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And cause problems in caring for your loved one? After mom was in the hospital for 3 days in April after 2 falls in 2 days, she was admitted to a re-hab for 17 days. When she came home, she started getting home visits by a nurse. At first a couple times a week and then tapering off to once a week. However the same nurse came each time and on a few occasions decided she was going to change some of me and mom's meds routines based on what mom (who has dementia) would tell her. Each time this happens I have to deal with the aftermath of arguing, accusing and generally poor behavior on mom's part.


The last episode happened just this past week and I'm sick of it. I had taken mom to her GP appt. on Tuesday and he said she was much better than she had been since he had started seeing her. Her O2 level was at 98, had no rales in her breathing and was moving more air through her lungs. He then called out to the nurses station and asked me about her Ativan usage. I had decreased her usage of it after she got home from re-hab because I believe she was getting too much and it was making her dizzy and causing the falls. (She hasn't fallen since). So I told her Dr when and how much I was giving her and he said that was fine and wrote a script for 1/2 of a.5 tab twice a day. I had been giving that to her already at bedtime and in the morning but since she was screaming all day long for more I would give her a quarter of a tab in between...more to shut her up than anything. But also because I didn't want her dizzy and falling again. So the visiting nurse comes in the next day while I'm at work and her caregiver is here and Mom proceeds to tell the nurse that I'm only giving her a quarter tab at the times I'm actually giving her 1/2 tabs. The nurse then takes it upon herself to call moms Dr and ask about the dosage. She didn't even talk to the Dr but the nurse. She didn't call me and ask me what was happening with the dosage or anything. She just told mom that I shouldn't be giving her 1/4. As a result Mom and I have been battling over this since Weds. She won't understand that I was actually giving her a tad bit more than the Dr. said. And only because she would sit and scream and cry for it.

I talked to the home health agency and told them I don't want that nurse back in my house again. I'm tired of trying to fix the things she stirs up. If I was doing anything harmful to mom it would be a different story but I'm not as witnessed by the Dr's comment on the last visit.

Any insight on this is certainly appreciated. I'm about at my wits end and ready to put mom in a nursing home due to the mental stress caused by a nurse wanting to put her nose in where it doesn't belong in my opinion.

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Garden Artist...I understand that I should not change the Dr. prescription and in fact HE decreased the dosage. He really doesn't even like to prescribe Ativan to elderly patients at all. As far as the nurse goes, I have requested that she call me in the past and she doesn't. I have met her on several occasions and requested that she keep me in the loop due to mom's inability to remember what is said to her. I work less than 5 minutes away from where mom and I live so I can be here for the visits and know for certain what is going on. I have left notes on the door for her to call me. I have had mom's companion care tell her to call me and she never does. Again this is not the first time she has done this. I did tell my mother what the dr and I discussed during her visit but she will use her selective memory and/or outright accuse me of lying to her. One of the other instances that caused a big stink was her telling mom that she could have as much Tylenol as she needed after the Dr. told mom NO MORE THAN 6 tabs of 500mg DAY. Mom was taking over 6000 mg a day when I first moved her here with me.

And no I'm not willing to try to work this out with the nurse. I've already requested a different nurse. I made it abundantly clear that I am Mom's caregiver and that mom gets confused and forgets easily and can't effectively relay information. That was established on the first visit she made to mom and mom even told her that the nurse needed to let me know what was going on.

Sorry for the rambling nature of this but I'm tired ...need to go to bed and sleep. But thank you for your insight.
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In all fairness, I think when the the nurse called the doctor she was responding as she'd been trained to do, and perhaps making the assumption that as a nonmedical person you shouldn't be changing prescribed doses, as she understood them to be from your mother's conversation.

However, I don't see any reason to change the med routines otherwise, if you mean she changed the times your mother took them, but not the dosages. Some meds shouldn't be taken together and some should; perhaps she felt there was some issue there, but she should have raised it with you so as caregiver you would be aware of those issues.

When we've had home care, I usually meet with each of the staff on the first visit so they know I'm involved and any questions on care should come to me (in part because Dad would be unlikely to even hear what they said). The only potential misunderstanding occurred when a social worker made some conclusions without telling me, but they were "no action" conclusions. Still, I would not want her back because I don't think she really wanted to be in elder social work.

Would you be willing to sit down with the nurse to try to work this out, and/or do you feel another nurse from the same agency would be better?

I do think the nurse absolutely should have kept you in the loop, assuming you made it clear that you are your mother's caregiver.

As to how to handle the issue with your mother, maybe you better just tell her you and the doctor discussed the issue, you were following his orders, but the nurse misinterpreted the situation.

I have found that patients often listen to home care people before listening to their family, in part because they're "authority figures" and have the training which we caregivers lack.
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