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Do assisted living facilities sometimes forget about dispensing medications to residents? Like maybe the staff is new and they don't give the medications or right medication for a week or so? Does this happen more than it should?

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Glad it was found out what the problem was. How was it found out. Did you speak to the RN? They figured it out for themselves? Brother stepped up to the plate?
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lisatrevor Nov 2023
My father told me. Apparently everyone, the facility personnel and my brother, were well aware of the situation. That's a really good thing.
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Update: I found out today that my father's recent abrupt pain was due to a change of medications that was ordered by his doctor. So I was right his pain was due to a change in medication. Because I don't have the POA and I am not on good terms with my brother who does, I have to take my best guesses to what's going on. The good news is the pain issue is now resolved.
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NeedHelpWithMom Nov 2023
So happy for you and your dad that this issue has been resolved.

Living with unnecessary pain is miserable.

Older people have enough aches and pains in their lives to deal with. They don’t need any new symptoms.

Since your brother is POA he is in charge of monitoring your dad’s care.

Put this incident behind you. Don’t dwell on it or look for future incidents to occur. Enjoy the time that you have with your dad.
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Lisa,

Instead of concentrating on how much you have helped your dad, why not look at your father’s care as a group effort?

Certainly, your dad is capable of expressing how he feels. I would think that if his pain continues that would be enough motivation for him to say something himself, either to your brother or the qualified staff.

Whether you approve of your dad’s decision or not, he has named your brother as his POA. It would be a wise choice to accept this decision gracefully.

Honestly, what difference does it make, regarding who says what? The only thing that matters is if your dad is receiving proper care.

You have said numerous times that you are glad that your dad is in an assisted living facility.

Have you ever thanked your brother for making this wise decision to move your father to a facility where he is looked after 24/7 by a professional staff?

Aren’t you grateful to return to being your father’s daughter instead of the stressed out caregiver?

I am not insinuating that your brother hasn’t hurt you. All siblings have had disagreements from time to time. Sometimes they are able to be resolved and sometimes they aren’t.

In my opinion, a person cannot point a finger at someone else without looking at the fingers pointed back at themselves. No one is perfect. Not you, not me, or anyone else. Unless something is unforgivable, let it go and try very hard to work as a team.

If there is too much water under the bridge with your brother, then be kind and stay out of his way. Respect that he has assumed an important role by being your father’s POA. Be supportive for your father’s sake.

Remove any bitterness from your heart. Bitterness will backfire on you. Be at peace. I wish you and your family all the best.
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"What she and some other posters don't realize is that I have pointed out numerous issues for my father that were then resolved. Without me my father would now have a very different life. In fact without my input my father has had a lower quality of life."

My question is, why do you post these questions here when you KNOW you're going to micromanage your father and pitch a fit at his ALF ANYWAY, regardless of our advice???

Naturally you'll get the facility-haters coming out of the woodwork with unrelated horror stories of what happened to their uncle's sisters next door neighbor and links to even more horror stories, just for chits and giggles. In 7 years of dealing with my parent's AL, I had NO ISSUES with QMAPS and nurses forgetting, forging or stealing meds. No issues at all. For what it's worth, which is absolutely nothing. Except that pain meds had to be SPECIFICALLY REQUESTED EACH TIME BY THE RESIDENT bc very, very few docs are willing to schedule them, for obvious reasons.
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NeedHelpWithMom Nov 2023
It does seem like Lisa’s brain is wired for, ‘Repeat! Repeat! Repeat!.’

She has a defensive answer for all of our suggestions.

If we looked up rumination in the dictionary, Lisa’s photo would appear.

I am not trying to be cruel. I know what it’s like to be stuck in a loop from my own experience. This is why it is painful for me to see her responses.

At some point in time, we do have to consider listening to others views and suggestions.

People on this forum, my ‘in person’ support group that I attended, my therapist and my friends certainly helped me to see that I was not seeing the entire spectrum of the situation that I was dealing with.
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"Read BlueEyedGirl’s post. It’s very well written and could help you."

I did. What she and some other posters don't realize is that I have pointed out numerous issues for my father that were then resolved. Without me my father would now have a very different life. In fact without my input my father has had a lower quality of life.

I am doing what I can without any conflicts but I fully understand that my father made the decision for the POA and he will have to live with all that brings.

