I'm new here! I'm sorry this is a long post - I'm really bad at being brief!! I just moved my parents into a residential home of my dad's choice (that I liked too) because he couldn't cope with my mum's increasingly difficult behaviour at home (she has late stage dementia - Alzheimer's officially though we think mixed - vascular too). They moved in almost a week ago and I've spent 3 afternoons there this week trying to get them settled...yesterday the manager said I'd have to 'leave them to it' soon and 'get on with my own life'....?! (I have no intention of going in this often normally, but my mum is distressed most of the time and my dad is not coping well - and it's their first week!!!) My main concern is that I thought we'd picked a home that seemed to be person-centred and considerate but the day after they moved in, my mum (who has spinal fractures from osteoporosis) was crying and squealing in apparent pain and I asked for her to be given codeine (which she's written up for) so she was, and she seemed much more settled. The next day I was there when she started to get very distressed again and I asked again for codeine (mum can't tell us she's in pain, but I also have old spinal fractures from an accident and I've had chronic pain for many years from them and I'm pretty familiar with the physical signs...and I know my mum's body language enough to know when she is in pain). Anyway, I was then told that the nurse in charge had reviewed her pain meds and put her on 4 times a day paracetamol as that was more effective than occasional codeine and there would be some coming round at tea time. (They put my dad on it too, even though all he's ever used for occasional pain has been some anti-inflammatory 'rub'....!) Mum continued to cry with apparent pain (and because her hallucinations were getting worse - she sees unfriendly little animals...) until I left, feeling unwilling to push it when the nurse was so adamant we try the paracetamol first ("wouldn't you rather she wasn't given strong meds she didn't need??!") Yesterday I spoke to her again and expressed I really wanted her to be offered codeine if she continued to cry and be distressed on the paracetamol. They said 'oh yes' in that way when you know they are not really going to, and sure enough - today, mum's crying again when I phoned, and she's not getting any codeine. I know that recent research shows paracetamol is not effective in lower back pain or arthritis, and I also found research that shows pain meds can reduce agitation in dementia sufferers by up to 17% with none of the side effects of antipsychotics. My mum's hallucinations are worse than ever, and my dad says he doesn't know if it's pain or the hallucinations that are causing her distress - I think it's that her pain causes her hallucinations to be worse and the distress is probably from a bit of both from her body language. I think they should try her on codeine, particularly as she's just moved and is probably having a flare up of her back pain from all the change, and if then she's more settled then surely that's enough evidence that it's probably the pain causing it and to keep up the codeine for a few days then review it perhaps. But this seems to be becoming potentially a huge battle. I told my dad I'd leave it for the weekend (I'm also unwell with a chest infection and bad asthma right now so could do without another 1hr round trip to the home this afternoon!) and try again on Monday, but now I'm feeling so bad because I think my mum's sitting in pain (and might be all weekend) and no-one is helping her. I'd thought of asking to get a review by my mum's new doctor (although the nurse I think works with the doctor who the home registered my mum with), but I'm so new to this and I don't want to alienate the home or make life harder for my parents because they think I'm being difficult, but I'd hoped the home would have been happier to listen to the people who know my mum best, but I've come across medical staff with misguided attitudes about keeping people from any painkiller stronger than paracetamol before many times and i'm worried this is going to be one of those situations...all the care staff seem to defer to this nurse-in-charge...am I wrong?!!! Any advice anyone...?!!