Lorazepam as 'standard prescription'?

sarahmcc

Registered User
Apr 3, 2014
26
0
My Grandmother-in-law moved care homes a few days ago and we were really shocked to discover that during her stay at the last care home she was prescribed 'tranquilizers', as it was described to my mother-in-law. I phoned up the new care home today for more information and they said it was lorazepam and it was probably prescribed as standard. They said my GIL had probably never even had any, and they only used it to calm residents as a last resort.
To me this sounded very wishy-washy. Having looked on this forum it seems like a standard drug for many, but she wasn't on it 4 weeks ago - why now? I think we should have been informed. My MIL said my GIL seemed extremely dozy on one occasion and didn't know why.
My GIL tends not to get hysterical unless she's in pain or can't see her daughter (recent covid problems at the home caused massive issues). It's very worrying not knowing what's going on.
I have to say, I'm glad my MIL got Essential Carer status because I'm not sure the last care home was really giving her the care she needed. I don't mean they were terrible people, but more they were unable to cope with 57 residents and so missed little things that had big consequences. I wouldn't put it past them to administer drugs before trying to use patience and words to calm her.

I really hope this new home is better. I am now very suspicious of care home management because of the bad experiences from the last one. So any experiences people can share would be most welcome.
 

Frank24

Registered User
Feb 13, 2018
420
0
My Grandmother-in-law moved care homes a few days ago and we were really shocked to discover that during her stay at the last care home she was prescribed 'tranquilizers', as it was described to my mother-in-law. I phoned up the new care home today for more information and they said it was lorazepam and it was probably prescribed as standard. They said my GIL had probably never even had any, and they only used it to calm residents as a last resort.
To me this sounded very wishy-washy. Having looked on this forum it seems like a standard drug for many, but she wasn't on it 4 weeks ago - why now? I think we should have been informed. My MIL said my GIL seemed extremely dozy on one occasion and didn't know why.
My GIL tends not to get hysterical unless she's in pain or can't see her daughter (recent covid problems at the home caused massive issues). It's very worrying not knowing what's going on.
I have to say, I'm glad my MIL got Essential Carer status because I'm not sure the last care home was really giving her the care she needed. I don't mean they were terrible people, but more they were unable to cope with 57 residents and so missed little things that had big consequences. I wouldn't put it past them to administer drugs before trying to use patience and words to calm her.

I really hope this new home is better. I am now very suspicious of care home management because of the bad experiences from the last one. So any experiences people can share would be most welcome.
I had an experience with being encouraged to get this prescribed by a home Carer… the care home have never had to administer it and it is used as a last resort as it increases risk of a fall and makes people very dozy..
 

Sarasa

Volunteer Host
Apr 13, 2018
7,195
0
Nottinghamshire
My mother didn't settle at all when she moved into care. It had already been suggested before she moved that she be on risperidone as her behaviour could be very volatile. GP and I decided not to go down that route as mum was living at home without support and already was confused about the medication she was taking. When mum moved into care in a different area the mental health team there prescribed lorazepam. At first mum had a very minimal dose and it did take the edge of her behaviour. When she moved floors a couple of months later the dose was increased, something I didn't find out for some time. Certainly about that time mum's cognition seemed to decline and she did have several falls. Whether it was the drug or not I can't tell.
Mum has recently moved care homes and I've flagged up the use of lorazepam as something I want them to check. Previous care home felt it was still necessary, but I wonder if it's time for a new strategy.
 

lollyc

Registered User
Sep 9, 2020
947
0
We have this as an 'as required' for Mum, who is at home with me.
There are days when she becomes extremely agitated and no amount of anything will settle her. She can't walk, but will attempt to stand, then slump to the floor. It is a godsend for these times. Yes, it makes her sleepy, but the agitation is obviously the result of some percieved anxiety, which must be quite frightening.
 

