Medication in resdential homes

noelphobic

Registered User
Feb 24, 2006
3,452
Liverpool
Does anyone know whether it is common practice for homes to either ask consent of relatives before putting a resident on new medication, or failing that to at least advise them of it? My mum was in an EMI home for a year and has now been in a nursing home for a year. We have found out accidentally on a couple of occasions that she was on medication that we knew nothing about. In the care home we found out that she was on Epilon, even though we were never told that a diagnosis of epilepsy had been made. She has been unwell for the last few days and it came up in conversation that it was 'nearly time for her sleeping pills'. We didn't know she was on sleeping pills! An after effect of her seizures last week has been that she has been very aggressive, which is extremely unusual for her. My sister visited her today and said that she seemed 'doped up', which would lead me to believe that she may have been prescribed sedation of some description. While I would not necessarily be opposed to this, I would have hoped that myself or my sister would have been asked or advised, given that my mum is not in a position to consent herself.

I'm just wondering whether I'm expecting too much here and wondered what others think and whether anyone else has experienced this.
 

Brucie

Registered User
Jan 31, 2004
12,413
near London
I'm not sure what is considered normal.

Jan moved to her nursing home, which is 25 miles from where we lived when she went in there. She then was assigned a new GP who is responsible for all residents at the home. I have told the GP of my wishes for Jan's care and I believe the GP is both responsible and pragmatic.

I've asked to be informed of any major changes of medication, but, without checking each time I go, I am not really sure whether her medication is changed, or not.

It may be that Jan is now so far down the line that her medication stays fairly consistent.
 

connie

Registered User
Mar 7, 2004
9,519
Frinton-on-Sea
Lionel's home does inform me when they ask the doctor or district nurse to see him. He had some minor problems with constipation etc. I therefore get the impression that they cannot prescribe or alter off their own bat.

I would hope that they would tell me of any changes in his main medications, however it is early days yet. He has only been there 3 months.
 

noelphobic

Registered User
Feb 24, 2006
3,452
Liverpool
connie said:
Lionel's home does inform me when they ask the doctor or district nurse to see him. He had some minor problems with constipation etc. I therefore get the impression that they cannot prescribe or alter off their own bat.

I would hope that they would tell me of any changes in his main medications, however it is early days yet. He has only been there 3 months.
Hi Connie

They did mention that they had asked the GP to see her. I might phone tomorrow and ask whether the GP has been and whether her medication has been changed. Sometimes it is easier on the phone - if I wait until I go to visit then it's not always easy to find someone or they're busy. Whereas if I phone in the morning between breakfast and lunch then there seems to be more staff on and they come to the office to answer the phone, and the records are kept in there.

I just feel sometimes feel that I haven't managed to achieve a good working relationship with the staff. I don't mean that I have a bad relationship with them, it's just that it seems a bit hit and miss and I think life would be easier if communication was better.

Brenda
 

Grannie G

Volunteer Moderator
Apr 3, 2006
71,740
Kent
I was told my mother would have to change over to the GP who visited the home, but although I was told if he`d ever been called out to see her, I was never told about any change in her medication.
Then, I was too green to have asked.
Sylvia
 

noelphobic

Registered User
Feb 24, 2006
3,452
Liverpool
Grannie G said:
I was told my mother would have to change over to the GP who visited the home, but although I was told if he`d ever been called out to see her, I was never told about any change in her medication.
Then, I was too green to have asked.
Sylvia
My mum has been with the same GP practice for a long time. When she moved into her current nursing home they asked if we would like her to be moved to 'their GP'. I was given the impression that they were easier to call out, something to do with the locum service I think. However, I felt that my mum had had to go through too many changes because of her condition, my dad's death etc so told them she would stay with the same GP. I actually think it would be easier in many ways if she was with my GP (who is also my sister's) but don't really want to change now.

I will give the NH a ring in the morning and then go and see her after work. If I am unduly worried then I will just have to find out who is in charge and ask what her meds are and make a point of writing them down. Plus, depending on how it goes, ask for it to be put on her notes that I want to be informed of any changes in medication.
 

jenniferpa

Registered User
Jun 27, 2006
39,448
The trouble is that, while they should tell you, as far as I can find out, they have no LEGAL requirement to tell you with the way the law stands currently. I think all you can really do is put the "notify me" letter in as many files as you can access (GP's and nursing homes especially). It seems ludicrous that someone suffering from dementia can be supposed to be competent in this area, but unless they've been sectioned, that's the supposition. Obviously, that's not how it works when commonsense prevails, but sometimes commonsense is in short supply.

