I think my mom might be over-medicated, how can I tell?

krn, if you feel that your mother is being over medicated, then why don't you take her to another doctor? Do you have POA....I'm sorry if you mentioned that before and I may have missed it. If she knows people then is she capable of telling you how something feels? This is a place to come and vent and the others here will offer you their experiences with their own loved ones....the disease may be the same but the symptoms and how they affect people can be so different. Every single person here that has offered me some advice I have thought about it and it has helped me so much because I realize I am brand new to the home caregiver role and I DON'T know as much as I thought I did. 25 yrs of transporting and caring for the elderly in the back of an ambulance didn't give me the day to day ins and outs of a routine. I'm finding out. I am married to an emergency room physician.....I'm not even going to get into the current state of abuse of the medical system......it is horrendous to say the least. But being married to him does not give me anymore knowledge of how to take care of his mother. She has her own physician to do that. If I thought for one minute he wasn't caring for her correctly I would change in a heartbeat. Believe me when I say that caring for the elderly is only better than good when $$$ are involved.....there are none. Let me give you an example.....several days ago, in the ER, hubby had a patient in cardiac arrest and "worked" him for 2.5 hrs! And yes, he sent him onto a specialist with a heartbeat and breathing. Guess what he gets paid from Medicare for his services.....a whole $25.00. This is for all doctors, not just ER. The amount can be as low as $12.00 depending on the diagnosis. I'm sorry to say that if there is not a supplemental insurance policy, doctors will not spend an inordinate amount of time listening, testing, etc. That's not to say they don't exist, because there are some doctors out there who truly care and have not been "jaded" by the system yet. There is nothing wrong with questioning if you feel something isn't right but as I have said before, being a pest is only going to get you on the bad side of the outside caregivers and you will never be in the loop to glean any information. It's difficult to watch your loved one decline.....my mil is not the same person she was a year ago when we moved her close to us. Her mental status has changed so much, her mood swings are a little hard to deal with sometimes, but I come here to boo hoo and these wonderful people remind me that this is a disease and there is nothing I can do about it except continue to care for her to the best of my ability and when or if it gets to where I can no longer care for her then I will turn her over to others who can. You said your mother's physical problems are being taken care of now....that's all you can ask for.....just continue to love her and be there for her.....my hubby has to remind me occasionally that "no one gets out of this life alive". I wish you the best because I know this is a difficult time for you.

i am concerned about the medication because she is displaying side effects-negitive side effects-
if she was being medicated in such a way as to relieve
her and make it easier ,lesspain,less aggitation,removing
the feeling she describes as "my heart is racing",
releaving the feeling in her throat that she says makes
it difficult to swallow- if her meds were dealing with these things,or helping tocalm her down,lighten the fear,etc,then i would have no problem-
i realize she is going to die-she is declining- but now that some of her physical problems have been managed,for now,
she is eating,gets hungry and eats--
i am the one who notices these things,i dont know why the
visitng nurses,the social worker,the aides,why no one else
seems to think my obsevations are anything but denial-
maybe they are-in a way, but i do know that there are many meds that are around-for this kind of situation,-
and it is possible that there may be other ways to manage these things.

while she is still alive, i find it very disturbing to be advised
to just hand her care over to agencies and doctors and inadaquate caregivers.I will question and be a pest as long as i feel something isnt right or that there is another way to deal with her problems.
so thanks for the advise, but im not ready to give in-
and my mom and i are trying to deal with the inevitable, her death- we have been talking about it-
and my grieving started months ago-
but she is still here,alive-she knows who people are-
and she is suffering-
i think i may have been under the misconception that this
was a place i could vent-andmaybe get a little relief-
maybe i just find it too difficult to be told to just face it-
but she is my mom,and i cant just go along when i feel
somethings arent right-
i do have good intuition-we all do- we need to follow our gut -
i grew up around doctors, my father was an orth surgeon for over 50yrs,started manyorth clinics -taught so many at HSS,NYH,etc-doctors dont have all the answers,
and the system certainly isnt set up to make it any easier for the patient and /or the families-unless $$$ is to be gained.

