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Esther Asked January 2010

Should nursing homes give high doses of sleeping pills and tranquilizers to dementia patients, so they will stop screaming for a nurse?

My mother has dementia and cannot control the screaming. This usual happens when she is left alone. I hate seeing her so drugged. However, the nursing home said if she does not remain silent, she will have to leave. Can they do this? What recourse do I have, as her daughter?

EXPERT Carol Bradley Bursack, CDSGF Jan 2010
This is so difficult for everyone. You mother can't control her screaming (this is not unusual). Drugs to calm her are really the only option and they often do make people too sleepy. Some homes will use more medication to control the screaming, and some will not for the reason you mentioned.

Perhaps there are different drugs they could try? You can see that it's difficult for the other residents to hear your mother screaming, yet you rightly don't want her over drugged. If there is a good answer for everyone here, I don't know what it is. But trying other meds may be useful.

Carol

ImageIMP May 2012
This kind of overmedication to "control" elderly patients' attitudes & nursing requirements is not limited to patients with demential or to nursing homes... I felt helpless & angry when a friend's 80 yr old father had a stroke which left him with partial paralysis but mentally completely bright. I visited him shortly after in the hospital and he was mentally alert, had a positive attitude about physical therapy & regaining his mobility, and looked forward to leaving the hospital. I visited again one week later, when I could get back up to the hospital, and this time found him strapped into a wheelchair & sitting by himself in the "lunch room", a tray filled with a horrible array of monochromatic mush in front of him. He was drooling, babbling, and didn't recognize me - "Ma'm? Where am I? Why are they keeping me here & feeding me pig food?" - I made a frantic call to his son, thinking he must have had another stroke or other setback, and was told the hospital staff was giving him "necessary" medications "they give to older people" to control his attitude because he was too hard to "handle". I was outraged - what was the problem? Did he expect preservation of some dignity if he soiled himself? To be treated as a competent adult when they addressed him? Unfortunately, I wasn't a relative - had no say - and could only tell his son he was allowing the hospital to take away the only weapon Paul had to fight with - his mind. Sadly, but probably predictably, Paul developed kidney and other issues, and the decision was made (??!) to discontinue hydration & nutrition and just let him lie there for three days until he died... This should be criminal! He just needed the same treatment and help that would have been routine and expected for a younger person - not to be drugged out of the world...

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Alohajosie Jan 2010
Having cared for a mom with dementia for over 2 years now and a mother-in-law with pre-alzheimers, one medication that assisted the agitation of my mom in the beginning phase of her dementia is called "depakote". Her doctor prescribed this medication at a very low dosage so that she is able to control her agitation yet remain calm and not sleepy. This medication "depakote" is normally used for agitated patients with dementia. This drug has been a tremendous help with my mom's stability and functionality. Depakote in conjunction with "Namenda" (which slows down the progress of dementia/alzheimers), my mom's dementia has improved tremendously from the rapid deterioration of her memory.... You need to find a doctor who is truly an expert in this field of dementia & alzheimers....I hope this information may assist you...Good luck to you.....

sanityLost Jan 2010
Excellent answer. I finally got a Dr. to listen to what I was saying. Mom was in pain, was screaming, being combative and then depressed as well. They kept upping her morphine and adding many different anti-psychotics. I started to keep a log of exactly when she started these behaviors and when they were not effecting her. The Dr. listened and removed some meds and added a new one and my mom is back!!!! I don't know how long this new med will continue to give us the right response, but I am eating up every minute of having my mom back! Good luck!

sskape2 May 2012
When my Mom needed rehab several years ago, the NH immedialely put her on some heavy duty sleeping meds, and tried to get me to admit her to the alzheimer unit. A nurse took me aside and recommended a small dose of a med called trazodone to calm her anxiety, and it worked well. I got her out of there as fast as I could, and she is still home with me today, doing fine and her alz has progressed along, but she is content. So I feel blessed.

FloridaMom Nov 2014
My husband was put into rehab/nursing home after his hip replacement operation. Soon I noticed that ALL patients fall asleep right after their evening meal. Still, I couldn't imagine that all of them were drugged! One evening I carelessly drank my husband's fruit drink, kissed him "Good night" and started driving toward the town 120 miles away... After proximately 30 minutes I became sleepy, very sleepy.. I pulled of I-95 into the rest area, turned off the key... and woke up an hour later totally disoriented... When I questioned the staff regarding sleeping medication being in the drink, they flatly denied it. I could have died that evening...

akn64 Jan 2010
Our nursing home forced my mother with dementia to an in-patient psychiatric hospital to get her medicine set at a level that would control her agitation and aggressiveness. Sadly, while in the hospital, she inhaled vomit and almost died. The medical trauma advanced her dementia and now she barely needs any medication because she's lost so much of her mental capacity. It's a sad story and I feel nursing homes have way too much power over their residents. Our hands were tied. She was either sent to a psychiatric hospital or she would have to leave the nursing home.

MrHenry Nov 2014
The situation is strange to say the least . A sleeping or calming agent in a drink ? How could amount be ensured if as in this case , it was not even consumed. Check medical charts of your love one. Get acquainted with close aids ,ask him. Things do go on in NH that allow aids to tend to more patients .HBO has done a segment on NH. It might not be as bad as it appears. KEEP CALM AND STAY THE COURSE.

jeannegibbs Nov 2014
What have you done about your suspicions, FloridaMom?

My mom, in a nursing home, often wants to go to bed shortly after dinner. She did the same thing when she stayed with me. At my home I know for sure it wasn't drugs, and I have no reason to think it is at the nh.

I am so glad you were alert enough to pull off the highway and rest! Have you discussed this incident with your doctor?

Litldogtoo Nov 2014
@Florida Mom - is he still in rehab? I wonder if you can get some of that drink and put it in a container and have it tested. I, too, am in FL and I'm beginning to think something isn't right down here. They told me that they can't have railing on the rehab beds because of a law. Yet if a patient falls out of the bed (my mom broke her pubic bone a few days ago and has dementia to a point where she wanders) they get written up.

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