My mother moved to assisted living on Thursday afternoon. We took all of her medications, otc and prescriptions. They were all turned in. She had two pill organizers filled with her medications which she takes AM, noon, and PM. Different ones at different times. She also turned in the remaining medications in the bottles that clearly state her prescription and the prescribing doctors. We understood this was protocol and had no issue, but they never gave her the noon and PM medications that first day. Nor did they let her have some of the otc meds like Tylenol, allergy medicine, mucus relief, etc.
Next day, they brought her about half of her meds in the morning all at once. But they have yet to give the others, and have not given the diuretic and prednisone so her feet are very swollen. She has complained each day. They said they sent an order to her primary doctor on Friday to approve the other meds, but have not heard back and won’t until Monday of course. He did approve her otc meds to have in her room, but then they sent another order for the prescription meds they did not give her. I guess I am wondering why they were not all approved from the get go? They are prescribed from several specialists ( cardiologist, pulmonologist, urologist) but her primary care doctor should have all her prescriptions on file, correct?
So, Saturday night she calls me to complain again about her medications. She was on the phone with me when the staff member came in so I heard their conversation. The staff member was a little annoyed and short with her, and told her there was nothing she could do until the doctor’s order came through,etc. My mother gets very snarky with people, especially those “waiting” on her needs ( including me!)
Anyway, it is a situation where she just has to wait till Monday, and she can’t accept it.
But it concerns me why this wasn’t taken care of before hand? How could this have been avoided? We thought we were doing as they asked, but clearly we should have gotten pre-approvals from her PCP before she moved in(?) My sister and I have never dealt with AL before. There seems to be a lack of communication, which my mother has zero tolerance for. She can be very difficult, but she calls me and there is really nothing I can do at 10:00 pm on a Saturday night! I hope to get it straightened out, but in the meantime, she us saying things to staff like, “so people just die on the weekends because you can’t get ahold of the doctor?!!” I told her she was not going to die; she had been given the more important meds. It’s only been two days…..what am I in for?
As for the shower situation, that's familiar too. Until last week she wasn't given even one shower without my asking and she went as long as 12 days without being bathed. I was even lied to and told that she had a shower but refused to have her hair washed etc. My mother might not be able to tell me she had a shower last Tuesday but can absolutely tell me if she had a shower today. I feel like the administrative/office staff avoid eye contact and scurry away when I go in the office.
I worry about the residents who might not have family nearby or someone to advocate and look out for them.
All of my mom’s medications; prescription and otc were turned in when she entered the facility, which is their policy. They had previously gotten what they called an MAR (?) from her primary doctor, approving her meds and dosages etc. One of them, prescribed by her urologist, was not in his records for some reason. There were also otc meds and prednisone that were not on the paperwork he submitted to the facility, ( even though he was the one who renewed her prednisone last). So it took time to get those approved, The thing is, her doctor’s office is literally across the parking lot from the AL facility and the local hospital is across the street! Yet it takes days and days to get anything done. It just doesn’t make sense. My mother signed the papers and paid the deposit two weeks before she moved in. I offered to give them a list of her medications, but was told it wasn’t necessary, just bring them at move in. We also moved her things in before she moved in so we could have provided the meds beforehand, but that was not communicated. We thought a smaller facility would be easier to communicate with, but communication seems to be the biggest problem. Live and learn I guess. But my siblings and I are all feeling terrible about how this has played out. Hoping we don’t have to move her out. I don’t think she will want to go through this again.
I appreciate all who responded. I think we have finally resolved the meds situation for my mom, but not without serious damage done to her transition to Assissted Living! Those first days should have been so positive and reassuring to my mom and to us, her family. It was her reluctant choice to go to AL, and they really blew it. They definitely got her off on the wrong foot. I hope they can repair it, but I’m not sure. They just affirmed all of her fears about AL: that she will have no freedom; that once they are paid she doesn’t matter; that no one will listen; that she is being “ warehoused” till she dies”. And, they undid all of our reasons for suggesting AL in the first place; her meds would be well attended so she wouldn’t forget(ha!); she will have trained personnel assisting her with bathing,
(she went 6 days without a shower after they told her at intake that she would have bath or shower twice a week!)
I finally got her bladder control medicine approved yesterday, but it still was not given till today! I do not understand why it took so long. We turned in the medicine that clearly showed her prescription and the prescribing doctor, but for some reason it was not on the primary doctor’s MAR . I called his office and he called me back directly, and texted to he that he had approved it and it still took another day!
I spoke to the AL director about all of these missteps and to the nurse in charge of meds. I told them that she has not left her room in 6 days because she has not had her bladder control medicine and she has not had a bath! She is self conscious about both of those things of course! Whenever we asked any of the CNAs and/ or other staff, nothing. No one knew anything, or they would “find out” and come back, or they passed the buck. One shift would blame the other shift. I asked why they did not communicate with each other at shift change?
