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The RN's in Personal Care are to administer eye drops: AZOPT in both eyes in the am and AZOPT and Lisiprinol in the pm in both eyes at least 5 minutes apart. When she was moved to Personal Care from her Independant Living Apartment I was no longer permitted to stay with Mom overnight. The nurses were telling me in the am they gave her eyedrops before I arrive. I started started tom come in earlier so I could see for myself if she was being given eye drops. When I stayed with my Mother in Independent Living I never missed a pill or eyedrop. That is how it should be in Personal Care. To my horror when eyedrops were administered in front of me in the am the Nurse was incorrectly giving her Lisiprinol in the am and was not giving her the AZOPT in the am. Further she was only being given AZOOT at night. This had gone on for approximately 2 months. She had a visual hallucination in the dining room about a month later. She saw an airplane land upside down in the parking lot and a man come and turn it right side up. She saw another airplane land iupside down and a man turn it rightside up. I went along with her. She then told me that she was on a cruise last week and the women all had on white gowns and wore lots of diamonds. After dinner when we went back to her apartment and she got into bed she became frightened. She saw a man's hands coming out of her closet and holding onto her open door to the living room. I went into the closet and checked it thoroughly so she would not be afraid. The she saw hair hanging on the bathroom wall that she she's from her bed when the bathroom door is open. We leave the light on in th bathroom at night. Finally she went to sleep. That was her only hallucination. It was all visual. I found an article on Charles Bonnet syndrome on the internet that comes from a variety of eye conditions including Glaucoma in older adults with later life vision loss. My Mother can still read the newspaper with glasses. Her Glaucoma has progressed with her eye Dr. sending her to a specialist because he noted a change. We have an appointment with him next week. We reported the failure for Personal Care to properly administer her medications, ie. her pills and significantly failure to administer her eyedrops for a continuing period of time to the state licensing bureau.upon advice of the Obudsman. I have not heard back from them. The facility limits my visits to 8 am until 8 pm. I am here everyday. I am uncomfortable that I do not see the giving Mother eye drops. Mother is 99 years old. My questions include any answers that might be given. There are many bad circumstances surrounding this issue. We are trying to sort them all out. It is too overwhelming to state all matter in one question. We are starting here. God Bless any help or ideas.

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I don't know if visual hallucinations can come from eye problems. That is certainly something you can ask the specialist. In any case, the eye meds should be given as prescribed.

The kind of hallucinations, delusions, and paranoia you are describing are very common in some forms of dementia.
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Since you are seeing a specialist perhaps you could ask him/her to contact the facility doctor or DON to stress the importance of proper a eye regimen and the effects of their negligence. I understand why so many people launch lawsuits, this is pure negligence with life altering consequences.
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There's a reason why some meds need to be administered in the morning and some in the evening. The people at the Personal Care unit need to be aware of and adhere to the schedule prescribed by the opthalmologist, who I assumed was the prescribing doctor. If there's a director of nursing, I would let her know of this, in a polite way though b/c the offending RNs could get angry at you and take it out on your mother.

At your next appointment, perhaps you could ask the prescribing doctor to write a letter emphasizing the need to adhere to the schedule he wants. Keep a copy for yourself before delivering it to the nursing director in your mother's facility.

One of the things I've noticed about RNs in some rehab facilities (not the same as Personal Care but also not on the same level of acute care as a hospital) is that they're not as energetic or responsive to patient needs, depending on the rehab unit and depending on their age.

There's not the same level of scrutiny, of responsiveness, but there is more independence on the part of nurses to make their own decisions.

I dealt with this twice on the issue of locking up Nitryglycerin. I didn't object to other meds being in a locked cabinet in the room and administered as needed, but I objected to locking up the Nitro.

When I pointed out that if need dictated, the Nitro had to be quickly accessible by my father, the nurse responded that he should ring the buzzer for someone to come, unlock the cabinet and administer the Nitro. (Yeah, if he's having a heart attack he's going to have the presence of mind to ring the buzzer? Then wait for someone to come with the med cabinet key?)

I sweetly and somewhat pleadingly responded that if my father had a cardiac event, he needed that immediately and couldn't wait the 1/2 hour that it often took for someone to respond to the buzzer request for help. I kind of hinted at liability as well.

Thereafter, I found the Nitro in the top drawer of the little dresser, not locked up in the med cabinet.

So sometimes you have to be persistent to get the staff to do what they should do without prodding.
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If your mom never had hallucinations prior to missing her eye medications I think it's reasonable to wonder if there's a link.

You're there from 8am to 8pm and you never see your mom's nurses giving her the eye medication. It's pretty safe to assume that she's not getting the medication.

Have you tried contacting the nursing supervisor with your concerns? The nursing supervisor might be easier to contact and have a discussion with than the Ombudsman.

Medications are important. Facilities hire people for the specific purpose of giving out medications. I can't help but wonder why this facility repeatedly ignores your mom's eye medications. Do they think that because it's "just" eye drops that it's not important?

During your mom's appointment next week perhaps you can explain all of this to the Dr. See if he can't prescribe the exact same meds so that you can give them to your mom. Although you'll have to inform the facility that you're giving your mom medications. They may frown on that but maybe it will help your mom get the meds she needs from the facility.
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