Jaded'n'faded

Registered User
Jan 23, 2019
5,258
0
High Peak
We have this as an 'as required' for Mum, who is at home with me.
There are days when she becomes extremely agitated and no amount of anything will settle her. She can't walk, but will attempt to stand, then slump to the floor. It is a godsend for these times. Yes, it makes her sleepy, but the agitation is obviously the result of some percieved anxiety, which must be quite frightening.
And that is correct usage!

The worry is what happens in care homes when PRN meds (as required) are prescribed. I'm perfectly happy for them to be given when the patient needs them but I'm concerned they are given when, 'Old Mavis is being really annoying this morning...'
 

lollyc

Registered User
Sep 9, 2020
947
0
I'm certainly not saying these should be given out like sweets, but I think we also have to accept that there are times when nothing else will work. I could go out for a walk and leave my mother to it. But, is leaving her, clearly in some sort of distress that she can't articulate, the solution?
Dementia is a brain disease. We can't cure or treat it, but we can manage some of the symptoms with drugs. We would expect another disease to be managed. Dementia is no different.
 

Jaded'n'faded

Registered User
Jan 23, 2019
5,258
0
High Peak
Yes I do agree that whatever can be given to ease distress should be given. It should be part of what @DesperateofDevon mentioned as 'comfort care'. For some reason my mother was never offered any Happy Pills despite being paranoid, delusional, aggressive (at times) and generally angry and miserable. I wish she had been. But it was very much against the CH's policy to medicate 'when not necessary' and I respect them for that.

However.... the result - as I saw it - was that whenever I visited there were always a few residents in distress, shouting or kicking off in some way. (This was a 'normal' home - most people there had dementia but it wasn't EMI.) And mum was often in a foul mood. The alternative - which people always quote when referring to care homes, is a bunch of drooling zombies in wing chairs sitting around a TV they are not watching.

But there has to be a happy medium somewhere. If a person is anxious and fearful they should definitely be given something that would relieve that suffering.
 

lollyc

Registered User
Sep 9, 2020
947
0
Worth a read:

Very interesting. And all very lovely in principle.However, in the real world?
Patting the dog or being mindful ain't gonna happen. 6 week reviews don't happen. Who decides what constitutes severe distress? All very well to say when you aren't living with it.
I don't want my mother to be a zombie, but if the alternative is a weeping, agitated, frightened wreck, then zombie it is.
 

DesperateofDevon

Registered User
Jul 7, 2019
3,274
0
Yes I do agree that whatever can be given to ease distress should be given. It should be part of what @DesperateofDevon mentioned as 'comfort care'. For some reason my mother was never offered any Happy Pills despite being paranoid, delusional, aggressive (at times) and generally angry and miserable. I wish she had been. But it was very much against the CH's policy to medicate 'when not necessary' and I respect them for that.

However.... the result - as I saw it - was that whenever I visited there were always a few residents in distress, shouting or kicking off in some way. (This was a 'normal' home - most people there had dementia but it wasn't EMI.) And mum was often in a foul mood. The alternative - which people always quote when referring to care homes, is a bunch of drooling zombies in wing chairs sitting around a TV they are not watching.

But there has to be a happy medium somewhere. If a person is anxious and fearful they should definitely be given something that would relieve that suffering.
Could it be that cost of meds is a factor ?
mum & dad always placed on the cheapest options & I questioned this with GP’s prescribing - cost is always a factor sadly.
Pushing for other better suited drugs costs CCG’s more .
its always money !
 

Jaded'n'faded

Registered User
Jan 23, 2019
5,258
0
High Peak
Very interesting. And all very lovely in principle.However, in the real world?
Patting the dog or being mindful ain't gonna happen. 6 week reviews don't happen. Who decides what constitutes severe distress? All very well to say when you aren't living with it.
I don't want my mother to be a zombie, but if the alternative is a weeping, agitated, frightened wreck, then zombie it is.
I also found the article interesting. The problem seems to be that where alternatives to drugs are suggested as a first line, the actual suggestions are pretty laughable: counselling, CBT, multi-sensory stimulation, animal-assisted therapies, increasing activity and exercise, etc.

