We're having an issue with my dad getting his medications correctly. He is 88 years old in stage 7 dementia. He gets Seroquel for sleeping 9:00 a.m., noon and 3:00 p.m. Not at all at night time, so he naps during the day and he's awake all night, wandering, and tearing up his room. I'm trying to get out the doors They are also not giving him his Zoloft or respridone, which is for his anxiety, until 6:00 p.m.
He's been in this facility for 2 weeks and we've had many talks with staff. Also had a meeting with the owner and staff member about this issue. He also acquired a bladder infection because he's not drinking enough water. Any thoughts or advice?
someone had mentioned that seroquel is an antipsychotic. Risperdol is also an antipsychotic. HOWEVER- at certain doses it does not work like an antipsychotic. For instance, sleep. Also at certain mg doses, they can also work as mood stabilizers. I know this from personal experience and having a great psychiatrist and therapist. They let me know this because taking antipsychotics scared me to death- just the name “antipsychotics” is scary to me.
now is the time to start an open line of communication with the care team. Check in with them every day. Keep expressing the time change on medications. If they have an in-house doctor- ask them to schedule a visit ASAP. It’s best if you can be there during that visit so you can ask questions, ask them to clarify things you might not understand (why the seroquel during waking hours 3x a day instead of just at bedtime) if you don’t understand something, ask away! A good facility will participate in strong communication. If nothing changes in the next 2 or 3 weeks, then maybe it’s time to check out other places. And when you do that, be sure to talk to residents family members you see while you’re there and ask them if they’re happy with the facility, and have they ever had concerns and what did the care team do for them to rectify the concerns. I wish you good luck and some helpful answers!
Demand to speak to whoever the prescriber is. Also, why are they giving him Zoloft for anxiety? Tell the doctor to write a prescription for Ativan that will be given to him as needed for anxiety.
They're drugging him up during the day to make work easier for the daytime staff and that is unacceptable. Make the prescriber of these drugs explain to you why they are administering them as they are.
Also, if your father isn't drinking enough water, why aren't they giving him coffee, or tea, or watered down juice, or soda? Maybe he doesn't want water.
Please don't let this facility get away with this lazy, and completely incompetent careplan. Go to your state's Ombudsman and tell them about it. Go to his regular primary care doctor and tell him too.
It depends on specific circumstances and how your communications go with the dept director, their (or your dad's) MD on staff, and the facility administrator.
If you are not getting the quality or information you feel you need for his care, then I would make other arrangements - as what is the point of paying for his care if he isn't getting it?
If they are not receptive in a timely manner, then I would be very alerted.
So much also depends on the medical / condition of your dad.
I have had to contact the licensing board of a nursing home.
Initially I contacted the Ombudsman to help me. (This will take you too long ... to wait) although I would call the licensing board anyway and let them know of your concerns.
In the interim, if I were you (and able), I would hire a personal caregiver to be with him to ensure he is getting what he needs, such as medications, water, adequate attention from staff. Do BEFRIEND the line-staff, the aids --- they are often overworked and under-paid. Being 'nice' to them may help you/r dad get more attention. I would focus on the administrator, social worker, managers.
Gena / Touch Matters
If you are still not getting the results you expect, it is time to look for a new facility.
Actually, if you are able, the person to talk to would be the doctor who is prescribing the medications. That would include the time medication should be administered. The problem is, it is often a visiting doctor, who comes and goes on their own timeline, so you may not ever see them or know when they are going to be there.
You are right to advocate for your loved one in a nursing home. Your requests don't sound unreasonable. Some nursing homes simply aren't equipped with adequate staff to provide the level of care you ideally hope for.
If they are unable to provide the care your father needs and deserves, find one that can.
they sound neglectful
i would be viewing and talking to other places and ask what their checks would be
I would tell admin that you need another meeting and that the medical record should be there along with the medication sheets so that you can time the times of administration of his medications. Let them know you are trying to work WITH them so they have a more calm resident. (I am ASSUMING he is in MC, and not in ALF, as he needs memory care now).
If, after several meetings this isn't working you are looking at needing a change I do know that YOU already know Dad isn't an easy placement. And places DO cherry pick. In fact they often HOPE you will take a problematic resident elsewhere, and may throw a party as you exit. Just saying, this now is falling into the sad realm where there are no good answers and EVERYTHING is imperfect. Just a fact.
