Mom is in an AL facility, there now for about six weeks. For about eight years, she has taken oxycodone 3-4 times a day for severe spinal stenosis. Now she is not given a dose by the nurse unless she specifically complains of pain, and most often when the nurse or therapist asks if she is in pain mom will say, “no, I am fine.” Then after the nurse leaves, the complaining begins, with “pain that’s worse than it’s ever been.” Sister lives in the AL apartment with mom (a nice 2-bedroom) and has begun to complain of mom’s extreme irritability—they have days where mom is terribly mean and acts out towards sister.
I think that mom is essentially going into withdrawal when she goes a couple of days with no meds, because she does not say she is in pain. The nurse says she is only allowed to give the opiates “as needed” and if mom says she doesn’t need pain meds, then none are given.
This also happened in the hospital when mom had brain surgery. I stayed with mom the whole time, and assumed mom was on her regular schedule with all meds. Then terrible irritability began there too, and diarrhea, and the full-blown withdrawal before I realized they had cut her off her oxy cold turkey—when the nurse would check on mom, polite dementia mom would say she was fine. I did not understand until that happened that mom would have to explicitly ask for pain meds in order to be given her usual dose. I am shocked that the hospital didn't manage this issue better, especially with a patient with dementia.
Anyway, any tips? The nurse is not very keen on just giving mom the pain medication anyway, if she says she isn’t in pain. Shouldn’t SOME allowances be made for the dementia? I feel mom should have her usual 4 doses, as she was able to physically do more when not in pain l, and functioned overall so much better than now. But even if not all four doses, at least a couple doses daily to keep withdrawal symptoms away!! Seems like a no-brainer to me.
Mom and sister are fairly new there—maybe 6 weeks? Mom’s doctor will be the one in the facility, and she has only seen her once. So no track record there, only notes from the previous GP who retired a couple of months ago.
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Not ironically, the person who FIRST put me on daily opioids (and I will admit I take the lowest dose of codiene I can get) many years ago.
With the pain pills that WORK....I can WORK. Without them, in a few days I am of no use to anyone.
Dr has said many times that the abusers are not scared off by the 'laws' at all. They still get their 'fixes'.
To take someone in chronic pain and deny them their pain relief is, to me, absolutely cruel.
The 'war on opioids' is a joke. The pendulum will swing the other way, eventually, allowing Drs to treat their patients with their best interests at heart.
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To withdraw someone without an MD specializing in withdrawal from this drug is very very dangerous.
You need to speak with the MD in charge.
She’s 86, for heaven's sake.
We will talk to the doctor. But I am still upset that the doctor wasn’t actively managing this, or the nurse, without me having to intervene. Seems sometimes like the medical profession is falling apart.
And then would complain to US about her anxiety.
We had the doctor change the prescription so that the med was regularly scheduled with EXTRA in case mom had breakthough anxiety about some particular event or issue.
The nurse can ONLY give what is prescribed. Talk to the doctor.