While it would be great to get the communication lines going, my big concern with this place your dad is in would be how long might the improvement last after you find a place to file complaint? Our mother is in a private pay MC and I can say that they DO communicate with me - I have received a call every time mom takes a tumble (she's developing into a weeble who does fall down, but usually a fairly easy tumble). I am pleased that they do keep me informed. While working to resolve that issue, is it possible to find another place for dad, where they might be better about working with you?
The general rate of pneumonia occurrence with Remeron usage is 2.8%; the incidence of pneumonia seems to occur most frequently in the first month of Remeron usage and in females. It is to be noted that one listed side effect of Remeron is difficulty breathing. If there is difficulty on exhalation, there is an increased risk of air remaining in the lower lobes of the lungs, with an increased risk of infection. So, yes, there is a slight chance that Remeron could be linked to an increased risk of pneumonia. Overall, however, the risk is slight. A slight risk may seem significant if it is you or a loved one who is the statistical anomaly that develops pneumonia.
Ombudsmen are state employees whose job it is to respond to complaints related to inadequate or illegal medical care for geriatric patients. To find the ombudsmen nearest you, check the website for your state's Department of Health and find out where their Ombudsmen are assigned.
Failure to maintain aseptic conditions in breathing apparatus is a genuine cause for concern. Please do not hesitate to call the ombudsmen. You may be preventing needless suffering among other elderly patients.
I'm glad to hear you are trying to advocate for your dad. I too would be concerned about his condition. The sad thing is so many medications have side effects. While some seniors can tolerate their meds well others cannot.
My dad was one of those that could not. Everyone would dismiss me. I failed to advocate for my dad while was in rehab. I saw how all his pills turned him into a zombie and almost killed him from lack of appetite. No one was connecting the dots.
Finally his meds were cut back and all the mind fog was clearing. But to find the right combo of pills and dosage was tough. My father got stubborn and angry about his pills. It's never easy but do the best you can and try to escalate your concerns with management.
Many antidepressants have the side effect of weight gain--for whatever reason. I know some are more likely to have this s/e than others.
Anti depressants can also CAUSE depression...everyone is different in their body's reaction to them--on reason you need to be under a pysch dr 's care while on them.
As for the CPAP. I hope they are only using DISTILLED water, not tap, for that. Also, it should be cleaned regularly. My hubby wears ones, most nights, and I do kind of harangue him about keeping that thing clean. The CPAP supplier sends him replacement hoses, filters and masks each month.
Medical conditions can cause an imbalance in serotonin and dopamine which can affect desire to eat. The purpose of the anti-depressant is to balance these hormones.
The DON is wrong!!! I have POA for my mother who entered a nursing home for "rehab" after double knee replacement surgery. I kept her doctors and took her to the visits. The NP was only to give my mother the meds prescribed by her doctors and not theirs. The DON and I went heads up all the time as she attempted to explain to me their procedures and as I explained to her I'm getting a little tired of having to be on b**ch patrol. I work for a Chicago law firm and although my mother can hold a conversation, if she chose to not think about her health care and put me in charge, then if you don't honor the POA, my "boss" will be more than happy to sue them and change the name to Mary's Manor. After 10 months, seeing rehab concluded she was in diapers, I met with the family, told them to give me 1 solid month bringing her home and let's see what we can do, meaning I needed their off days, family friend to come for a few hours a day so basically she was only alone at 2 hour intervals. First, she used the bathroom just fine once she was home in a portable commode next to her bed so half the battle there was won. 20 years later at 80 years young, she is only in pull-ups due to being incontinent and happily living in her own home.
I took Remeron for depression and I can attest that it does, indeed, give you the munchies. My mother was taken off Remeron because she was so lethargic at one point that a doctor took her off Remeron, in addition to any other medication that could make her sleepy. If your father is over 65, his liver might not be able to metabolize the medication as readily as a younger patient. Another factor to consider is how many other central nervous system medications your father is prescribed. The American Geriatric Association recommends a maximum of three.
An alternative to the antidepressant would be a supplemental drink like Ensure. If you father is lactose intolerant, Boost would be a good alternative.
If your father has dementia, then, even though he is verbal, he cannot speak for himself in a legal sense. Were you designated health care representative by a court? If you have legal standing to act in this capacity, the facility ought to communicate with you fully. I am troubled by staff refusal to communicate with you. If your father does have dementia, the nursing home should be communicating with you, given that you have POA.
Please so what Barb said above. Somewhere is a big misunderstanding or something yucky going here. I don't like that a bit. Ombudsman address and phone number should be clearly posted in NH and also on state or county websites.
Cricket1954, pneumonia is caused by something that shouldn't be in the lungs getting there -- bacteria, virus, or fungus. I am not aware of any medicine that has this as a side effect.
Do they never clean the cpap? Or do they do it on a schedule? How often do they replace the parts?
Isn't one of the side effects of mirtazapine (remeron) pneumonia? He's had it twice and on breathing treatments as I mentioned earlier. And, why don't they clean the cpap machine and tubing and masks?
