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Bryan50 Asked August 2019

Self medicating in assisted living?

I just moved into a New York State Assisted Living Program (I am 60) I take several medications, (I self administer medicate) one of which is Tramadol (a controlled medication). While I lived on my own, obviously I took all of my meds on my own. I took Tramadol, without incident (taking the medication as it is prescribed). I am sure just like others who take this medication, along with all other controlled medications- Why can't I self administer my Tramadol?
I understand the Opiod crisis, but like I said while I lived on my own I took Tramadol without incident.

JoAnn29 Aug 2019
If ur residence is like an AL, even though private, the state regulates them. In Moms AL, the RN was incharge of the meds. Medtechs disbursed them and kept records. The RN ordered them thru the off sight pharmacy they used. Even over the counter. All prescriptions given by personal doctors or ones associated with the facility. Your drug is a controlled drug and has to be monitored. When u were taking them on your own, the druggist would have been aware you were taking too many when you tried to refill. These drugs need a new perscription each month. 90 dayMail order cannot be done.

Tramadol is a strong pain killer. In my Moms situation it caused hallucinations and had to be dropped.

JudinWA Aug 2019
There could be several reasons. State law would be the first one that comes to mind. Secondly, the center you are living at may have had trouble with prior residents managing controlled substances, and added their own rules. After all thy know nothing about you or your ability to care for yourself.
Does your stat have an Ombudsman? This is a person who peaks on your behalf. Ask the Social service director who is the Ombudsman in your area--or teh equivalent. Perhaps you can find out wh the rules and regulations are--State and facility. Each resident has a Negotiated Care plan of some sort. Perhaps you can add into the Care plan your self-management of medications, including the controlled substance. With some guidelines specifying how you use it, how the usage is documented and tracked, and what the parameters will be if you misuse it based on your agreed-upon set of rules and guidelines. In other words you need to build trust with them that allows you to manage the medication yourself. The Ombudsman, or whoever, should b able to help you negotiate this. Ask them, under directed contract, to give you time to prove yourself worthy of managing the medication yourself. Then, if you don't or are unable to follow those rules, or get into dfficulty they can take back the responsibility of managing the medication.
All they have is your word about how you managed the medication. Of course all bets are off if the State law prohibits it. But don't take the facility's work on that , find an independent person to help you negotiate this very important right to self-care.
Good luck. I just moved into a Senior Retirement Center, and one does give up certain rights, even if it is as simple as how you like your chicken cooked, or as complex as managing a controlled substance.

Judy Mata, RN

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Ahmijoy Aug 2019
When my mother was in a facility, I couldn’t even bring her a bottle of aspirin. It had to be given to the RN, logged into her chart and administered by the nurse. Rules is rules. Facilities have hundreds of rules and regulations they have to follow or face losing their license. These are general rules and regulations that apply to every resident. They are not followed in a case by case basis. Evaluating every resident to determine if they are capable of self-medicating is not feasible. Not only that, but residents mental capacities can change and deteriorate and evaluations would need to be ongoing. If something should happen, even if the resident should unintentionally or intentionally over medicate or decide they will no longer medicate at all, it’s the facility who is held accountable. It’s nothing personal. They are not questioning your ability to take your medications on your own. But, now you’re under their roof and not your own and you need to follow their procedures.

AlvaDeer Aug 2019
Have you checked on the rules? They vary state to state. For me, in California, my brother is allowed to administer his own medications so long as his doctor signs that he is able. It is the doctor and my brother who monitor his medications. There are rules, such as their being in a lockbox; they are not allowed to be out in the room. But he is allowed. You may want to ask the question of your facility as I imagine it is their rule for their own reason. Do update us when you find out the answer.

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