Mom agreed to assisted living. Everything was paid for and set up. Furniture moved. Even Pictures hung on the wall. An hour before she was to go there, the nurse of the facility told her she would meet with her in the morning to discuss her medication management. At that moment mom called it off. She refuses to go now because her medications will be managed. I'm quite aware my mom has an addiction problem ...Thats why we chose to go to assisted living. Now I'm out over $6000. I live overseas. Friends did the moving. I can't ask them to move it back. I don't want to ...because the same stuff of repeated hospital visits for "anxiety," falls, and depression are going to continue. I'm at a loss. I don't know what to do. Is it time to step back and let her go it alone?
She blames us all for pushing her, even though she was excited for the last weeks until it came up about the meds. She is now living in her condo which has no bed, an uncomfortable pull out sofa and no clothes (all at the facility) not even a coffee pot. But she said she prefers this to having her meds managed.
I'm at a loss... Any thoughts welcome.
Only child...no other family
This is EXTREMELY common among the elderly. Of course her mom doesn't want oversight. That would mean withdrawal from her addiction. That would mean the end of her highs.
If OP is power of Atty she most definitely does have a say in her mom going to assisted living. If all else fails mom will need to battle this one on her own unless she completely loses her mind. Otherwise op will lose her own mind which is so unfair to have to carry the burden because of someone's willful non cooperation.
Klonopin, the Benzo, is not for chronic pain. If she is running out of her monthly prescription of pills, she is abusing then. And that is not healthy.
Going through withdrawal of this med monthly is horrible, and she definitely needs some help. You have been given some good advice here, ignore the negative comments, you know what you are talking about as far as her prescriptions and needs go, she’s been taking these for years.
I hope you are able to find someone who lives near your mom to help with this. I can’t imagine having to figure this out 6000 miles away. Our daughter and her family lived 5000 miles from us for 9 years. I hope you find the help you need! Prayers and you are doing awesome. 😢💞
If it's opiates addiction it's very serious. It's not as simple as "managing medications" as some of our young experts in medicine suggest. It is very scary to watch an elderly person cold turkey because they do not have even minimal medication for pain. The blood pressure can be suddenly out of control even breaking through controlling medication. Not to mention shakes, anxiety, etc. Then there is of course the psychological addiction which is also very real.
So, of course, when someone with multiple illnesses is suddenly told they are losing control of their medicines, that's scary for them. It would be for me too as an asthmatic who took a long time to control.
It sounds like the nurse or whoever did a lousy job of making a new resident feel safe and empowered. Of course, these patients frequently have paranoia too. Don't know, but if she's falling, etc. it's not safe for her to live alone. The only thing I can think of is if a family member go with her to meet with the facility nurse as an advocate to actually find out what the nurse has in mind by "management." Maybe it's not at all what she thinks.
Sometimes even paranoid delusional seniors with dementia know what's best for them. God is merciful like that. I guess it is hope for us all. God bless you. These siruations create so much anguish.
Yes. You cannot help someone who won't help themselves. Leave her to her own devices, and whatever you do don't spend another penny on her care. Her problems should not be your problems.
Your profile mentions dementia, among other medical issues. This alone isn't enough to allow anyone to force her to move (per our EC atty, even with all the POAs previously done! others will say get POA and move her, but it isn't that simple.) However, if it has only been a few days since you paid for this place, it isn't lost yet. Just because she isn't living in the space doesn't mean you give it up!
If there is someone who is very persuasive in the facility or at the doctor's office, they may be able to coax her into moving. The doctor could refuse to refill her medication unless she agrees to move. As others have said, if they can convince her that they are just "protecting" her medication, so it doesn't get misplaced, lost, tossed or stolen, rather than making any restrictions, and encourage her to give it a try, at least for a few weeks... maybe?
Staff at mom's MC have told me that they can't force anyone to do anything or take anything despite them all having some form of cognitive issues. They have to coax the person into agreeing, somehow making it THEIR choice! This is what your mom needs - someone who can reason with her and help her understand they are not taking her meds away!
