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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!

Well what happened?
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Reply to Jasmina
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I would see if his meds can be kept in a lockbox that only the nurses/med administration staff can access. In mom's facility they did this, and the nurse signed the log each time meds and insulin were administered and how much. I'd inquire as to this type of procedure and tell them it is so you can keep track of how many dad is taking for his doctor (which actually is a good idea to do anyway as it helps assess his pain level and whether the meds are working).
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Reply to FrazzledMama
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Can you call his dr and inquire? My husband takes a controlled substance for ADHD and needs to go get a hard copy for the script. Since your husband rarely uses it, maybe you can get a hard copy script for it and take a limited supply into the facility when he needs it?
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Reply to Jannner
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Stop in out of the blue and check the med. You would know how many pills are left. Since she argued with you, and said they were found, they will all be there...
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Keep all but 1 or 2 pills then they call you needing more.
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I think you are making a mountain out of a molehill - all could be above board - stay vigilant but it might just be innocent - she brought this up herself so why point a finger at herself?
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Something is majorly amiss here. The suddenly "finding it in the trash can" sounds like a BS story to me. I would investigate this to the fullest extent. If you see your parent on a regular basis, request locking medication bottles from the pharmacy. This is a controlled substance!
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Reply to Llamalover47
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When my mom was in rehab, for CHF, she was allowed one glass of wine a night, It was labeled with her name and doled out like a drug.. So maybe this was an error, but if a glass of wine is treated like a drug,, I think a real drug would be watched?
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Reply to pamzimmrrt
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Pretty sure at this point maybe keep it with you and let them contact you if he has a flair up. Honestly it sounds to me you have a thief on your hands. If the story sounds suspicious....then it most likely is! Sad what this world has come to. Can’t even trust a caregiver to be a CAREGIVER!!!
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Reply to Teresaisme
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Start your own investigation, and call kaiser to see if it's been refilled. That bothers me a lot and sounds incredibly suspicious. The drug that turns up missing just happens to be the one that is most likely to be abused.
I wonder if she thought you'd just take her word for it and call in a refill, thereby essentially giving her the entire bottle. It makes sense the meds go missing before they get logged(most convenient time to avoid suspicion and personal accountability).
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Kristen246 Mar 4, 2019
Yes! That is exactly what I thought but wanted to
check myself incase I’m overreacting. Thanks for the validation. This is all new territory for me! 💜
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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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Reply to JoAnn29
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Claiming it's not there and then later finding it "in the trash" does sound flimsy. I would think it suggests more sloppiness than something nefarious. She might have mislaid it and then found it where she herself had put it, then made up this story. Either way, it does seem like she should have logged it immediately, not waited until later. A bit sloppy there, at least. As others have said, best to take a watchful waiting approach. Write down this incident, with date and any substantiation you have. Then if something else strange happens, document that too and go to management.

It's unnerving that happened when your dad first took up residence. Hope things go well now, but if not, you're obviously vigilant and observant, so you'll get to the bottom of it!
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Reply to Kittybee
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I know that here they will not just refill automatically any opioids without a written prescription from a physician each time. Could that be the reason it is filled separately? Also her calling you and asking you where it was would make you suspicious. So if she had something to do with it I doubt if she would have called your attention to it. If she found it in the trash I would think that would make her aware that someone else might have had something to do with it and be watchful.
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Kristen246 Mar 4, 2019
Good points! Thank you!!
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What a shame this happened at the start of an already stressful situation. Of course you are suspicious, opioid abuse is real. I hope your dad is able to inform you when he has requested the Vicodin so you can keep track of EVERY SINGLE PILL! My friend’s son lost his RN license for stealing opioids (died from OD). I would suspect the “misplacement” was a test of your vigilance. Best wishes!
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Kristen246 Mar 4, 2019
I also thought it might be a test of vigilance at the beginning. So hard because you want to give them the benefit of doubt at the beginning and start out on a good foot - especially when your parent is going to be in their care. So sorry to hear about your friends son. So sad. Opioid abuse can start out so insidious and then just take over ones better judgment.
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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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NeedHelpWithMom Mar 4, 2019
cetude,

Good suggestion.
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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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NeedHelpWithMom Mar 4, 2019
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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NeedHelpWithMom Mar 4, 2019
Exactly.
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In my mom’s NH, all meds were kept in a locked cabinet that reminded me of one of those tool chests on wheels. The only one who had a key was the Charge Nurse. There was a system of checks and balances. And, my mom was not even allowed to have aspirin in her room. It had to go in that cabinet and dosages had to be supervised by the nurse.
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Stealing of any Sort goes On in these Nursing Facilities. I would Not be One bit surprised..My Grandma used to get her Bras stolen and My Grandfather His Money, Honey..Keep an Eye on it More.
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NeedHelpWithMom Mar 4, 2019
Stealing does happen frequently. My godmother’s clothes were taken and they would use the excuse of them being lost in the laundry. Jewelry was taken. That doesn’t go to the laundry room. Simply taken.

My Uncles’s watch was taken that he only put in one place every single night. It mysteriously disappeared off his nightstand. Yep, stealing does occur.
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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 4, 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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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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Reply to NeedHelpWithMom
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The reason med assistants are paid as well as they are is for this very reason. Dementia drugs are now being sold in the street for recreational purposes and for some bux. Namenda and aricept. It's appalling.
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Reply to Segoline
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In my Moms AL, no resident was to have their meds in there rooms. It was dispensed by Medtechs. I was able to bring what she had left but they were put under lock and key. When new prescriptions were needed they contacted Moms PCP. It could be that the med, being used when needed, was forgotten. Or, he has some left and refills were not needed.
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Reply to JoAnn29
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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 1, 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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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 4, 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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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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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 28, 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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