We tried to remain patient over the weekend because there is not much anyone can do about that. But her first shower should have been on Friday, and no one knows why she was not bathed. And as I stated before, she did not get ANY of her meds on the first day! Just so many things went wrong that should have been in place seamlessly. My daughter used to work at a very large county health facility and she said that this small, local ALF where my mother is, is so lucky that we have not reported them. I told her we will if anything else happens. We were so hopeful that in our small town, this beautiful, small ALF was available. It’s minutes from my home, it’s relatively new, clean and has residents whom she knows, and has great reviews.
I just can’t understand why this first week was so poorly handled. I have documented everything so if we have to file a complaint or meet with the head director, we will be prepared. I think we have been patient long enough. NOT the experience we were expecting.
IF your mother has been signed up for the medication administration program at this ALF, then they should have had this matter all straightened out before she moved in. I'm sorry you're going thru such a thing, and can only imagine the aggravated calls you're getting from mom. My mother also felt she was The Only Resident living at the ALF, not one of 100 people, and that as soon as she needed or wanted something, the CGs had to stop what they were doing to see to her every need. That's not to diminish this matter about your mother's meds; just to empathize with you about your mother's Me First attitude. It's hard (nearly impossible) for them to learn how to wait their turn in life, I know.
I hope this matter resolves entirely in short order. I would also highly recommend you sign your mom up for the docs who come into the ALF to treat the residents. That was the smartest move I'd ever made with my folks and facilitated a much easier run of things in general. Give mom a while to adjust to things too, and see if you can get her OUT of her apt and socializing with the other residents so she's not hyper-focused on what's 'wrong' and complaining 24/7
Good luck!
1) Pulled and provided her entire med list from her MyChart medical records. It included Doctor, dosage, timing, etc.
2) Provided a typed list of all of Mom’s docs, phone numbers, address, specialty, and meds they are responsible for.
3) Took all remaining meds in labeled bottles to facility and reviewed timing, etc with head nurse.
4) Note: I was a forensic drug chemist for years and understand the state and federal rules related to dispensing medication. I have never blamed the poor med techs as they have to follow protocol. I went to the nursing manager - she was responsible for ensuring this was worked out.
Even after all of that it took days for them to get her meds initially correct. I was insane.
All I can recommend is listen to her/ your instincts and check daily to ensure her meds are being dispensed appropriately. If necessary have them pull a med chart which should list meds given along with times. This has been invaluable especially when I suspected her Parkinson’s meds were not initially being given 1 hour before meals - otherwise they don’t work as well. They assured me they were but Mom was barely able to walk. When the med chart was reviewed - sure enough - they had been giving her the meds all at once at breakfast. I was furious.
I have to say, after less than a week or so of me “being a pain” to both the AL and Mom’s docs, it was worked out. And with minor exceptions for over a year they have her meds down correctly. At this point - especially with my Mom on Hospice care, the med techs are her/our “angels.”
Don't mean to scare you, but do pay attention to to your gut feelings. We placed MIL because we simply could not keep increasing her care at home, and budget constraints don't allow for a wide selection of facilities. This one seemed so promising...
I'm all for protocol. I think protocols are great, and nothing makes me happier than a checklist and an entire manual of Standard Operating Procedures.
But a protocol that does not follow the process complete from one end to the other is not a protocol, it's a tripwire. And this ALF's protocol did not start where it ought to have done, at pre-admission. A four to five day hiatus in your mother's medication routine because THEY didn't either get her ducks in a row themselves or advise you on the requirements for doing it for her is flipping outrageous.
Make a formal complaint with a view to the ALF's treating this as a learning experience and improving their admissions procedure. I don't care how common it might be, this is *poor*; and worse, as Alva points out, gets her off on the wrong foot. Not Fair.
Is your Mom capable of taking her own medications? My brother was on Level I and was able to administer his own meds.
If your Mom is not able to administer her own meds safely this will sadly take some time. I am a bit surprised that the number of meds and number of MD orders and how this would all work wasn't completely discussed with the MPOA and Mom prior to going in.
I hope they will get this together quickly. It has a bad effect on Mom's overall trust going in, and isn't a good thing.
If mom is symptomatic from lack of this med, I would call 911 and have her taken to the ER.
Your mother should be getting her meds on the times prescribed. Her water pill, IMO, is important. I will be surprised if the pharmacy does not tell them the same thing I said.
Is this an emergency with any of her meds? If it is, get hold of the DON and her physician to straighten out.
If not, let your mother be snarky. She will reap what she sows; people will find her annoying. Not your problem.
this won’t work with a dementia patient tho.