Who is in control?

willemm

Registered User
Sep 20, 2006
41
0
After a few weeks in her first Residential Home, I find that my wife is being given a new medication. So far as I can tell it is of a type that could benefit her condition. I at first thought that it was for a UTI which she has tended to get, but looking it up on the net, I find it is not for UTI, as it is an anti-psychotic drug. I won't go into any detail except to ask (a) should I be informed of any new treatment by the home ? (b) by her GP ? (who, when asked earlier, said that he would still be her GP being local to his surgery) (c) could any other medical person than her GP prescribe for her?
I don't want to go barging into sensitive territory, but feel that there should be some feedback in such situations without the need for me to ask anyone. Reading up on some of the drugs that can be used for mental disorders of any kind makes my hair stand on end at their complexities and possible side effects, some of which can mimic or worsen the very condition they are supposed to be correcting.
There must be some kind of protocol for the administration of new drugs for people in care, and I just want to be better informed as to what that is, before taking any official action (if any).
 

jenniferpa

Registered User
Jun 27, 2006
39,442
0
It's a tough one, Willem. I would say that any doctor could prescribe for her, but I think it's a really bad idea if they do. Medication interactions can be a nightmare, and if all and sundry are prescribing, this is more likely to happen. As to your rights, I'm afraid I don't know. Logic would presume that you would be informed about such things as the closest relative for a dementia patient, but logic doesn't always come into it.

Jennifer
 

dmc

Registered User
Mar 13, 2006
1,157
0
hi willemm

im not sure the policy in homes, my mum is in a emi hospital and i know that they have changed /stopped her meds without telling us till later usually on the consultants orders, my mum is also on a anti-psychotic drug, do you know the name of the drug you wife has been prescribed?
i know in some cases the side effects can be worse than the actual dementia but i know in my mums case they do have to try these drugs to see if they can improve her condition or not,
could you not tell the staff at the home that you want to be informed of any changes to your wifes meds before they administer them?
wish you well with this hope you get some more answers soon.
 

willemm

Registered User
Sep 20, 2006
41
0
Thanks Jennifer & Donna, though worryingly for the apparent lack of a communication path in such situations. I have done a lot of previous research on all manner of medications for Alzheimer's, Dementia, Parkinsonism (not Parkinson's) and Anti-psychotic drugs, all of which have previously been tried in the past (before going into a home) but without success, in fact either no change, or side effects too drastic to tolerate (one led to the need/urge for going to relieve the bladder no fewer than 50 times in one day - we were both exhausted as she needs support to rise/walk/sit each time).
As her former carer I was obviously kept informed by her Mental Health-care Manager of any new medications to be tried, but all of which were prescribed by her GP or went on his record.
It is surely important that particularly in this extremely complex and sensitive field of medication, the GP should have a full record of all that has been administered and the results.
On a different tack, surely the patient (who in this case still has some normal mental capacity, if only at times) should be treated the same as any other patient, or at least have a close person kept fully informed. Or am I being over simplistic about this?
 

willemm

Registered User
Sep 20, 2006
41
0
Thanks Jennifer for that link to the Dept of Health article on Patients Rights, it goes some way to clarify several aspects of my situation, though it assumes that the health authorities concerned are those directly involved with the patient, which is what I am trying to better establish where the home is concerned.
The article does include some very useful links to access for further info. which I may try.
I have to say that, even when my wife was being treated by mental health medical people, their approach was still of a "suck it and see" nature, and I generally only found out what their prescriptions were for by reading the PILs and additionally getting info from Internet sources (of which there are many). I have sufficient faith in the home owner (not in Scotland, by the way) who has extensive knowledge and experience of dementia to continue with the medication at least for a suitable period, but will nevertheless like to know where I stand should I feel the need for greater involvement (as is recommended by the Patients Rights legislation). Everyone seems to be agreed, including myself, that what really matters is what is in the best interests of the patient,
You mention "new medical health act" - can you tell me more? What is it intended to cover; when is it due?
 

willemm

Registered User
Sep 20, 2006
41
0
Thanks (again) Jennifer
The MCA (effective April 2007) does fill in a lot of gaps in the existing legislation, especially with the new LPA (Lasting Power of Attorney) which does for medical matters what the EPA does for financial and property matters. It may come a little late for anyone whose mental capacity doesn't enable them sign up for a LPA. My wife does have an EPA, but that was drawn up a while ago, and her capacity has fallen away somewhat since. Will have to wait anyway for the opportunity to try it out, but am sure that existing legislation/codes of practice cover what I need if it becomes necessary.
 

Brucie

Registered User
Jan 31, 2004
12,413
0
near London
Hi willemm

did you ever tell the home that you wished to be notified of any change in medication, condition, etc?

I think sometimes homes think that relativew might not wish to know.

I find that by making it absolutely clear that i wish to know anything that changes in any way, I get told.
 

Dave W

Registered User
Jul 3, 2005
268
0
63
Bucks
Speak to the home

I'd strongly agree with Bruce here. Both in her home and previously in hospital, I asked to be informed of any plans regarding medication, and was consulted at each step.

As Mum's original GP was out of the frame once she was in hospital, this helped in that I was pretty familiar with a lot of her medical history, and both the home and the hospital said that they found that very helpful.

Given the history of different medications have no effects or adverse ones, I'd say you're very much in the same boat. I've no idea what your rights are, but you could couch any communication with the home in terms of being aware of her history and being a possible source of advice.

From my own experience, a number of different options had to be tried on several fronts (anti-psychotics, blood pressure and an ongoing problem with constipation) before regimes that worked and were tolerated could be found, and there were many unfortunate or sad episodes along the way ... but a solution was found. I was also able to point out that some particular medications has been tried in the past and didn't work or made things worse, so was able to spare her going through a second trial.

Dave
 

willemm

Registered User
Sep 20, 2006
41
0
Hi Brucie & Dave
In response to your views and experiences, I have to admit that I didn't specifically ask to be informed of any change of medication because my wife is still registered with her own GP (i.e. is in the same area) and I assumed that any referal for illness (or to try out some other medication) would go through him and that I would be kept informed of the nature of this event.
I will be taking the matter up with the home to ensure that I am kept informed. Dave's reference to his knowledge of use of various other treatments is an important one, to avoid the giving of drugs already tried with all their unpleasant side effects, then only to fail.
 

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