Jennifer
 

cynron

Registered User
Sep 26, 2005
429
east sussex
nursing home meds

My husband has been in a NH for 3 months. I have spoken to the home GP and he has halved the dose of quetiapine at my request and also taken him off another drug which we both agreed was not now needed. He said he did not believe in Old folk being put on drugs for life without a review. A man after my own thoughts:)

Cynron x x
 

mocha

Registered User
Feb 17, 2006
176
86
Lancs, England
Changing or adding drugs

The Senior Nurse at Ron's NH told me today that they had reduced his blood pressure tablets as he had been experiencing low bloodpressure recently.
After reading this thread I asked him if it was policy to keep relatives informed and he said that it was but they did have relatives who weren't really interested.
Talking to one of the other wives who does a lot of voluntary work for them she said that only about 35% of residents have regular visitors which shocked me.
 

May

Registered User
Oct 15, 2005
627
Yorkshire
Talking to one of the other wives who does a lot of voluntary work for them she said that only about 35% of residents have regular visitors which shocked me.


Mocha, I find that so sad.....:(
 

Clive

Registered User
Nov 7, 2004
716
Incontinence Pads

Whilst on the subject of NHS medication in residential homes can I ask what the experience is with Incontinence Pads?
Are these usually provided by the NHS?
Do some homes prefer to buy their own because they can get better ones on the open market?
I have just found that mum does not get hers from the NHS and I am not sure if the Residential Home is telling me that this is because it is difficult to get them from the NHS, or because it is less of a hassle to buy them privately. Or if this is their way of telling me the bill will be going up.
 

noelphobic

Registered User
Feb 24, 2006
3,452
Liverpool
mocha said:
After reading this thread I asked him if it was policy to keep relatives informed and he said that it was but they did have relatives who weren't really interested.
Talking to one of the other wives who does a lot of voluntary work for them she said that only about 35% of residents have regular visitors which shocked me.
My mum seemed a lot better last night - more alert and not at all aggressive. I asked if her medication had been changed recently and was told that it hadn't been. I asked if it was policy to inform relatives if medication was changed but didn't really get a straight answer - something along the lines of 'you'll be informed if you really want to be' and 'we would only be doing it for her own good'. I do feel that answers given are defensive sometimes and don't understand why, as I certainly wasn't attacking.

As far as people getting relatives go, I have to say that it doesn't surprise me that much any more. Some of the residents in my mum's nh seem to get lots of visitors, some get hardly any.

My mum has been in 2 homes now. One of the questions I was asked by both when she moved in was 'do you want to be informed if anything happens in the night', which I can only assume to mean a deterioration in condition, a need to be admitted to hospital or worse. I replied that of course I would want to be informed and both homes told me that some people don't want to be contacted during the night - now that did shock me!

Brenda
 

jenniferpa

Registered User
Jun 27, 2006
39,448
It's depressing isn't it? I suppose it would shock us on TP: we're an essentially self-selected group of people who are trying to get the best care for our loved one. We wouldn't be on these boards if our aim was to stuff them in a home and forget about them.

Jennifer
 

DeborahBlythe

Registered User
Dec 1, 2006
9,222
Incontinence products

Clive said:
Whilst on the subject of NHS medication in residential homes can I ask what the experience is with Incontinence Pads?
Are these usually provided by the NHS?
Do some homes prefer to buy their own because they can get better ones on the open market?
I have just found that mum does not get hers from the NHS and I am not sure if the Residential Home is telling me that this is because it is difficult to get them from the NHS, or because it is less of a hassle to buy them privately. Or if this is their way of telling me the bill will be going up.
It would be worth contacting your local health authority, (Primary Care Trust) to find out what their policy is around supplying incontinence pads to residential homes. Try and find out the PCT's number from the phone book or from the home itself and ask to speak to their Incontinence Adviser. In my mother's area, the PCT would supply up to four incontinence pads per day and this was also the case when she moved to a neighbouring area and different NHS authority. If people are entititled to NHS supplies of incontinence pads in one area, I can't see why they wouldn't be entitled across the country. It's not as if these are 'vanity' issues , like removal of tattos, for example.

I suspect your home is trying to pull a fast one, and you should make some discreet inquiries about the pads. Also, be aware that there are different thicknesses of pads too. Thin ones are usually deemed suitable for night wear , I believe, but it's worth finding out what sort are being used. Thin pads used at the wrong times will mean your relative is sitting or sleeping in damp/wet underclothes and at risk of soreness.

