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View Diary: Elder Advocacy and Being a Detective (74 comments)

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  •  My mother in law (3+ / 0-)
    Recommended by:
    cany, Villanova Rhodes, worldlotus

    got a bad drug reaction at a nursing home, and was sent to the hospital.

    Once I got permission to review her records, I checked each of her medications, and sent the doctor a very polite note suggesting where I thought there might be a negative interaction (and including references).  I figured this was a lot less confrontational than my going in and yelling at them that they were a--holes, which is what I felt like doing.  The doctor emailed me back that she agreed, and would change the medication.  Unfortunately the hospitol had already begun treating the problem caused by the interaction with an even more dangerous med that ended up causing fatal GI bleeding.

    One thing to watch for with the elderly is that meds doses are often based on clinical studies in younger people who can metabolize drugs much more readily than can the elderly.  Also many of the elderly are frail with relatively low body weights and drug doses typically aren't adjusted for a patient's body weight or volume of distribution.  

    Nursing homes classically overmedicate with antipsychiatric drugs or sedatives to acheive "compliance" which is often shorthand for staff convenience.

    One other bit of advice, since I have been a nursing home patient, is to insist on visiting at night, and if you can, set up a recorder.  Some of the abuse that goes on at night in these places is brutal (not all places and not all staff, but it does happen and night shift is the likliest time).  If I ever have to go back (and I sincerely hope not) it night time when I would want a personal care assistant.

    Democrats give you the Bill of Rights; Republicans sell you a bill of goods!

    by barbwires on Fri Dec 09, 2011 at 05:53:06 PM PST

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    •  Yes, I worry about all of this. I will seriously (2+ / 0-)

      think about your recommendation for recording, but lately, mom has not wanted to sleep in her bed and has been sleeping on a couch in the main room.  She isn't used to going to bed early and I asked the people there to just let her decide for herself when she wanted to go to bed.

      But now that she's so incoherent, I am going to have to make some changes.

      I have no other family so whatever is done is done by me. The sense of responsibility is just overwhelming, believe me.

      202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

      by cany on Fri Dec 09, 2011 at 07:07:11 PM PST

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      •  Are you by any chance (2+ / 0-)
        Recommended by:
        cany, Villanova Rhodes

        your Mom's power of attorney for medical care? If you aren't, see what you can do to become her her POA.

        If you ARE, then you definitely have a say in her treatment.

        Be very aware that low blood pressure leads to falls, which can result in fractures and much worse.

        Hang in there.

        I am in a similar situation in that I am the responsible party (POA etc.) for my dad, who had come to live with us 11 years ago and is now in nursing care. My siblings are out of state (if not out of the country) and therefore I am pretty much on my own.

        "No one earns $100 million. You steal $100 million." --Fran Lebowitz

        by SNFinVA on Sat Dec 10, 2011 at 10:03:10 AM PST

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        •  Yes, I am POA for both health and finances. (1+ / 0-)
          Recommended by:
          Villanova Rhodes

          I will be going to the next doctor appointment with my mom (I have gone to every single one for over 6.5 years or so) which is tomorrow, and will ask some questions.

          202-224-3121 to Congress in D.C. USE it! You can tell how big a person is by what it takes to discourage them.

          by cany on Sat Dec 10, 2011 at 04:09:32 PM PST

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          •  Ask questions (2+ / 0-)
            Recommended by:
            Villanova Rhodes, cany

            and also make it clear that you expect some clear answers.
            Take notes if you have to: you are probably exhausted by all of this, so give yourself the chance to write things down.

            Also make sure that whatever orders the doctor writes for medication are written VERY CLEARLY, so that there is no room for misinterpretation. It is really important that communication between her physician and the nursing home is idiot-proof.

            With my Dad, I have made it very clear from the outset that I do not approve of over-medicating him, and that I want to keep the number of medications (and therefore possible adverse interactions) limited to as few as possible.

            I'll be thinking about you. :o)

            "No one earns $100 million. You steal $100 million." --Fran Lebowitz

            by SNFinVA on Sat Dec 10, 2011 at 05:02:14 PM PST

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