I am trying my best to live my own life. I will be speaking tonight with an old friend. That should get my mind off this.
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AlvaDeer Nov 2023
That's good news, Lisa.
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I would ask Dad if he has talked to the RN concerning his pain. If not, then you can. Tell her that Dad has been complaining about pain and has been in bed for 3 days because of it. If Dad does not complain or the aides say something, the RN has no idea. This is a residence just like if Dad lived in an Apart. He needs to make staff aware he is having problems. At that point, the RN can go to Dads room and check him out. Then RN call his PCP or your brother. You've done what you needed to do to get the ball rolling. Then you step back and allow RN and brother to do their jobs. You ask no questions, you just make a statement and let it go from there.
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How in the world would we know? Difficult to prove, especially when dementia is in the room.
Do you suspect Dad is not getting his medications, Lisa?
If you, you should inform your brother, who is the POA, but given your constantly being sort of "at" him, I would have some solid proof of your accusations.
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Unfortunately, medications are not always delivered to the patient and while most are caring and competent nurses there are bad apples in every bunch. My friend was a victim of financial abuse during her stay at a nursing home. An RN and CNA thought it was okay to write checks to themselves from her checkbook. Unfortunately, this was not discovered until after she passed. I discovered the bank cashed the checks even though "her" signature was misspelled. The funds, over $11,000 and a page of blank checks were never recovered, but thankfully both employees were terminated. The RN was reported to the board of nurses. Please Advocate for your loved ones. If you cannot visit often hire a trusted individual like a local nurse to make weekly visits.
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AZDesertgirl Nov 2023
Dear YourCareCoach,
Thank you for offering these real solutions that our loved ones encounter while living in a facility. A trusted individual must oversee the patient’s care, frequently.

Thankfully the two employees were terminated. Sad, it was after your loved one passed. Are doctors the only ones who supposedly follow the Hippocratic Oath?
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Lisa, with all due respect - I know you care about your father. And I can certainly appreciate that. I'm going to say this as gently as I can - and I mean this in the hopes of preventing you from ending up like my FIL's sister is about to if she pushes much harder.

But reading your posts reminds me of dealing with my FIL's sister. And while I recognize that the situations are different - you see your father and FIL's sister only talks to him regularly on the phone and hasn't seen him in person in years - the overall impact is very similar - at least from 30,000 feet.

While you may *think* that your steady involvement is what is keeping everyone on the same page and what is keeping the facility and your brother in line - if your brother and the facility are anything like our family and the facility where my FIL is living - everyone is already on the same page and well in line.

My FIL's sister's constant involvement (and what we call her handwringing behavior at the slightest thing) is actually causing the opposite of what I hope is her intended effect. I want to believe that she has good intentions and is trying to be helpful - though her delivery leaves A LOT to be desired and she is burning bridges left and right in the attempt to ensure that her brother is taken care of. (there is also quite a bit of an attempt to absolve herself of her complete lack of involvement in her mother's care years ago but that's a whole other story).

By continually inserting herself into things that she only has part of the story for she makes huge logic leaps and bypasses all of us and does the wrong thing 99% of the time causing messes we have to clean up. And in the process, she simultaneously "supports" FIL's delusions and agitates him to the point that he gets worked up and then she gets off the phone with him and doesn't see the end result her "help" has caused.

What does that mean? It means she has become part of the problem. And if it continues our only option is going to be to prevent her access to him. It sounds absolutely cruel. And under most circumstances it would be. But in his condition - he doesn't need to be worked up and agitated by someone who isn't even here and who hangs up the phone and doesn't see the damage she is doing and who leaves the staff to deal with the fallout. And SHE isn't the one who gets the phone calls in the middle of the night.

As I have read your posts here - while I do think that you care deeply for your father - I also think you are deeply mistrusting of your brother - who your father chose as his POA. I think you still have a problem with that. I think you are LOOKING for things that are wrong. And I think that you need to take a deep breath and just enjoy your time with your father. Your brother is responsible for his care. You can point out issues that you see. But don't try to solution them. That's not your responsibility.

POA is a huge responsibility. It's not just pointing fingers and making demands. it is weighing and balancing and considering EVERY angle and possibility. And it is protecting the person from issues, even if that issue is themselves or someone they love. Don't make yourself a problem for your dad or your brother. Just love on your dad and make yourself helpful to your brother and stop tilting at windmills.

I will now step down off of my pedestal. And understand that this comes from a place of dealing with a well meaning loved one who only sees what she wants to see and never sees the entire picture, and who is making it impossible for the POA and the rest of the family to actually take care of my FIL because SHE doesn't believe we are doing right by him.
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NeedHelpWithMom Nov 2023
I truly hope that Lisa reads your posting more than once.
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OP: That sounds completely possible and consistent with all that I've read, observed, and experienced.

