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April 25, 2018 - Welcome Guest!

Advice » Hard Knocks

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Mixed up meds

Question:

This is about my mom who is 72 yrs old and in a nursing home. She is in bad health and is on several medications. She is an epileptic since she was 2 weeks old. She has had several strokes and the muscles that allow her to swallow are paralyzed. She has a feeding tube and a foley catheter. She is prone to aspiration pneumonia.

At about the same time every night her face and neck become extremely hot and her face is flushed and it takes 2 to 3 hours to cool her off. We take her temperature but it never seems to be high. I think this is a reaction to her meds or the combination she is taking. I have asked that she discontinue her Depekote and start a new med for her epilepsy but I was told was not possible. Clearly there is a reaction in her meds.

The meds she takes every day are: Depakote10ccBID, Lasix10mgQD, Allegra60mg every 12 hrs, potassium chloride20MEQ BID, Atenolol25MG QD, Digoxin0.125mgQD, She was getting the potassium TID and had it changed to BID. I think that here has to be one or more of these medications causing her to become flushed and extremely hot on her face and neck. I desperately need help. I am afraid she is toxic even though her levels on Depekote are supposedly normal. She does not tolerate meds well and has a lot of drug allergies, some have almost killed her and this is what I am afraid of is happening now but I can't get any co-operation from the nurses at the nursing home.

Johneen Nations (48 year-old woman) from Childress, Texas

Answer:

I can certainly understand your distress. I can offer a few suggestions that might at least place you in a better position where your mother's health care is concerned. I do not know if your mother continues to be her own guardian or if you have any legal control of her care, i.e. power of attorney, etc. For the purposes of this response I am going to assume you do not have a power of attorney and you are powerless to "dictate" what you think ought to happen.

The first step you can take is to give your personal pharmacist a list of the medications your mother is taking. If you do not have a pharmacist you are comfortable with, any chain such as Rite-Aid, CVS, Eckerd, should be able to look at the list and give you a print out of contraindications for the medications your mother is taking. Have this information provided to you in writing.

The second step you can take is to set up an appointment with the social worker at the nursing home. Explain your concerns and ask him/her if a multidisciplinary team meeting can be set up on behalf of your mother. At the very least, the physician, head nurse, social worker, nutritionist, nursing home director and yourself should be present. If your mother is able to provide meaningful feedback or would feel empowered by being present, include her as well.

If there is still no indication of cooperation from the nursing home and if your mother's care is provided through Medicare benefits, you can also call Medicare to report your concerns. You can be as firm as to report your concern as a form of medical neglect. Medicare may grant a second opinion or other insurance company to ensure your mother's care is adequate and appropriate. You may also be able to seek a second opinion independent of the nursing home if you are willing to pay out of pocket.

If you have the means or if the option exists, you might consider transferring your mother to another nursing home facility. This may be the first problem you have had with the staff or it may be an indication of a deeper organizational problem; and you may not be alone in your frustration.

Tips for you personally: when you approach the parties involved, state your concern clearly and concisely. When requesting the initial meeting with the social worker, mail a letter with your concern in writing. As much as possible, leave emotion out, other than statements conveying your concern for your mother's well being. The more concise you are, the more responsive the parties will be. When you meet with the parties involved, remain calm.

Finally, after you have exhausted all other options, you can take an extreme measure and call Adult Protective Services (state agency) and make a report of neglect. I only suggest this if you have received a second opinion stating your mother may be in danger if changes are not made regarding her medical care. The agency may investigate and at the very least, you might be able to have a caseworker or advocate assigned to your mother.

Good luck and take care,

DeeAnna Merz

This question was answered by DeeAnna Merz, M.Ed., LPC, CRC. DeeAnna has over 10 years experience in helping people with issues such as depression, anxiety, anger management, stress, transitions, chronic health problems such as endometriosis and sarcoidosis, self esteem, addictions, relationship issues, domestic violence, and people who were abused as children. She is a Licensed Professional Counselor in the State of Georgia and a National Certified Rehabilitation Counselor.

For more information visit the site or contact information page on QueenDom.

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