If none of that works (it may take a few tries!), someone else's suggestion about telling her that if some emergency happens, a fall, injury, illness, whatever, and the state steps in, then she will NOT have a choice where she lives and she will DEFINITELY have medication managed, if not discontinued! Makes the AL seem like a pleasure palace!!
If you have someone (friends?) who helped move her things, can they take her to "lunch" at the facility and excuse themselves to use the bathroom, leaving her with staff? Sometimes trickery can work... Prearrange this with the staff!!!
It is going to be difficult handling this remotely, so hopefully you have some good, helpful people on the other end! But remember, you paid for the month, so you have a month to work on her. If some headway is made, but still no move, pay for another month and continue working on her. With no real bed, clothes, etc, she can't continue long at her condo. What about food, toiletries, etc? Who supplies that? She isn't going to be able to keep this up for long.
Should she get ill and they had to send her to a doctor, they have to know all of her meds and when she last took them. Maybe that will ease her mind.
You might also want to make a visit to her primary doctor now and take all meds w/you for him to ensure he has them all listed as prescribed meds. He may well already know all these meds and is ok with what she takes. There are times you/I may think someone is over medicated, but the doctor dispenses things until some reason is pointed out to them of side effects/quantities/etc.
I now have a brother in the same situation in a nursing home. He has numerous spine and other issues that require pain medication but all I get is arguments that he is addicted. Dependency is not the same thing as addiction.
Additional comment: I just read in one of your posts that your mom takes 3 pain pills a day. I would venture to say, if she has significant pain, she is not addicted - just dependent. Three pills a day would be under-treating her pain. To reduce her medication or under-treat her pain is cruel and inhumane. Again, I would go back to the doctor who prescribed the 3/day or find a pain management specialist and discuss increasing the number of pills or the dosage of the pills, i.e., like an extended release. Do not switch her to NSAIDS. Not only do these damage the liver/kidneys, they can cause serious heart problems. No elderly person should have more than 2,000mg a day and no more than 1,200mg if they already have liver/kidney problems. Besides the fact that NSAIDS aren't as effective as opioids to begin with. More people die of NSAIDS every year than those who are in pain and legitimately take prescribed opioid pain medications. The rest of the statistics of overdoses are people who steal prescription pain pills or those who die of heroin or illegal fentanyl smuggled in from Mexico.
Or perhaps there’s a reason he only prescribes one a day, because he doesnt think there is truly chronic pain there?
I would call the doctor to find out. If her meds can be increased by two pills, she should be happy.
I told her that no responsible doctor would prescribe her medication if it wasn’t controlled so she would have none at all
she said “I guess I”m in a pickle and I have to go” and so she went
she does not like it but she has her meds managed, it was either go or no medication
its a nice place, expensive but she has the care she needs
find out who is prescribing and report them if they are overdoing it
Have you tried showing her that you understand her reluctance, her fears, her grieving over loss of youth, health, vigour, independence? When we're young we have doors opening, paths to choose from, future possibilities that are exciting and almost unlimited. As we grow older our options narrow, and most of our lives are behind us.
When older people rudely rail against those who try to care for them, it is not you they are against, it is the hard things of life, and of getting older, that bug them. Of course in an ideal world they would not take it out on their carers. But some personalities do that.
We can fight their personality and resent them (easily done, hands up!) or we can figure out how best to help them manage their emotions and behaviour.
It sounds in this case like your mum has clearly stated exactly what she does not want - to have someone else control her medications. I understand that! It is likely that there are other areas where she fears that others will be increasingly controlling her life. Her choices are already limited by time and health.
1) Show her that you understand, and care about, her feelings about all the changes. Specifically mention the meds and ask what about it worries her.
2) Ask some questions to find out how she is feeing about other things.
3) Work through with her all the upcoming changes, and ensure she does not feel all control is being taken away. Work out some things she can have a say in and make it clear you will honour those.
If she has dementia or other cognitive issues, she may not be able to understand the severity of the results that her actions will bring, but I think you might try to explain it. Or might it be better for her doctor to do so?
I should ask the facility to put everything on hold for - say - 48 hours. Let the dust settle. Hold your peace. Keep talking to your mother but not about that. How often do you normally speak to her?
