Health Department.
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Has the Head Nurse told the House Doctor to contact Dad's own doctor about the prescribed eczema ointment medication and application schedules? Removing and not replacing prescribed medications is unadvised medical practice anywhere, and nursing homes are no exception.
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The NH takes charge of the meds, in part for contractual and licensure reasons, pertaining to who is qualified and allowed, or certified to give out the medications. Of course they want to pay as little as possible to the least qualified staff. Be the squeaky wheel, and ask them to have a qualified (R.N.?) apply the cream. And, bring a receipt to the admin office and demand replacement of this Rx!!!!! You will not make friends being this smart, so be wise while protecting Dad. You are right to pursue this.
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Hope he gets the necessary treatment soon, and your efforts on his behalf are realized, if not rewarded. Kudos to you, keep trying!
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Contact your long term care ombudsman, the number should be on a poster or flyer in the hallway of the nursing home.
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I can understand why they might initially confiscate the cream until they can determine if its ingredients might be contradictory with any of the meds they are giving him - but to keep it? That's odd. Seems like, if there's nothing in it to interfere with his other meds, they would treat it like any other med (ie) administer it with the other meds and take it away so it doesn't pose a danger to other (confused) patients that may wander in.
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Surprised about being able to bring prescriptions in. The facilities my daughter works foe supply all meds. Private Prescription plans are not allowed.
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It costs so much to live in a NH in the first place. The right people need to help at the right time.
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Yes ,I have found the all or nothing approach with medication management in NH or AL. Imagine if you were in charge of medication for in such a facility. How could you track prescriptions with multiple pharmacies per resident? Yes, I think contractual obligations with preferred providers play a HUGE role, but how could an institution track multiple providers per individual?
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The comments made after I posted reminded me of a policy I thought was very well thought out, but it was implemented only at one of 6 nursing homes in which my family stayed during the course of their rehabs.

At Medilodge, rooms were outfitted with dressers (as is typical), the top drawer of which was a locked medicine drawer. All the meds for the patient were kept locked at all times except when a nurse administered them. Unless someone stole a key or had lockbreaking knowledge, it was impossible for a resident to wander in and take someone else's meds.

It also was a lot safer than a nurse using a cart and going up and down the hallway to pass meds. That always made me nervous - it could be so easy to become distracted as I frequently saw patients' families go up to the nurses and ask questions.
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It's the law. Their nursing home, nursing, CNA licenses all require securing all PRESCRIPTION medication, and controlling dispensing. State and Federal laws from FDA, HHS, DEA, and Medicare/Medicaid/ACA all have regulations on drug billing and dispensing, guidelines for quality control for patient safety and financial accountability. It is a HUGE PART of what a medical facility does! This question truly surprises me, because a nursing home is an extension of skilled nursing care to a non hospital, yet inpatient, setting. You want that control in a hospital. You expect it in a pharmacy...why wouldn't you expect it HERE?
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missmacintx is correct. This nursing home is breaking the law if it is not following up on Dad's current prescriptions. Contact the patient's lawyer.
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This has finally been resolved. I requested a list of all the meds he takes and in that process asked about the cream that had been lost. A nurse dug around in this cart where they keep meds and found it. Now he gets it twice daily. Thanks for all the responses.
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