Also her mood and behavior have changed a lot in the past few weeks. The drug that concerns me the most is the simvastatin. At home I gave her very high dose omega 3 fish oil. And this kept her cholesterol down. My question is, can I tell the facility/doctor that I do not want her on the "statin" and substitute it with pharmaceutical grade fish oil? (Sometimes called esters Or omega 3, legally, as her daughter do I have the right to tell them to take her off that medication? I am mom's medical proxy. Her bill for medication for 4 weeks is $150.00. At home it was $50 for blood pressure meds. They also have her on high dose very strong anti-depressant (mirtazapine) if it works I don't have any issue with her taking it.
And we really don’t know what her lipid labs are- they could be sky high.
Speaking with the doctor would be my first step.
For information on drugs and drug interactions, you can consult ehealthme.com, WebMD, Drugs.com and the NIH drug information library. To find out about medication either recommended for the elderly or not recommended, download a copy of the BEERS list from the American Geriatric Association. My mother's doctor did not appreciate my research, but staff at patient care meetings helped to broach my requests in nonthreatening terms.
If you want it so that you are calling the situation on thier health care, they need to be in a small private pay custom care facility. It will be pricey. But if thier “duals” so it’s medicare & medicaid paying, the medication management will be whatever is the most cost effective & ok for M&M compliance.
Check out your medical journals...statin-drugs do more harm than good.
Mood and behavior for the better? Is the anti-depressant necessary? What mg? Seniors don't require high doses of anything....especially if it's a new drug.
Start off with 5 or 10mg, and increase if necessary.
Just my 1/2 cent ;)
My experience was that ONLY IF they came in with say an time limited RX from a specialist MD - like for my mom it was a retinal specialist opthalmalogist who had mom on a specific med for post surgery issue - would the NH staff MD allow medication to be done and ditto it into mom’s at the NH health instruction chart so it would be administered.
All medications come from whatever outside vendor pharmacy the NH uses. The RX for NH come packed usually different from a consumer pharmacy. They come in 30 - 60-90 day blister packs usually on hanging files with reportage tags. If family mpoa wants to use another pharmacy the NH can tack on a outside vendor fee. Like $100-$250 a mo. I’d bet a case of Processo that the only way around this is IF mom is on some kinda drug that HAS to be compounded as that’s specialty pharmacy stuff so there’s probably a Medicaid waiver to allow these RXs.
Please please don’t bring in an OTC medication and leave it hidden in mom’s chest of drawers thinking that you will on your own give it to mom. Doing this can be reason to have mom viewed as noncompliant for care and mom / you are send a 30 day notice (to find another facility).
RE: $$: You are paying for the medications and a person to administer them. I asked about that in hospital where DH was charged more per day than we paid all month.
You are paying the pharmacy (inhouse) to fill the prescription, the person seeing they get to the floor and the person administering the medicines.
Good luck with that - I finally started refusing to allow them to medicate my DH and I carried my own. It's a terrible fight. If she is in a NH (not sure what SNF is) - unless you can be there to see to the administration of the medications, your hands are probably tied.
I think that unless there is a real risk of heart attack or stroke a Statin could be eliminated strictly due to age. Any benefit from a statin to lower cholesterol at this point may be unnecessary.
And another point since you are her Health Care Power of Attorney you can make a decision like that.
At some point after my Husband was diagnosed with Alzheimer's his doctor wanted to put him on a statin. I had a discussion with a very good friend of his (a doctor as well) and he said there really was no point to taking the statin now. He called me a week or so later and said that he had thought about it and it might be better if he started the statin because if my Husband had a stroke it would be more difficult for me as a caregiver to care for someone with Dementia and Stroke symptoms. So he went on the statin but I took him off when he went on Hospice. (Also discontinued Aricept at the same time)
There is another "natural" that can be given Red Rice Yeast rice contains natural statins and that can be a lot less expensive than the prescriptions.
You should ask for a meeting with the doctor to discuss the medication changes that have been made. You have the standing, as Health Care Proxy to challenge the use of a particular med, like a Statin, but I don't think citing its cost is a particularly effective way to approach the issue.
Remeron is actually a very" gentle on the brain " antidepressant which also has good antianxiety properties. It is also used to increase appetite.
Once Medicaid kicks in, her meds will be paid for by them, isn't that correct?
Going forward, when you attend care meetings for you mom in the future, always asked them to run a list of her current meds for you. It's the only way to keep track of changes. It also helps if your loved one ends up in the hospital. The NH will send the current list with the patient, but they sometimes go astray. It helps to have a backup copy in the hands of family.