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[FL]
I'm quite upset. I received a frantic phone call from my brother in law that he was asking me to call the facility because they were saying his inhaler wasn't on his medication list and he was having an asthma attack.
About 5 minutes later the night nurse came back and they had his inhaler with his name on it.
I don't know why they told him it wasn't on his list unless they didn't look, but they won't let him keep it at his bedside as a precaution.
What can be done about this? The facility is short-staffed at times and I'm also upset they thought it wasn't on his medication list when it always has been.
They have told him in the past it has to be locked up and only administered by the nurse.
That if he has an attack he just has to wait for the nurse to answer the bell or goto the hospital.

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If there is any dementia dx they won't allow this at the bedside without an MD order to do so due to overdose risk. Often panic attacks can mimic asthma attack. Overuse of some inhalers can be very dangerous.

Time to go in and meet with administration to see if MD order needed or how this is best and most safely handled. So very sorry for what must have almost certainly moved quickly to panic for you brother.
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Reply to AlvaDeer
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The Nh does want it available bedside bc it is a prescription AND there is the very real possibility of a resident with dementia being all “happy hands” and picking it up. That inhaler is perfectly palm sized to be taken without anyone noticing. And fwiw should it go MIA, it will mean a stack of paperwork to be done, plus having to be on the lookout for someone else using it and it probably is not an easy drug to get a duplicate RX on as those metered dose units are not cheap.

On the nursing station unable to find it, I bet the inhaler was not put into the hanging bag system that facilities use because the inhaler is a bit of an Outlier from the usual meds. By that I mean there is for each resident a bag on hanger with all their pills in it and most are in a 30 day pillow packs. Whomever was at the station looked at the bag to find his med and it wasn’t there. ((The bags usually are on a rolling rack which goes into a locked closet or room by the Nurses station. Then rolled out for whatever medication management required.)) But NH has to have a system for meds that are prn - like an inhaler or an epi-pen - where his inhaler was to be placed. It sounds like an oversight issue.

Here’s my suggestion:
- when you go to visit make it a point every so often, to go to the nurses station to get the inhaler “as your bro is requesting it”. & that you will take it to him for him to self administer and then you will quickly take it back. So that it puts him & his inhaler on staff radar. If he’s needing it every so often with no pattern, it is falling off their radar.
Plus you get to see precisely where it is set.
- at his next care plan meeting bring up this incident & also ask how it is being monitored for refill of the RX. I’m guessing it’s Albuterol with that safety cap and metered dose counter?, if so somebody needs to be super mindful of this and put the reorder in when it hits 25 puffs left. & probably needs to be done with a new RX signed off by the NH medical director. The inhalers probably are not coming from the pharmacy that this NH uses for 99.9% of residents pillow packs meds and is an outlier for refills. I’d ask about this at the care plan meeting so that if this is the case so then everyone is aware of the issue and in getting timely refills. & at the end of the meeting, you probably will be asked to sign off that the meeting happened and you write in something like “staff to monitor for RX refills after each use”, this way they are accountable.

best of luck in being his advocate!
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Reply to igloo572
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Does your brother have any memory impairment or beginnings of dementia? If so I would be careful to check whether what he is telling you is accurate or not. They may not be keeping it at his bedside because he is taking it too often or losing it, etc. You should maybe have a calm discussion with the nurse in charge or the admins to get a feel for whether other issues are at play.
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Reply to Geaton777
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