Re the question of changes of medication, it is perfectly reasonable to ask to be informed about this, and about visits by the GP. If you are seeing your relative a fair amount, you may well pick up on reactions that you would want a GP to know about, and it's a good idea to see the GP with your relative once in a while.
 

ginger

Registered User
Nov 13, 2005
21
NE Lincs
when my late mother was in her NH, I requested that I be informed of any changes to her care plan, medication, G.P visits, also any changes in her health condition. This was written up in her notes and duly followed. My mothers nursing home did not use drugs unless it was really neccessary. I would ask to be kept informed of any medication or changes to her condition or care plan.
Take Care
 

janjan

Registered User
Jan 27, 2006
229
59
Birmingham
Had this trouble myself a few weeks ago, Went with dad to memory clinic,and to cut a long story short i found out dad was on a seditive that we didn't know about , that the doc wasn't very happy about . He said he wanted him wened of it within 3 months ,and he would see him then to see if there was an improvement in his health.
When i got dad back to the n/home i went to see the manager to find out why mom wasn't imformed of the change in his medication.
I was ushered into his office.
He looked on dads notes because he had only become the manager in December, and dad went in the home in November.
Apparently dad was put on it in the home he was in for restpite in October. He said how sorry he was and asured me we would be informed if medication was changed.
Well when i went a few days later, the nurse then told me that the hospital put him on it before he was admitted there.
Well i just said i dont remember dad being druged up to the eye balls when he was at home with mom.
Also i said i don't realy care who's fault it is he's on it, nobody told me he was causing any trouble of a night time, but it's making him more prone to falls and the doc here has been told he has to come of it.
You know when little pieces of the jigsaw falls into place, like the morning you visited and you can't understand why your dad look's comotosed and it frightens the life out of you.
Strangley enough i havn't long been back from visiting tonight, i asked the nurse if he was being taken of the seditive, and she said yes.
I don't want to upset anyone but we have to be the voice for our loved one's when they are unabe to do this themselves.
I am happy with him there and it wasn't that home that put him on it anyway.
I did ask him tonight if he likes it there as he was having a good day when i arrived to see him, and he said yes.On the days when he seem's more alert i still try to ask him if he his ok, because his speech went along time ago, so it has been difficult to know how he feel's about things. sorry this as been a long post.
 

janjan

Registered User
Jan 27, 2006
229
59
Birmingham
Had this trouble myself a few weeks ago, Went with dad to memory clinic,and to cut a long story short i found out dad was on a seditive that we didn't know about , that the doc wasn't very happy about . He said he wanted him wened of it within 3 months ,and he would see him then to see if there was an improvement in his health.
When i got dad back to the n/home i went to see the manager to find out why mom wasn't imformed of the change in his medication.
I was ushered into his office.
He looked on dads notes because he had only become the manager in December, and dad went in the home in November.
Apparently dad was put on it in the home he was in for restpite in October. He said how sorry he was and asured me we would be informed if medication was changed.
Well when i went a few days later, the nurse then told me that the hospital put him on it before he was admitted there.
Well i just said i dont remember dad being druged up to the eye balls when he was at home with mom.
Also i said i don't realy care who's fault it is he's on it, nobody told me he was causing any trouble of a night time, but it's making him more prone to falls and the doc here has been told he has to come of it.
You know when little pieces of the jigsaw falls into place, like the morning you visited and you can't understand why your dad look's comotosed and it frightens the life out of you.
Strangley enough i havn't long been back from visiting tonight, i asked the nurse if he was being taken of the seditive, and she said yes.
I don't want to upset anyone but we have to be the voice for our loved one's when they are unabe to do this themselves.
I am happy with him there and it wasn't that home that put him on it anyway.
I did ask him tonight if he likes it there as he was having a good day when i arrived to see him, and he said yes.On the days when he seem's more alert i still try to ask him if he his ok, because his speech went along time ago, so it has been difficult to know how he feel's about things. sorry this as been a long post.
 

noelphobic

Registered User
Feb 24, 2006
3,452
Liverpool
janjan said:
II did ask him tonight if he likes it there as he was having a good day when i arrived to see him, and he said yes.On the days when he seem's more alert i still try to ask him if he his ok, because his speech went along time ago, so it has been difficult to know how he feel's about things. sorry this as been a long post.
I really empathise with you there. My mum's speech is very poor indeed and I am often not sure whether she understands what I am saying to her. It is so frustrating and so difficult to have any kind of conversation. Sadly almost the only times her speech is clear these days is when she is angry :(