If your mother is declining fast, the people who are "overmedicating" her may be just trying to save her from the agony that attends the medical condition that is causing her decline. Death cannot be postponed indefinitely. It may be time for you to deal with the impending loss of your mother to a process that is as natural as birth. Gather your friends and family to support you in the difficult period that is approaching, as you put it, "fast." The process will be painful for you, but there is a healing that comes from dealing with it. Good Luck, and God Bless You.

I had not thought of that, retiring...or arrested for gross incompetence. This guy really is a loo loo...I know about over booking too, they triple up on app most days we have been, and it wasn't like this ten years ago!

Welcome to the wonderful Wizard of Oz Jsomebody!!! What happened with you routinely happens in doctors offices and let me tell you why. Most doctors work off insurance plans and have more patients than they can reasonably handle so the staff is often overworked and underpaid. Charts go missing but they are often misplaced or misfiled (English is not often the first language in office staff). Medical assistants call in a prescription have a long wait on hold with the pharmacy and sometimes can't get through so the chart goes on the side. Sloppy penmanship by the doctor so the medical assistant has to "guess" what the doctor means. Some doctors are often preoccupied during the visit and they write down the wrong info..... and the list goes on. This is why you need to speak with the doctor while you are in the office and confirm the meds and dosage. There are a lot of great docs out there. Why don't you tell Grandpa that his doc is retiring as of the end of the year and offer to help him find another?

Is she taking morphine for pain? I've heard that people start declining when given morphine. Also, some of the anti-psychotic drugs given to the elderly have warnings saying that they can cause death if the patient is has dementia, or is diabetic, etc.

Here's one: just this afternoon a gal called back from Grandpa's Doctors office with the lab results and said..."Here is the new prescription, start giving him the Dilantin at 100 milligrams three times and day and come back on the tenth for a blood test to check the level again..."

I was a bit shocked......I told her that THAT IS THE DOSAGE HE IS CURRENTLY TAKING NOW...???

She was flustered and confused. I am not surprised...this office has lost charts, medications, missed appointments, not called back for three weeks for a test result that took four days...I mean were are looking at gross incompetence here now...

She gets a bye as she is a new employee there, but even the doctor is an imbecile I swear. If this was my doctor I would change doctors immediately but Grandpa doesn't want to change doctors so it is what is is....INSANE!

Gonna put this on grossed thread too..

Hi again--and that was a good thought that vernon had to offer--It is possible she is taking other meds that she may be sneaking-or on the flip side, she pertends to take some necessary meds-and just takes them and hides them---Like I said earlier--there must be a way to get to the bottom of things.. In many cases-depending on the meds-a simple blood test could show if your Mom is over or under medicated...Check this out.
Best,
Hap

Defintiely get the meds list. If she is taking them herself, make sure of HOW she actually takes them - some people organize bottles a certain way and make mistakes so they are taking double doses of something at times. I finally confimred this with my mom, who inadevertantly quadrupled the dose of a statin she was on, and it basically led to the end of her indpendent living - long story. Even the best meds lead to bad side effects in some people. My parents' generation habitually never questioned or botherered to understand what their meds were for, and they COMMONLY keep taking pills that are killing them. I am a peditrician and I like it a lot better with modern families who are very suspicious of side effects and will call you (ideally) or at least stop on their own before anyone is likely to be seriously harmed. I just heard about a friend of a friend who was put on HOSPICE due to a bad medication reaction until a smart doc figured it out and got it stopped; he promptly returned to much better health and has a good prognosis for a lot of extra years.