I sure wish you good luck and applaud your actions so far, which are perfect. You have investigated, found what is wanting, spoken to staff and spoken to the admins. While it may take a month or so to work this out, stay calm and assure them you are wanting to help get it arranged so it works for BOTH your self-interests.
Good luck. I hope you'll update us.
I am caring for my very difficult spouse at home - for 9 years now, because he has been neglected, over-medicated (which was ineffective), and subsequently kicked out of two nursing homes.
If I could pick and choose, I'd much rather have a sweet, cooperative,
90 pound grandmother to care for than a strong, heavy, combative 63 yr old man, who, incidentally does NOT respond well to medications.
At least a dozen ( I can't even remember to name them all) have been tried, with the result of making him even more anxious and agitated!
And the anti-psych medications had undesirable side effects! His head would turn from side to side, as if slowly shaking your head "NO" and this lasted at least 6 months after stopping the medication!
Now, I only give him Trazodone and depakote at bedtime, which are incredibly helpful, as long as he's not drugged during the daytime!
I SO wish I could find a care home (on my budget) with a staff to lovingly work with him and manage his behaviors and provide the care this once loving man so deserves! I hurt every day of life and I'm trying to do this as long as I can. I know once he's placed in a SNF, he will very likely be neglected and overdosed on morphine until it kills him. The thought of him being scared, confused and neglected by strangers is heart-wrenching for me! I have talked with his 3 sons about what they want to do when I can no longer do this. They have decided they would not try and care for him at home; he will have to go into a nursing home.
So, I just keep on trying.
Are you assuming so based on his behavior?
Are you witnessing it?
How long has he been in this facility?
What type of facility is it?
Are you his MPoA?
If you're getting your info from your Dad, this may not be accurate. If he hasn't been in the facility very long (less than 2 months) and the meds are new for him, I'd give it at least 2 weeks to work, and if they adjust the prescription, then probably another week or 2. This is based on my own experience with my MIL in AL and then LTC.
Bladder infections (UTIs) aren't only caused by lack of water. Enlarged prostates happen in about 70% of older men, among other causes. Also hygiene, if he's in charge of his own this may need to be improved.
"Older men are more likely to get bladder infections, also known as urinary tract infections (UTIs), because of structural and functional changes in the urinary tract. These changes can make it difficult to empty the bladder completely, which can lead to bacteria building up.
Causes:
- Enlarged prostate
- Benign prostatic hyperplasia (BPH) is a common condition that can make it difficult to empty the bladder.
- Kidney stones (they can trap urine in the bladder)
Other conditions:
Diabetes, neurological disorders, and other chronic conditions can increase the risk of UTIs.
Weakened immune system
Diabetes, and other conditions can weaken the immune system, making it easier to get a UTI.
Incomplete bladder emptying
Constipation can prevent the bladder from emptying properly.
Prevention:
Maintain proper hygiene, including regular bathing and thoroughly drying after cleaning
Stay hydrated to help get rid of bacteria
Practice emptying the bladder every 2-3 hours
Avoid becoming constipated"
Good luck to OP finding a facility that will attend to dad's needs in a respectful manner.
No medication can be given without a doctors prescription. Does the facility have all the prescriptions? Are you talking to the Director of Nursing?
When my Mom was in LTC I had to pick a doctor associated the facility. You need to find out how the doctors orders were written. The doctor may have changed things. Made adjustments felt other meds were not needed. The nurses can only give meds prescribed by the doctor. They can only give them at the times the Doctor ordered them. The facility must follow Doctor orders. The State will come in and check to make sure residents are getting their meds correctly. There is protocol that needs to be followed.
Water. With my Mom, they left a big cup on her table. The aides went around every so often and refilled. Did not do Mom any good, she was out in the common area most of the day. The aides did come around and give the residents water.
There is no one on one in a facility. Your Dad is not going to be cared for like you would have. Younay need to make sure Dad gets water while your there. My daughter, RN, works in NHs. I used to ask her what I should complain about and what not to. You will have to pick your battles. His meds are one of these battles.