The other replies offer practical suggestions.  I’m here just to affirm your concerns. Pain meds are skipped, go missing, etc. all of the time. The last time my mom was in the hospital her pain meds sat on the cart for hours after she was supposed to have them. It was a busy night in the ER. I learned what had happened through eavesdropping.

I recently posted about a neighbor of mine, in a SNF for pain, who got no meds at all over a full weekend (same for everyone else around him). Horrific understaffing.

And then, of course, there is this sort of thing:

"More patients sue Yale over fentanyl diversion they say left them in excruciating pain | Connecticut Public (ctpublic.org)" https://www.ctpublic.org/news/2023-10-17/more-patients-sue-yale-over-fentanyl-diversion-they-say-left-them-in-excruciating-pain

(“fentanyl diversion” refers to an addicted nurse stealing the fentanyl and replacing it with saline)

I had a home health aide here at my mom’s once (extraordinary person; so smart, so fantastic at her job; and a real “see the good in everyone” type) who, just before leaving, gave me a broad smile and said “you really need to hide your mother’s pain medications.” 

And yes, there’s simple forgetting and mix-ups.

Every time I check the meds in my mom's electronic record they are wrong. I get the errors corrected and new ones appear. It's nuts.

Again, for actual practical suggestions, see the other replies.

Good luck and take care.
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lisatrevor Nov 2023
"Every time I check the meds in my mom's electronic record they are wrong. I get the errors corrected and new ones appear."

That's what I'm concerned about here. I can't access the electronic record because I don't have the POA. My brother would have a fit if I asked or said anything about this.

I spoke with an aide this morning. I didn't say anything about him possibly not getting medication. I simply told them my father has been in pain and this is unusual because it was controlled well for several months now. They said they know he was in bed the last few days. They said they will report this to the doctor. They said. They didn't write anything or input that in the computer. I'm concerned but will be there tomorrow to see if there's improvement.
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I get you are close to your Dad & care.

I don't get the method of checking if your assumptions, suspicions or conclusions are correct. Seems like hints implying wrong doing, awaiting someone else to confirm.

Clear communication cuts through all that.

As said.. Dad, you appear to have pain? Do you? Did you tell staff or your Doctor?
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Your brother has the POA, he will handle this. I am sure the facility is aware of this.

Or, ask your father, you seem to be there everyday.

More questions to find fault with your brother and his handling of your father.
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NeedHelpWithMom Nov 2023
If I were her brother I would be sick to death of feeling like I was walking on eggshells.

We have only heard Lisa’s side of this story. There are always two sides.

This situation is way more than a simple misunderstanding between the two of them. It’s an ongoing feud.
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Who has Medical poa or health care proxy?

Inform that person that dad's medical status has changed.
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MeDolly Nov 2023
The brother that she keeps posting about has the DPOA, she has weaved him into one of her responses below, yet again.

This is one of her "What Do You Think" episodes.

She, he or whoever we are dealing with will continue as long as we respond to these posts.
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How do you know that, I guess Dad, is not getting his meds. Again, you should not have anything to do with this because ur not POA. In Moms AL there are Medtechs with med carts. Each cart has the meds and a schedule. Each time a med is given the Medtech must initial the schedule. If the med is not on the schedule, there is a reason. My Mom kept her doctor but some ALs have their own. Maybe the resident went to the Drs and it was felt he/she did not need the med anymore. Maybe it was replaced. I would think the RN would be reviewing residents prescriptions. They are the ones who would put it in the schedule, I would think. You could ask the RN but she is not obligated to tell u anything if u do not hold Medical POA. And you know what happens when you try to talk to brother.

Why can't you just visit Dad and not nit pick everything. Again, brother is overseeing Dads care. He may know things he is not obligated to tell you. Its between him, Dad, Dr and AL. You could ask Dad.
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lisatrevor Nov 2023
My father was doing great up until last week then within days he slowly started having pain again like he had before he was prescribed the right medications months ago. Last week he was at the workout room every morning for an hour and a half. Then hangs out with his friends. The last three days he's been mostly in bed and in pain. There's definitely something going on that came on abruptly. The only thing I can think of is that because of the personnel changes they may not be giving him the right medicine. It's only a best guess. Like you said I can't get too much involved because I don't have the POA and me and my brother are not on good terms. I just wonder if the facility has missed some of his medications. Does that happen?
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