The DON and the Administrator both said they didn't have to talk to me even though I am the health care representative and POA because he can speak for himself. They never tell him when they change or add medications. They also closed his PO Box and didn't tell him. They got rid of his Doctor and assigned him a facility Nurse Practitioner and didn't tell him or me. They told me it was "inappropriate for me to interfere and ask questions. After this the charge nurses insult me and/or ignore me.
Cricket; I'm hoping that you are your dad's Health Care Proxy, or at least that you have a signed HIPAA release so that you can be the recipient of information like this.
In the early days when my mom was in the NH, she was in the fairly early stages of Vascular Dementia and appeared "sharp as a tack" to most of the folks who dealt with her. The doctors, nurses, etc., would visit her and tell her things about her health, clearly expecting that mom would be able to pass that information on to us. Of course, by the time I got there--"mom, why did they change this med?"--mom's response was a shrug (she also had aphasia, which came and went. It came around ALOT when I visited.
I agree with Hugemom that there is a breakdown in communication and that the way to fix it is in an in-person care meeting in which you make your need for communication clear.
If you don't know, then there is a breakdown in communication between you and the facility. The NH always called me when there was an incident, a fall, or a change in medication with my mom. They recorded that they called me and informed me. It must be a law that they must because they always did. When I visited, they were always open and very willing to talk. If the facility is not like this with you, start with the social worker and the Director of Nursing. You have to wonder what else they're doing with him that you are not being informed about.
My mother also has benefited from the mirtazapine (remeron). Now not depressed and it does help with her eating. She lost 22 pounds in a skilled nursing unit after a fall. Now the weight is slowly coming back 1 pound at a time. It is not making her eat like a horse....just helping!
It is not always easy to get in touch with the PA or doctor for a nursing home. Discuss your question with the Director of Nursing, who can pass your question on.
Do you think your father might be depressed? Depression can make one listless and not interested in eating. Most antidepressants take weeks to be fully effective, so you'll have to wait and see if it helps.
Probably best to discus this with your doctor. Obviously there is a whole medical history/diagnosis/medication to consider. I would ask your doctor for clarification. Low dose Anti-depressant's can be useful to help with other conditions and at a low dose they do not work as an effective anti-depressant (for depression). Your doctor can give you more information. All the best.
While working to resolve that issue, is it possible to find another place for dad, where they might be better about working with you?
Ombudsmen are state employees whose job it is to respond to complaints related to inadequate or illegal medical care for geriatric patients. To find the ombudsmen nearest you, check the website for your state's Department of Health and find out where their Ombudsmen are assigned.
Failure to maintain aseptic conditions in breathing apparatus is a genuine cause for concern. Please do not hesitate to call the ombudsmen. You may be preventing needless suffering among other elderly patients.
I'm glad to hear you are trying to advocate for your dad. I too would be concerned about his condition. The sad thing is so many medications have side effects. While some seniors can tolerate their meds well others cannot.
My dad was one of those that could not. Everyone would dismiss me. I failed to advocate for my dad while was in rehab. I saw how all his pills turned him into a zombie and almost killed him from lack of appetite. No one was connecting the dots.
Finally his meds were cut back and all the mind fog was clearing. But to find the right combo of pills and dosage was tough. My father got stubborn and angry about his pills. It's never easy but do the best you can and try to escalate your concerns with management.
Anti depressants can also CAUSE depression...everyone is different in their body's reaction to them--on reason you need to be under a pysch dr 's care while on them.
As for the CPAP. I hope they are only using DISTILLED water, not tap, for that. Also, it should be cleaned regularly. My hubby wears ones, most nights, and I do kind of harangue him about keeping that thing clean. The CPAP supplier sends him replacement hoses, filters and masks each month.
An alternative to the antidepressant would be a supplemental drink like Ensure. If you father is lactose intolerant, Boost would be a good alternative.
If your father has dementia, then, even though he is verbal, he cannot speak for himself in a legal sense. Were you designated health care representative by a court? If you have legal standing to act in this capacity, the facility ought to communicate with you fully. I am troubled by staff refusal to communicate with you. If your father does have dementia, the nursing home should be communicating with you, given that you have POA.
Do they never clean the cpap? Or do they do it on a schedule? How often do they replace the parts?
It may be a misunderstanding, but if you are healthcare POA, you need to be kept in the loop about his meds and treatments.
Do you need assistance in getting in touch with the Ombudsman?
In the early days when my mom was in the NH, she was in the fairly early stages of Vascular Dementia and appeared "sharp as a tack" to most of the folks who dealt with her. The doctors, nurses, etc., would visit her and tell her things about her health, clearly expecting that mom would be able to pass that information on to us. Of course, by the time I got there--"mom, why did they change this med?"--mom's response was a shrug (she also had aphasia, which came and went. It came around ALOT when I visited.
I agree with Hugemom that there is a breakdown in communication and that the way to fix it is in an in-person care meeting in which you make your need for communication clear.
It worked to increase my mom's appetite.
Do you think your father might be depressed? Depression can make one listless and not interested in eating. Most antidepressants take weeks to be fully effective, so you'll have to wait and see if it helps.
Low dose Anti-depressant's can be useful to help with other conditions and at a low dose they do not work as an effective anti-depressant (for depression). Your doctor can give you more information.
All the best.