It has clearly been written by someone who has never lived with a person with dementia on a bad day!

So @lollyc , maybe next time your mum is a weeping, agitated, frightened wreck you could make things right by getting her to do 30 star jumps then going to see some bunnies.

Or you could do the sensible thing and give her something to take the edge off and lessen her suffering.

I completely agree with you. If there was a real alternative we wouldn't need the meds, would we?
 

Palerider

Registered User
Aug 9, 2015
4,160
0
56
North West
Very interesting. And all very lovely in principle.However, in the real world?
Patting the dog or being mindful ain't gonna happen. 6 week reviews don't happen. Who decides what constitutes severe distress? All very well to say when you aren't living with it.
I don't want my mother to be a zombie, but if the alternative is a weeping, agitated, frightened wreck, then zombie it is.
Thosee who live with or care for their PWD know them best

I posted it so people could see some of the guidance, which in mums case would be completely inappropriate -CBT and counselling would not be an option. Mum was prescribed lorazepam to try to get her to rest up from wandering repeatedly -it had some effect.
 

lollyc

Registered User
Sep 9, 2020
947
0
Thosee who live with or care for their PWD know them best

I posted it so people could see some of the guidance, which in mums case would be completely inappropriate -CBT and counselling would not be an option. Mum was prescribed lorazepam to try to get her to rest up from wandering repeatedly -it had some effect.
Thanks @Palerider , I hope it didn't sound like a criticism. It's useful to know what criteria they work to - even though most of us would agree that the alternatives are unrealistic and impractical.
 

Ton3

Registered User
Dec 2, 2019
90
0
Reading your replies on here is what I love about this site, through all the tears and upset that caring for and watching a loved one suffer with This awful disease I come here and comments such as the Star Jumps and Bunnies make me laugh out loud not only because it is funny but because it is so true and hits the nail on the head, unless you are caring or helping to care for a PWD you cannot understand exactly what it means day in and day out with so many changes minute by minute at times let alone daily.
So i just wanted to say thank you one and all for always giving helpful information but also for keeping my sense of humour in tact and easing some of the worst days ever for my wife and myself. I hope that @sarahmcc you also find help and comfort on this site as your journey continues....
 

Mough

New member
Dec 1, 2021
1
0
My mother didn't settle at all when she moved into care. It had already been suggested before she moved that she be on risperidone as her behaviour could be very volatile. GP and I decided not to go down that route as mum was living at home without support and already was confused about the medication she was taking. When mum moved into care in a different area the mental health team there prescribed lorazepam. At first mum had a very minimal dose and it did take the edge of her behaviour. When she moved floors a couple of months later the dose was increased, something I didn't find out for some time. Certainly about that time mum's cognition seemed to decline and she did have several falls. Whether it was the drug or not I can't tell.
Mum has recently moved care homes and I've flagged up the use of lorazepam as something I want them to check. Previous care home felt it was still necessary, but I wonder if it's time for a new strategy.
My husband was prescribed Lorazepam and after taking 3 tablets he had a complete personality change. It can have a paradoxical reaction with some people.
 

Shedrech

Registered User
Dec 15, 2012
12,649
0
UK
hello @Mough
a warm welcome to DTP
your experience does show how meds can have such different effects on each person .... unfortunately that's why it can be trial and error to find the right meds
now you've joined this supportive community, do keep posting
 

WORNoutWARRIOR

New member
Dec 14, 2022
3
0
My husband was prescribed Lorazepam and after taking 3 tablets he had a complete personality change. It can have a paradoxical reaction with some people.
I don’t understand. How did his personality change? I have been diagnosed recently and asked for lorazepam and was told no bc it would accelerate the symptoms. I really wish I had been given it. I was on it for 20yrs and now they have taken me off. Starting back in January 2022. I went through terrible withdrawal for the past 6mo. I have been going through all my established doctors looking for someone to prescribe but no one will. My anxiety is terrible. So is a quick temper. I’m trying to stay calm and I pray over my brain constantly.