There is one important issue that needs to be remembered.......let me give you a scenario: your mom or dad is seeing the doctor for some illness, they don't seem to get better or it gets worse so they go back to the doctor and tell them it's not better or this is going on.........so the doctor writes a script for the worsening or new problem. The patient doesn't know to ask and the doctor FAILS to tell the patient to stop taking the previous med......so mom or dad just continues to take whatever is prescribed....if this happens several times......well you can imagine. That's why when our loved one starts going downhill mentally it is wise for someone to have POA so that they are very aware of what is happening medically. If there is no POA.......please remember that HIPPA prevents anyone from discussing your loved ones history. Fines for someone violating HIPPA start at $25000, so you can see why it's difficult to get information. It also helps that when a loved one is in the hospital.....it's okay to be concerned and ask questions.....but I guarantee that if you become "too overboard".......you are going to be shut out and on opposite sides with the ones doing the caring. Yeah, I know being married to a physician makes me somewhat biased, but I have worked in ems for 25 yrs and have seen a lot in and out of the hospital setting.

thank you-
it helps when i hear someone i dont know-who can be objective-
to reassure me that i am doing what i should be doing-
i would say the same to someone-don be afraid- i say that all the time, but somehow when it is me-inmy situation- i too get intimidatedand i know better- and its just helpful to read your comments--thanks-

and about that aarp pharmd- i have to check that out- it sounds like a very smart and logical contact- thank you so very much

I am so sorry about your mom. As my mom declined the dosages of her meds were to strong and had to be changed. Also my moms doc actually perscribed the same pain med under two different names. They were perscribed for two different injuries but still everyday she took two times the amount. As patients decline you should always ask the doctor if there are any meds that can be taken away. We are going thru that with my dad right now. DO NOT BE AFRAID TO ASK YOUR DOCTORS QUESTIONS SHE IS YOUR MOM! My prayers to your you & your mom.
Debbie

Years ago I had read in AARP magazine about a PharmD who went into nursing homes (and private homes) to review medications. This is a doctor of pharmacy who is independent and all they do is review the meds that are currently being taken and advise the family of interactions. Whats great is that this is all they do so unlike a doc or a pharmacist ( or tech) who might have made a mistake they have no agenda other than making sure that your loved one is on the RIGHT meds and dosage. Hope this helps.

yes its amazing to me -the way that some drs.come to decisions
about our aging family-sometimes i have to say to them- that doesnt make sense-what are you talking about-
like they cant ake a istake and they cant explain it to us because we wouldnt understand-man- that really gets me mad
i have had many dissagreements with doctors-so much so
that this time around with my mom in the hosp, for 3 weeks, my brother became the one who had POA, my name was taken off
from the paper-he goes along with most of the doctors- it causes alot ofstatic between us- iknow how things are done in hosp- and u really have to watch and be anactive advocate for the patient- otherwise they are just another old and dying person-treated withlittle dignity and respect.
i my brother is a little more aware of what is and isnt being followed thru as far as medical care-
i still make a fuss- i still go a bit crazy- but hey, its my mom, i have to do what i feel is right- and i will admit if i amwrong- i am not totally against "them", but at least they know my mom has someone who is checking things and watching out for her-
its a horrible situation-
i hope it doesnt happen to me-if it does, i dont know if i would want to be exposed to indignity and pain that i see around me

Yes, same issues here, grandfather never liked pills wouldn't tale em if he could get away with it and has such a fiddly issue with Dilantin we have been in the ER twice for Toxicity levels of it.The Dr. for some reason thinks if 400 is too high and 200 doesn't register, 400 is the way to go..and we go...to the ER again for same over medicated issues.

Talk to her doctor and the pharmacist who often is more educated on medications than many physician I have noticed and monitor her. Over medication of the elderly is extremely common in the US.

THAT IS A GOOD POINT-but she has always been against taking too much medication-she has been very allergic-
all her life- and so even any pain med-aspirin-tylenol- medicine
she didnt take- which could be why she is seems to be very
medicated-her resistance is low-
her problem isnt sneaking it- if it were left to her-she wouldnt take it..
but thank u for sharing-
and thank goodness it wasnt critical pills-
i would have been going crazy it it was me--

Sorry if this is repetitive... I gave a quick review of the responses and didn't see it noted.

