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Hi - I’m not accusing anyone yet at this point, just wondering what the game might be - caregiver addiction or selling meds?


The first day my dad moved into his new beautiful Board and Care assisted living home, we brought all of his newly filled medications. He has a prescription for hydrocodone (vicodin) that he RARELY uses, only when he has a flare up of osteoarthritis. I specifically pointed this medication out to the head caregiver (the house manager) so she knew that this medication is not part of the daily regimen, just to be used as needed. She acknowledged. Later that evening she called me and said that the hydrocodone was missing, asking ME where it was and telling me I needed to get it to her ASAP so she can log it in. I told her the last time I saw it was when I handed it to her! She kept insisting “No, she didn’t have it”. I was perplexed what happened there. We went round and round on this numerous times. Well, the next morning she lets me know that the medication had been found! Hummmm?? She said she looked in the trash can and, THERE IT WAS! Said in all her busyness of moving my dad in and logging other meds it must have fallen in the trash!?? Anyway, I discussed with my siblings and we decided to not jump to conclusions at this point since dad seemed to be handing the new move ok so far, but keep a watchful eye on this. So today I looked online on his Kaiser account to see if anything (including the painkiller) had been refilled yet. The B&C uses an outside pharmacy to get prescriptions and charges Kaiser. Anyway I noticed that the hydrocodone was no longer on the list of his prescribed meds on his kaiser account. I’m confused and am wondering if they could get it switched to the other pharmacy and are getting it filled. My dad is clear minded and has not had any pain that there should be a single pill gone from the original bottle and would be no need to get it refilled. I feel that something funny is going on here but I don’t want to accuse anyone without proof. Im just looking for thoughts or experiences with this and if there are any (besides the obvious that someone is addicted) scams with caregivers selling meds like this.


Thank you!

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Never had experience with this but my mother worked as an aid in a nursing home for years also at a major hospital here in Los Angeles and heard and seen medication "disappear". If this were my Daddy... I would log everything this will give the head caregiver know that you do not want this to happen again. And that you are CYA and theirs! as far as ordering the medication I guess its just me but I don't like when the pharmacy just orders my dads meds... I am a control person I want to know what is being ordered, and when. Be watchful.
Blessings
HGN
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I'm not following the logic here. The pills were temporarily missing but were found - this points to sloppy procedures but unless the bottle in the trash was empty why are you jumping to the conclusion someone took any of the pills?

And while the prescription not showing up on his list of medications is puzzling I still don't see any reason to conclude any medication has gone missing, wouldn't it be more suspicious if he received a new script when you knew he hadn't been taking any?

I'm no expert on how medications are handled where you live but I think a more logical explanation would be that the restrictions on renewals of narcotic medications, coupled with the fact he seldom used the vicodin, have resulted in there being no automatic renewal for this drug.
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Kristen246 Mar 2019
Hi cwillie - thanks for your response. As I mentioned I’m not concluding or accusing anyone of anything, just putting out there if anyone thinks this odd or if there is something I don’t know about that I should be on the lookout for. I just think it odd that with all the medications he takes there has only been unusual things happening around this one medication, the one that is constantly in the news as being a main player in the “opioid crisis” our country is facing right now. Just trying to be diligent in looking after my dads needs. Would hate for him to be in pain and then finding out his pain pills are not available to him.
Thanks again for your input. I really appreciate it. 🙏🏻
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Hi.
My 2 cents.

If suddenly there is a refill on vicodin, you simply confront them.
& report to facilitator.

you are never too suspicious when asking strangers to look after your loved ones.!!!
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Yep!
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I would call the pharmacy and ask why the med was no longer in the list of medications that your dad has. They can see on their screen what is going on about that. Id tell them what happened at the assisted living place and your very concerned. They will make a note on his script page to be very wary if someone calls in about it. And let you know too. Id do that immediatly.

I would also call his doctor. Did the doctor cancel the script? Id tell him/her what is going on. That medication is your dad's and no one else.
The doc/keiser might change that med to something else, so its not so apealing to staff. They can put in his electronic chart if anyone calls in a script for him. And to let you know.

Id also raise hell to his AL place about a controlled substance being in the trash!!!??? And the argument it was somehow it was "lost or you never gave it" Hell no!!!! Dont buy that one for a minute. They should have a nurse who logs this type of medication in ASAP and your initials that you gave it to them. Right down to how many pills were in the bottle. That way they have proof it was given to them, and the amount of pills left. And how much they gave out.

Id go straight over this persons head to complain. Who is her boss? What type of place are they running where meds disapear, then reappear in the trash??? How many pills were found in the trash??? Who else has this happened to? Id also tell them 1 single pill goes missing and you will file a police report. That way they have a record that someone was tampering or taking the meds. It will be a record so they are put on warning. It wont look good to the home to have that done. They certainly wont want that.

