We're having an issue with my dad getting his medications correctly. He is 88 years old in stage 7 dementia. He gets Seroquel for sleeping 9:00 a.m., noon and 3:00 p.m. Not at all at night time, so he naps during the day and he's awake all night, wandering, and tearing up his room. I'm trying to get out the doors They are also not giving him his Zoloft or respridone, which is for his anxiety, until 6:00 p.m.
He's been in this facility for 2 weeks and we've had many talks with staff. Also had a meeting with the owner and staff member about this issue. He also acquired a bladder infection because he's not drinking enough water. Any thoughts or advice?
No medication can be given without a doctors prescription. Does the facility have all the prescriptions? Are you talking to the Director of Nursing?
When my Mom was in LTC I had to pick a doctor associated the facility. You need to find out how the doctors orders were written. The doctor may have changed things. Made adjustments felt other meds were not needed. The nurses can only give meds prescribed by the doctor. They can only give them at the times the Doctor ordered them. The facility must follow Doctor orders. The State will come in and check to make sure residents are getting their meds correctly. There is protocol that needs to be followed.
Water. With my Mom, they left a big cup on her table. The aides went around every so often and refilled. Did not do Mom any good, she was out in the common area most of the day. The aides did come around and give the residents water.
There is no one on one in a facility. Your Dad is not going to be cared for like you would have. Younay need to make sure Dad gets water while your there. My daughter, RN, works in NHs. I used to ask her what I should complain about and what not to. You will have to pick your battles. His meds are one of these battles.
Are you assuming so based on his behavior?
Are you witnessing it?
How long has he been in this facility?
What type of facility is it?
Are you his MPoA?
If you're getting your info from your Dad, this may not be accurate. If he hasn't been in the facility very long (less than 2 months) and the meds are new for him, I'd give it at least 2 weeks to work, and if they adjust the prescription, then probably another week or 2. This is based on my own experience with my MIL in AL and then LTC.
Bladder infections (UTIs) aren't only caused by lack of water. Enlarged prostates happen in about 70% of older men, among other causes. Also hygiene, if he's in charge of his own this may need to be improved.
"Older men are more likely to get bladder infections, also known as urinary tract infections (UTIs), because of structural and functional changes in the urinary tract. These changes can make it difficult to empty the bladder completely, which can lead to bacteria building up.
Causes:
- Enlarged prostate
- Benign prostatic hyperplasia (BPH) is a common condition that can make it difficult to empty the bladder.
- Kidney stones (they can trap urine in the bladder)
Other conditions:
Diabetes, neurological disorders, and other chronic conditions can increase the risk of UTIs.
Weakened immune system
Diabetes, and other conditions can weaken the immune system, making it easier to get a UTI.
Incomplete bladder emptying
Constipation can prevent the bladder from emptying properly.
Prevention:
Maintain proper hygiene, including regular bathing and thoroughly drying after cleaning
Stay hydrated to help get rid of bacteria
Practice emptying the bladder every 2-3 hours
Avoid becoming constipated"
I would tell admin that you need another meeting and that the medical record should be there along with the medication sheets so that you can time the times of administration of his medications. Let them know you are trying to work WITH them so they have a more calm resident. (I am ASSUMING he is in MC, and not in ALF, as he needs memory care now).
If, after several meetings this isn't working you are looking at needing a change I do know that YOU already know Dad isn't an easy placement. And places DO cherry pick. In fact they often HOPE you will take a problematic resident elsewhere, and may throw a party as you exit. Just saying, this now is falling into the sad realm where there are no good answers and EVERYTHING is imperfect. Just a fact.
I sure wish you good luck and applaud your actions so far, which are perfect. You have investigated, found what is wanting, spoken to staff and spoken to the admins. While it may take a month or so to work this out, stay calm and assure them you are wanting to help get it arranged so it works for BOTH your self-interests.
Good luck. I hope you'll update us.