While surely correct in their suggestions, it seems the responders are basing their suggestions on the idea your Mom is being given medication. If, however, she is taking (or sneaking) medications herself then she should have one person dedicated to giving her the medication she needs with the pillbox hidden during the interim.

I bring this up because in my own history a few days went by before I discovered the Alzheimer's Victim was sneaking medication out of the pillbox I kept in the same place it had always been kept. (Of course, the Victim had no idea they were sneaking pills... the pills were simply available for the taking.) Thankfully, it was only a few days and amounted to only about 3 pills extra than normal... and they were not 'critical' pills.

Good luck!

Yes it is possible that your Mom-has a low tolerence to her medications, or how they interact, or it may be something else entirely...If possible, contact your physician and let him know of the symptoms that you are observing, and review all her medications---and move forward from there. Also be sure that you do get all your Mom's meds from one place, as it usually is put in a computer-which will alert the pharmacy tech of negative interactions---this also may include OTC meds as well.
Best,
Hap

If mom is in a nursing home......keep in mind that the "norm" is to keep the noisy ones "snowed". They don't bother them as much.....sleep alot, etc. If mom is at home you need to know exactly what she is CURRENTLY on. I have posted here before, but I think it bears repeating.......a lot of older folks go to the doctor, and of course we know symptoms change, the doc prescribes something new, but they fail to tell the patient to STOP taking the old med. So it's easy to be over medicated. That's why you should step in and find out what has been prescribed. For example my MIL has been taking a once-a-day dose of an anti-psychotic with an anti-depressant at nighttime. Her doc says increase anti-psych to twice a day, once in a.m. once in p.m. Okay will do..........in discussing with hubby (who is a physician) and reading online...........this med is NOT to be given in separate doses, give it all at same time. And we also discovered there is a combo pill out now that is the anti-psych and antidepressant together. Will ask for that at next refill. Ask questions........no one should have anything to hide. Do you have POA? If not you might run into HIPPA, but you can work around that.

yes , i agree-
i used to alwaysbe with her at all her doctors appts to help explain, take notes, add anything if necessary- now the situation is different
my brother has become her health proxy-although he is over 4 hours away, i am no longer included-family issues- he hired an agency to help with her day and now nite care- and i have been told to stay out of her health care. i ask many questions, and
challenge why certain meds are being given-i even have the audacity to diagree with some of what they recommend-
ive been thru this with my dad-and i know hosp and doctors-
and even under the best circumstances, mistakes are made-
so i am not always a team player- and i know these agenies
for health home care- somemay have a few good people-most are out to make $-nothing wrong with that
but not at the expense of the elderly-or anyone for that matter
so thanks for your suggestion-i just have to figure out how to get a list of the meds.
thanks for your time
k

The meds shold be reviewed regularly by her doc. Do you go into the exam room with her?....if not you shold consider starting & ask questions.
Pharmacutical companies give doctors kickbacks & perks for prescribing their meds......this can be a real problem & needs to be kept in check. If the doc is writing scripts for your elder that are not covered by their medicare D then it is usually a red flag that they are new meds being pushed by a pharm rep.. You/elder can refuse to change to the new drug if that is the case. Greed gets into the picture far too often and you may consider changing docs if this is the case; but be careful & investigate the meds & conditions before you/elder make the decision to change....the next doc may be even worse.
I wish you the best.

thank you-

You may take a medicine list to your pharmacy and have them review the list for interactions. The pharmacy can let you know if there are any interactions.
Blessings, Bridget Wetterer

thanks- that makes sense but the meds have been already set up and put in their litttle individual sections, in a box for taking meds-each day had its own little section- i was told i was not to

Be Sure to READ what her Medications are For, what the label warnings are and that she is not doubling any dosage. If the doctor has put her on anti-depressives check the warnings. Remember, those pills that "help bladder spasms" are to be taken only before bed. They are very dizzy pills and make them sleepy. Most importantly if she is alert and coherent, Get her in an Adult Day Care activity....This will help to stimulate her body and her mind, and give you peace too.