I think your mother might have jumped the gun, here. The nurse told her they would meet to discuss meds, not for the nurse to confiscate every tablet in her possession.
I don't know if this is true for this particular facility and your mother's particular meds, but I would remind her that "medications management" simply means, literally, how the medications are managed. It doesn't necessarily mean that somebody else will be doing it for her. If the facility is satisfied that she is able to identify her medications, understand her px, and remember to take her medications at the correct times, there's no reason that your mother can't be her own "manager."
Don't forget that a competent adult is entitled to refuse medications if she so chooses, to take them with whisky if it pleases her, and to do all sorts of other ill-advised things that drive me up the wall daily.
[Yesterday evening: my instructions were to ensure that the lady's "pivotal" (a type of pill dispenser with a timer on it, that releases the right meds at the right time and sounds an alarm) was at her bedside. Sweet lady watched me place it carefully there, then pointed out that the pivotal was empty. So it was. Her daughter refills it for her (but, I didn't snarl, only when she can be bothered). Oh dear, I said, how will you take your bed-time meds? Long story and a hurried conversation with my Shift Leader later - this lady had a strip cut off from an old blister pack which contained unidentified pills from goodness knows when which goodness knows who had left for her. That's what she was planning to take. My hair stood on end - but it was "up to her...").
Now for your mother, her taking more than the prescribed dose and running out before refills, and the possibility of addiction, muddy the waters rather. But it's still a matter of *discussion* in which she, the consenting adult, will be the decision-maker; and the primary conversation should be between your mother and her prescribing practitioner.
So it all depends on The Rules - what are they? It may not be too late to reassure your mother about what will happen.
We have a poster here, Dorker, whose dad has chronic pain and is in end stage cancer. His demented wife INSISTED that he was abusing Oxycontin. Dorker believed her.
It comes to pass that dad is hospitalized and in rehab and Dorker mentions this "addiction" to the staff at all of the places. The medical professionals see NO issue with the number of pills that this elderly man is taking.
Pain is a frightful thing. I know that you are far away and that that makes this whole situation terribly fraught. If you have a label of "addict" from a qualified medical professional, then so be it. But taking 3 pain pills a day does not an addict make.
She has decided to stay in her home now.
She was reported to the authorities after the last time she was in the hospital that she should not live alone. They called me and I told them we organised assisted living. Now I need to call them to update.
In home care is not an option financially. We have a Long term care insurance that she chose but only covers ALF or nursing.
ONE pain pill at some point in the day is probably not covering her pain well. Prozac is taken everyday, or it's pointless. An occasional Xanax is not a problem. A LOT of people take something to help them sleep. Without good sleep, chronic pain becomes the overarching theme in your life.
What she NEEDS is a pain management dr. who will listen and compassionately treat her. Then, when she feels she can ask for and receive the meds she NEEDS to keep comfortable--I bet she sings a different tune about moving.
Until you have lived with chronic pain-- the kind that NEVER goes away, but is simply managed so you have a semblance of QOL, she isn't going to be amenable to letting someone else handle her meds.
There are MANY different 'cocktails' of meds mom can take to relieve her aches and pains. Just labeling her a drug addict doesn't help and is super offensive to those of us who DO have to take something daily to manage pain.
Just my opinion. And personal experience.
Can't she forgo the medication management is it's for chronic pain? If she's on a lot of other stuff, maybe all they'll 'manage' is that and let her get her other meds on her own.
As a chronic pain patient myself, I would hate to have someone standing over me, telling me what I can and can't have, and when.
One of my clients in ElderCare had Parkinsons's. Her meds for Parkinson's were very carefully metered out. Her pain pills were on her nightstand and used as she needed them.
Shes supposed to have 1 a day of the pain med...she takes up to 3 that I know of and runs out ahead of the prescription and ends up in the hospital going through withdrawl which she translates as Im dying. Multiple times. Its a circle that continuously happens and is happening more and more often.
Step back, call APS (or have a friend do it). Do not sign as "responsible party" for any of her care, unless you are signing for her her POA.
The last time she left the hospital , she left against medical advice. They reported her to protective service. By the time they followed up a few weeks later I told them she agreed to go to ALF. So Im not sure if they kept the case open. Ill have to check