Diazapam and disregard for Doctor's Orders?

Discussion in 'I care for a person with dementia' started by PollyP., Apr 29, 2015.

  1. PollyP.

    PollyP. Registered User

    Oct 8, 2009
    327
    Herefordshire UK
    Hi all,

    I've been very concerned about my mum over the past couple of months. Whenever I visit (usually once a week) I find that she is very sleepy and last Sunday I sat at her bedside for almost 2 hours, but was unable to wake her from a very deep sleep. When I got home I said to my husband, Mum is really going downhill fast.

    I voiced my concern to the Home manager the following day, and asked if something had happened to Mum, perhaps a mini-stroke etc. I was told that they would call out the doctor if they were concerned about Mum, but a lot of Mum's sleepiness was put down to her being almost 99! I asked what medication Mum was on, but I was told that she didn't have the records to hand, and she didn't look for them and ring me back!

    Last night I received a phone call from one of the Team Leaders, who had noticed that Mum has been given Diazapam every evening at 5pm. This had been changed from an earlier note from the Doctor which was "as and when required" as it had been noted that Mum reacts badly to Diazapam - gets itching and falling bouts due to it.

    This team leader was very concerned and decided not to give Mum the dose last night and has spoken with the Doctor and the Home manager about this.

    I am at present awaiting a phone call from the Doctor as I want to find out exactly what the situation is regarding Diazapam and my Mum.

    My great concern is -
    1.How qualified does a person have to be in order to give out the medication to the residents?

    2.Should there be a fail-safe system, so that the patient/resident is safe-guarded.

    3. How can the wrong dosage of medication be given to a resident for a couple of months without anyone checking her records or saying to themselves, WHY is she so sleepy all the time.

    This is NOT the first time, when Mum had a stay in hospital for a chest infection, she was given medication and it had a really bad effect on her, it was then decided by the Doctor, the Care-home staff and myself that it would be better if Mum was kept off certain drugs.

    I'll update this post as soon as I hear back from the Doctor. I'm still waiting for his call.

    Thanks to all, and hope that someone can answer the 3 points listed above.

    Pauline
     
  2. sistermillicent

    sistermillicent Registered User

    Jan 30, 2009
    2,951
    I am not sure how qualified a person has to be to give out medication. When I trained as a nurse in the year dot we always checked all medication against the original prescription with another nurse prior to giving it to anyone. However, care homes don't have qualified nurses, only carers who are unregulated and therefore there are probably no national guidelines about medication.

    The prescription itself should not have been changed except by a doctor. Any changes in the form of crossing out in any patient notes has to be signed and dated. Doctors prescribe and some trained nurses can but they have to do a long and complex training in order to be able to do this.

    No qualified nurse should ever give out a drug of any sort without consulting the prescription chart. This would be immediately available for them all the time. This would suffice without then having to check past records or notes. Any unqualified nurse should be taking even more care than this.

    It sounds though as if someone in the care home has decided that your mum needs her diazepam every day and has altered things illegally.
     
  3. Grey Lad

    Grey Lad Registered User

    Sep 12, 2014
    5,737
    North East Lincs
    I can see that this is a very worrying situation for you. Hope the doctor brings some sanity into proceedings.
     
  4. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,654
    North West
    I think it's quite possible that staff in some care homes do make unauthorised decisions about medication but it's also possible that in some cases they do not read the prescriptions/instructions properly.

    In any case, Diazapam is not recommended for people with dementia.
     
  5. patsy56

    patsy56 Registered User

    Jan 14, 2015
    840
    Fife Scotland
    Is this correct? Then why does her doctor have her on two small doses a day, she is told it is for her anxiety.
     
  6. nitram

    nitram Registered User

    Apr 6, 2011
    19,021
    Male
    North Manchester
    The SPC (Specific Product Characteristics) for Diazepam are >>>HERE<<<

    The consultant prescribed 5mg Diazepam PRN (as required) for me to administer to my wife, who had severe LBD, on car journeys to and from France, my daughter driving with me in the back with my wife. I only used them a few times when she became completely uncontrollable, they took effect after about 15 minutes.
     
  7. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,497
    Female
    Near Southampton
    In my husband's nursing home, only the nurses ever gave out medication. They also wore a red tabard so that everyone knew they were not to be interrupted except for emergencies.

    There is a difference between a drug being not recommended and absolutely not to be taken. For instance Rispiridone is not recommended for sufferers of dementia but plenty are prescribed it.


    Sent from my iPod touch using Talking Point
     

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