Sounding Board, please help!


Many of you know my mother had a stroke in early June.  After almost a month in two different hospitals, we had to make the very difficult decision to put her in a nursing home.  I have full power of attorney, but here's the problem.  Today is the second full day Mom has been in the home, so I asked her nurse for a copy of all of the medicines that Mom is now getting (she had some that were dc'd, but the doctor has ordered for her to resume all medications that she was getting in the hospital upon her discharge.)  The hospital that she was most recently in made a mistake when keying in her medicines from the hospital here, so the nurses were giving Mom 3x the amount of one of her medicines that she was supposed to get.  I pointed out the error to them, and they corrected the dosage to 20mg at bedtime.  However, when the transfer was made from the last hospital to the nursing home, guess what?  That's right...the records still showed her getting 60mg of this medicine, so the home is doing the same thing.

I just have come back from visiting and attempting to feed my mother her meal, but she is so "stoned" she can barely open her eyes, much less eat.  I finally gave up trying to coax her into eating, and when she fell asleep I left for the evening.  So I get home and begin to look over the copy of the medicines that the nurse gave me (this is when I notice that the 20mg has turned into 60mg AGAIN), and realize that her stupor is due to this drastic dose of medication.  Not only is she getting 3x the amount she was taking at home and in our local hospital, the nursing home gave it to her at 9:00 a.m., 1:00 p.m., and 5:00 p.m.  The last time I had a medicine prescribed that was to be taken 3 times a day, it was supposed to be taken every 8 hours, not every 4 hours.  For a person who is 76 and who has been through so much physically this past month, 60mg of a medication for depression is too much.

So, I called the home and asked the nurse to dc (discontinue) the first two doses and make a note to only give the Celexa at bedtime, and she said she can only do that if the doctor orders it, or if the patient requests it.  She says my mom can talk, so she will have to tell them tomorrow that she doesn't want it except at bedtime.  I AM ABOUT TO BLOW MY TOP!  My POA, according to the nurse, is ineffective since my mother can speak.  Yeah, she can speak.  The problem is, she doesn't know what she's saying!  She thinks I'm her youngest sister, for pete's sake! 

Anyway, I politely but firmly told the nurse that I would be back again in the morning, and that I would check on this again, and that I hope to find the records corrected to 20mg at bedtime only.  I also told her that if I needed to take care of this myself, I would.  But I also told her that come Tuesday, when the Medical Director makes her rounds, my mother better not still be getting 3x the dosage she's supposed to receive. 

And unless they want to hear from my lawyer, they had better gain a clearer understanding of the content of my POA.

Okay...I'm really not hard to get along with, but this is my mother.  She can no longer speak for herself, and if I don't keep a watchful eye out for her, she will become a statistic just like so many other nursing home residents who go day to day in a barely conscious state because they have no one to care about whether they are being over or under medicated.


Stick to your guns. I ...

Stick to your guns. I have been through this with my mother and usually once they realize you are not going to back down, they will cooperate. Don't be afraid to involve your mother's doctor, your lawyer and anyone else in authority. Also if possible when you are going to have a conversation with anyof the staff at the nursing home about your mother's care, take someone with you to act as a witness. On the occasions that I didn't have someone with me, I kept a voice activated tape recorder in my pocket.
Ask the nurse that if in her opinion any patient who can speak, must speak for themselves, what happens to patients with mental deterioration. When something goes wrong does she want to be held responsible for taking instruction from someone who is not mentally competent.
There was one nurse in the facility where my mother resided who would actually try to hide when she saw me coming, because I had the audacity to back her down right at the beginning and I made it very clear, that anyone not acting in my mother's best interests, would pay the consequences.
Hang in there. It isn't easy, but it has to be done to protect your mother.

As a veteran of mental ...

As a veteran of mental health facilities ( I realize this does not apply to your loved 1) I know 4 a fact that they (nursing homes, MHF) are understaffed and overworked. If U feel that there R sufficient grounds, I would contact an attorney specializing in nursing home abuse. I personally know of one instance where the family (the patient, unfortunately expired of severe burns from a malfunctioning heating pad) won a multi-million dollar lawsuit. Don't let them SCREW your family...

sawomri said it right. ...

sawomri said it right. Take them on. Record everything or have a witness with you. In your state it may be illegal to record someone without their permission, in many states it only takes "permission" from one of the party's so you can secretly record. That's a strange one but I wish we had it hear in MD. Here you have to have both party's permission.

Make copies of the records too. Take names. Let them know you're taking names and copying records. Let them know that they Will hear from your attorney if this isn't resolved. Find out who their insurance co. is. If you contact them, you can be SURE that there will be some changes because that is who stands to lose the most.

Good luck!

Former LVN and primary ...

Former LVN and primary hospice care giver to my mother-in-law in my home---- I am here for you anytime. Nestle9---- you are right on! Keep it up. Your mother's care is supposed to be a team effort and that includes you. BTW--- you and your Mom are in my humble prayers.

I'm on board with sawomri, ...

I'm on board with sawomri, TGIX, and xntrik4certn. The people at the home do not know your mother and they think THEY are in a position to determine what is right for her ? NOT !! If it came down to it though removing her from the facility may be your only hope to prevent the over administering of medication from harming your mother. Either way, bug the shit out of her Doc, the charge nurse, the hosp admin people etc etc etc until it's fixed.

that's hard, emotionally, ...

that's hard, emotionally, and trying to keep it together for your mom as well as telling the nurses what they SHOULD be doing. good suggestions were already mentioned, I hope it works out for you, good luck and prayers are going to you and your mom and family!+++++

i have been through this ...

i have been through this with my mother who has been in a nursing home for the last year and a half. there are several things that you can do. 1. tell the doctor that the nurse is giving the wrong medicine and demand that it be taken care of or you will find another doctor. 1. contact the local ombudsman. the number should be posted in plain view around the hospital. if you don't see it the ask for it. 2. contact your state. i don't know where you are but i live in California and nursing homes are required by law to post a phone number of the state agency so you can call with complaints. i have done this twice and believe me my mother now gets excellent care. it's unfortunate but the "squeaky wheel gets the grease" and if you want your mom to have the best care then you need to stay on top of these people. i go every day and know all of the nurses and aids. i just told off a new girl on last Friday because mom was soaked through with urine. when this girl first started taking care of mom i told her that if you ask mom if she has to go to the bathroom she will say no then go in her chair. mom has Alzheimer's and instead you just say "honey lets go to the bathroom" and she goes. i explained this to her so when she tried to make the excuse that "Ellen said she didn't need to go" i didn't accept it. she knew that you don't ask mom you just take her in. after told her off i filed a complaint against her with the charge nurse. i usually only have to do this one on an aid. there was one that did it several times and since i was not the only person complaining she was fired. also don't be afraid to go to the administrator. you are the only one that will make sure that your mother is cared for. it's a sad fact that these places are understaffed so if there is on one to check on them people don't receive the care they should. stick with it and good luck

I'm sorry to hear about ...

I'm sorry to hear about your mom. You're fighting the good fight! Good luck!