Nursing Home, Hospitals and Meds

September 29, 2002

Hi group I read Peg's post about possibility of nh handing out wrong

meds. Everytime some one here in our little town starts in on the nh

and hospital here because of some mistake that has been made I point

out that it happens all over not just here.

Peg not only do you want to check to make sure that he was given his

meds but are they giving him the right meds? My client was given a

high blood pressure med instead of Eldypryl which is for PD, because

the nurse read my notes on meds and " thought " I misspelled the med

wrong as she was unfamilliar with Eldypryl and since I am

a " layperson " didn't bother to look it up! My client does not have

high blood pressure and stopping the PD med all at once is not a good

thing. She almost died of kidney failure. She was in the hospital

because of a possible blood clot or infection in her leg. She should

have been in the hospital for just a few days and ended up there for

over a week and out of her mind...she doesn't remember any of it.

Sandie is right on the time of the meds yes there is a " window " and

yes if the pt refuses meds they are thrown out. Everybody who works

with dementia knows how hard it is to get someone to take or do

something they don't want to take or do. There are ways around it,

the nurses if they know there is a problem should be trying to see if

there is a favorite food that they can put the crushed meds in,

applesauce is the standard but not everybody likes applesauce. Also

sometimes it is just a personality thing and another nurse may have

better luck.

The other thing about timing is if he is getting the meds at the same

time he was getting them at home. I forget if he is on PD meds? The

timing for these meds is differant for everyone who takes them so

they can't just be given when the nurses deside it is a good time. A

way to get around that is have the dr prescribe what times they are

to be taken.

At home if our LO is taking a lot of different meds we try to dole

them out throughout the day in the nh or hospital they tend to give

all of the one a day pills in the am if they are not specifically

marked what time of day they are to be given. This can be upsetting

to the stomach and if the nh does not agree to split them up talk to

the dr and have him give specific instructions as to time of day.

A good idea for all of you if you are not already doing it is to have

a med list with the name of the drug, dosage, and X per day. Don't

hesitate to ask the nurses to check this against their charts, most

nurses won't hesitate to do this. A lot of things can happen when

transfering information between clinics and institutions.

If you have a bad feeling about a med your LO is getting question the

dr about it, find out his reasons for going with this med instead of

another one. Just because the dr ordered it does not meant that it

is the best med. Good luck to all of you who are going through this

right now and keep us posted. Barb

September 29, 2002

Group-

While dad was in the nh, I learned there is a chart used with all meds.

listed...doses, how many a day, WHO gave them (med. aids need to chart

them, every time a med. is given)...and this list is a report called a

MARS. Sorry, not sure what it stands for but do know it is a

" medication record " . Where dad was at it was updated monthly, unless a

new order came in it would get added to the existing one. I would ask

the nurses for a photo copy of dads. Figured since I am the closest

family member, and Power of Attorney...I had all rights to it. They

never refused it to me. For all in the group with LO's in NH's, keep

this in mind. Then you have the information, hands on, and have time to

do the research and/or ask questions. Proved very helpful for us!

Sandie

September 29, 2002

Barb,

This is really good info to have. Just wanted you all to know that

I did question my step-dad's meds today and guess what ... someone in

transferring the records from the hospital to the nh made a mistake.

He should have been getting 3 Synamet a day and they had been giving

him only 2. When the nurse realized the mistake, she non-chalantly

says . . it's corrected now. This was alittle after one today. So,

I say ... " Then you'll be giving him his lunchtime pill now? " I'm

not sure she would have if I hadn't asked.

And ya know Barb, I worked in a nh many many years ago as an aide and

then as a home health aide, so I'm pretty open minded to the fact

that there are shortages of nurses and aides all over and the quality

of care is sometimes very poor. But then again, I've already ran

into some really caring, decent one's who obviously like what they

do.

I've printed both your's and Sandie's message about the meds. I'm

making a notebook of some of everyone's posts for my own means of

reference. Which reminds me .. I have a QUESTION for you or anyone

else that has info about this ...

Is Ativan one of the sedatives that is considered dangerous to LBD

and Parkingson patients? And why is that? What happens?

Had a talk with step-dad's daughter today, but that's another story.

And it's time for me to go to bed. So, until we meet again. I wish

everyone a good day tomorrow. Take care of yourselves and your LO's

and God Bless!

Peg

September 29, 2002

>Is Ativan one of the sedatives that is considered dangerous to LBD

>and Parkingson patients? And why is that? What happens?

Heck Peg all of you guys are doing so good without all of our well

intentioned advice, good for you on checking the meds. I was also

glad to hear that there is someone else that has nh experiance from

the employee side, I really do get upset when everytime nh is

mentioned it is negative...there are some real goods ones and some

wonderful people that work in them.

My husband is taking Ativan, I have not seen anything in writing that

it shouldn't be given to LBD pt's. My husbands neurologist

prescribed it when Bill first got real bad with the hallucinations.

He explained that it is the same sedative that is given before you

have an operation, the one that makes you not give a d__m. Bill has

not had a reaction to it and it helps to calm him, he can get some

sleep right after he takes it. It just doesn't seem to last long,

maybe 3 hours at the most and he can only take 1 twice a day.

Sandie's father had to quit taking it after he had been on it for

awhile. With dementia already a problem with this disease any

sedatives, sleeping aids, narcotics can add to the confusion but with

this disease we have to consider what is going to be livable for both

the LO and the caregiver. I have to ask is his daughter helping with

any of this? Just curious, thank God your mother and sf have you.

Barb

September 29, 2002