Dad has been in respite care for 3 weeks since Mum went into hospital then sadly died. He isn’t settling in well, won’t eat much, wanders about at night and sleeps during the day. He’s also anxious and possibly depressed. The care home have a copy of his LPA on file but we found out today he was yesterday prescribed an antidepressant by a GP at a nearby health centre over the telephone without a consultation or referral to his own GP. Can the care home do this without consulting us or his GP? As it happens the drug prescribed shouldn’t be given to people with heart problems, which Dad has so we have stopped the care home administering the tablets and have asked his GP to get involved.
Can the care home do this?
- Thread starter Harli
- Start date
Dear Harli,
I think your right to be concerned about a prescription being given over the telephone and your right about involving your dad's GP. This goes to show why the elderly need advocates. Keep doing what your doing.
MaNaAk
My mum was sent to a care home for 'reenablement' - and whilst resident in the care home, she came under the care homes GP.
Ironically the care home was near her sheltered extra care flat, and within catchment for her own GP, but the care home used a different one in the next town. I think this was linked to the way funding works.
As far as telephone appts go, if your dad is not going to provide the GP with anymore information than seeing him in person, I don't have a problem, I and my children from when they were babies have been prescribed medication over the phone.
If your father is not residing within the radius of his GP from which homevisits are undertaken it would be normal for your father to be treated by the home's GP. Your father is temporarily resident under NHS rules somewhere else, so can be seen by another GP.
I agree that a drug which is contraindicated for heart problems shouldn't be given, but the stress on your father's heart from wandering, the anxiety and depression will also take it's toll, and it sounds like some form of medication is worth a try, and often it is a balance of risks.
Ironically the care home was near her sheltered extra care flat, and within catchment for her own GP, but the care home used a different one in the next town. I think this was linked to the way funding works.
As far as telephone appts go, if your dad is not going to provide the GP with anymore information than seeing him in person, I don't have a problem, I and my children from when they were babies have been prescribed medication over the phone.
If your father is not residing within the radius of his GP from which homevisits are undertaken it would be normal for your father to be treated by the home's GP. Your father is temporarily resident under NHS rules somewhere else, so can be seen by another GP.
I agree that a drug which is contraindicated for heart problems shouldn't be given, but the stress on your father's heart from wandering, the anxiety and depression will also take it's toll, and it sounds like some form of medication is worth a try, and often it is a balance of risks.
Hi - I appreciate your concern over what seems a somewhat cavalier attitude to prescribing, but as @jugglingmum points out, sometimes prescribing is a balance of risks, A large number of care home residents with dementia are probably prescribed anti-depressants and a large number of the elderly have heart problems - so it follows that there will always be overlap and a level of risk management. Also, the more general contra indications are often there as a catch all to protect the drug company against potential litigation.
My Mum (PWD) has had a variety of anti-depression/anti-anxiety/anti-psychotics prescribed over the last few years that contra indicate with her heart problems. I personally am on repeat prescription for migraine that is contra indicated for those who have had arrhythmia or who have ever had BP issues. I have experienced both.
I think you may well find that the two sets of GP's will join forces and support each other - they usually do!
Perhaps have a word with the prescribing GP, or your father's GP about your concerns - they can either reassure you or alter the choice of medication. I have also found that a good pharmacist can provide really helpful info about medication.
Hope you get things sorted.
My Mum (PWD) has had a variety of anti-depression/anti-anxiety/anti-psychotics prescribed over the last few years that contra indicate with her heart problems. I personally am on repeat prescription for migraine that is contra indicated for those who have had arrhythmia or who have ever had BP issues. I have experienced both.
I think you may well find that the two sets of GP's will join forces and support each other - they usually do!
Perhaps have a word with the prescribing GP, or your father's GP about your concerns - they can either reassure you or alter the choice of medication. I have also found that a good pharmacist can provide really helpful info about medication.
Hope you get things sorted.
I’m not against antidepressants being prescribed and taken. Mum was prescribed them and they improved her mood considerably. I am just concerned the GP prescribed them without seeing Dad even if he couldn’t add much to the consultation, and that the care home didn’t talk to one of us first. I would have preferred his own GP, he is still in the catchment area, was consulted as he is aware of Dad’s health issues, as well as a previous heart attack he has stents in three of his heart blood vessels and he’s had a TIA. Dad’s GP is going to see him tomorrow so hopefully he can be prescribed a drug that’s not contraindicated for patients with heart problems.
I share your concerns and am glad your dad's own GP is seeing him tomorrow. If he agrees with the medication that has been prescribed at least you will know that the decision on any risk has been made with full appraisal of your dad's heart history and benefit to your dad to help him through this difficult period. Perhaps he will prescribe another medication with less risk.
The problem I have with this, and it happens with my mums care home, is that the manager of the home seems to think that she has power of attorney and doesn't have to inform us of anything. Medications are added, deleted, increased and decreased, and we find out by accident. We only found out mum was on antidepressants when a Dr in A&E asked us how long she'd been on them. Even if we didn't have LPA I would have thought we should be made aware.
I absolutely agree with you there. It's simply not ok to leave out the family, especially if there is an LPA present. That is a legal document, and if I was you, I would raise merry hell!
I also have a problem the home rang me to say the GP had prescribed codeine for my husband because he was complaining of a pain in his groin, I told them he can’t have it because of other meds’ he takes, it’s worrying that he could have been given it with possible bad results, the GP can’t have looked at his history it’s disgusting
Dad’s GP agreed the antidepressant was safe to take and advised it was what he would have prescribed under the circumstances. He was a little surprised it had been prescribed over the phone though. So that’s all fine. The care home manager however ignored our request that Dad not be given the drug until he had seen his own GP, despite the LPA. She maintains it is a copy (which it is, the lady in charge the day Dad was admitted took a copy of the original) and until she’s personally seen the original she makes all the decisions and that’s her rule. I’m sorry but this is appalling behaviour and I’m contacting Dad’s social worker today to raise a serious concern. He’s waiting for a space in a better place and it can’t come soon enough.
She has ideas above her station then. I'd be waving the original under her nose TODAY. Presumably she didn't take the copy of the original.
I absolutely agree, the GP should have seen your dad, I’m also really concerned that despite you holding LPA for dad’s health and welfare, you weren’t consulted, it’s not the carehomes place to make decisions about your dads health and welfare. I would ask your social worker to call a formal meeting to address this. I’m always worried about residents who don’t have advocates and how decisions are being made for them .
I agree with others...this is not her decision to take...way beyond her remit as care home manager and leaves your dad and others vulnerable. I too would be calling for an urgent meeting with manager and SW and put concern formally in writing. Is your dad's GP willing to keep your dad on his list and visit if needed while in respite? I hope so.
...and if it is HER rule to personally see the original poa document which is ridiculous if her staff have personally taken a copy from the original...that should have been made clear to you and she should have contacted you on day 1 to cover her administrative dictat
...and if it is HER rule to personally see the original poa document which is ridiculous if her staff have personally taken a copy from the original...that should have been made clear to you and she should have contacted you on day 1 to cover her administrative dictat
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