Id get to the bottom of that real fast. That is extremely sloppy control of medication. I dont believe that would happen. No not for a minute. Since your dad has his mental faculties ask him if anyone went to give him that med. Did he put it in the trash? I doubt it. Meds are usually doled out by a nurse. They are not found in the trash with the whole bottle. Or there is a protocol in place.
Id go to the head person over this. I wouldnt wait. Id say she argued about the med before it miraculously turned up. That way they will note if anything else is happening. If she said medication has gone missing before. I wouldnt let that slide at all. She is hoping you will let it go. This could be a pattern which no one is aware of. She also tried to say you never gave it to her. She then said it turned up. How do you know the med turned up? Id want to physically see the medication and how many pills were in the bottle. Just saying it turned up doesnt mean it did turn up. Did you physically see it? Id want to see it so I knew it was there and safe. She can say it is there, but he never gets a pill. If they are so inept at keeping meds what else are they inept at? Dont buy any of it. Not with controlled medication. Not for a minute. I would have to physically see it and know what proticols are in place. They lost your trust on medication management. Id say that right to them. I wouldnt care. Id also want to talk to the nurse about his medication and how that is handled. Everything from accepting medication intake to doling it out. You have an excuse your worried hes not going to get his meds properly. Talking to the nurse will let her know that there is an issue surrounding this. That way the manager might not get away with lost medication with the next person.
Id make darn sure I physically saw the medication in the bottle with a pill count. You can do this with the nurse. She could say the bottle turned up but there was only 2 pills left. Then blame it on the disappearance of the bottle. That way 2 other people know there is a problem with that and will be watching her.
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Exactly.
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Sadly, this kind of thing does happen in NH's all the time. I'm certainly not saying that it's in EVERY NH, but the story you tell is frustrating, to say the least.

She found "only the Vicodin" in the trash? Hmmmmm....

Well, you don't want to make enemies nor unsubstantiated claims. Now she KNOWS that YOU are a little suspicious, so I think this person, at least will keep a clear head about this.

I don't know anything about Kaiser and the meds--but others will and will weigh in. I don't see why the Vicodin wouldn't be refilled right along with all the other meds. And the Vicodin should be on his meds list always.

Sounds like you are a good advocate for dad. Keep it up. The fact you knew exactly how many pills he should still have is good and very on-task.

Knowing he has someone(s) on the watch will keep the B&C staff on their toes.


You may want to talk to the person who is OVER the manager. Just quietly--or you make just want to take a watch and wait attitude.

Unlikely the CG would be selling the meds. Much more likely they are taking them for themselves. But, you never know.
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Kristen246 Feb 2019
Thank you for responding. This helps me to get perspective on the situation and keep a wait and watch approach, like you said. The sad thing is my dad is adjusting SO well there and the caregivers are very good to him, so it would be hard to shake that up if something else arose with the meds that wasn’t right. Hopefully it won’t!??? Thank you! 🙏🏻
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The AL should be getting orders regarding medication from the doctor in charge of the patients there. I am not clear if this is a different type of AL with less residents. My mother has been in 2 different AL facilities. The one issue that has been the same is the medication. Each AL has one pharmacy it does business with. All medications are held in the wellness office. All have to be prescribed by the doctor that oversees the residents. Even over the counter medications are held by them to be dispensed by them. If a specialist is seen that prescription is given to the office. They oversee it all and use only 1 pharmacy. The resident and any family member have no say in the medication. At the present facility that my mother is in I am called if there is a change or addition of a medication. I do not inform them about any medication. If a new problem develops I may ask them if a medication could be considered if I know it to have helped in the past. They then will inquire that of the doctor. I do also find it odd that pain medication might have gone missing but at least it was found. I believe you could check from time to time to see how much of that medication is left. Actually I think you should since this has happened. Hopefully there will be no more issues for you. The 2 facilities my mother has been in differ in many ways but the system of medications are almost exact.
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AndreaE Mar 2019
I agree 100%. This was the exact same procedure when my mom had to be admitted into a rehabilitation center/nursing home 3 times. The only thing I could do as far as my moms pain medication goes, was to check to see if she was given it that day, and at what time. If she needed it more often I would have to have the charge nurse call the center's physician (which happened to be my mom's primary care physician). Ask the nurse if any vicodin were given to your father and if the prescription is still full and go from there.
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It’s clear that you aren’t accusing anyone of anything, just being cautious. Don’t blame you. There is an opioid addiction epidemic these days. Very sensitive subject for me. I grew up with a heroin addict. My brother would have done ANYTHING to get his fix! I have known nurses and physicians who became addicts. No one chooses to become an addict. They don’t ever think it will happen to them but it can happen to anyone.

Fortunately, myself and my other siblings were so traumatized by my oldest brother’s addiction that we despised drugs. I think that is fairly common, you either follow the behavior or do the exact opposite.

You are right to question the meds going missing. It’s an opioid.
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I'd say confiscate your dad's pain meds. Then issue them to him as needed. If the AL can't keep track of them, maybe you can. Also, try setting up a hidden camera in his room where you can check in on him regularly. This way you'll know if something fishy is going on. Hope these suggestions help.
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gdaughter Mar 2019
I'm with you, or leaving only a couple with the Bd and Care, though if something is going on, they may say he needed them...but there is no mention of dementia, so he should be able to say if he needed them or not.
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In Florida, nobody is permitted to handle any kind of medication without a nursing license to the exception of close family members. If anybody is administrating medications without a license is practicing nursing without a license. If you suspect unauthorized staff handling medications you can contact management or even better the police department and file a report. The employees can be drug tested. On the other hand if the Vicoden is rarely used, just don't refill it. Use motrin or aspircreams instead
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cetude,

Good suggestion.
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When Mom entered her AL, I was told that she would need to order her meds thru their pharmacy but could use her insurance. I took all her meds but was told they needed to order them. Well, because of DEA regulations she had to use up what I brought and then they could order. In the meantime what I brought was put under lock and key. Moms facility and most facilities use blister packs. In the state of NJ, Medtechs are allowed to dispense medication.

I think at this point it was an oversight. The bottle may have been on the desk and fell into the trash.
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