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An update on my mother. About three weeks ago, on February 12th, my mom went on a 24 hallucination episode, screaming at people and yelling at people that were in her bedroom. Tried to talk to her, but it was of no use, was up with her most of the night and day. At 9:00 on Monday night she fell asleep and slept until 4:30 on Tuesday afternoon. When she woke up she could not sit up or stand up. She still was hallucinating and on Wednesday morning early I called the Ambulance to take her to the hospital. They checked everything and stated that all was good blood work, no UTi's, CT scans, and they stated that all was good but her head. They did order some rehabilitation for her due to not being able to stand up or sit up in bed on her own. So she went off tot he nursing home. Now mind you I still do not have Guardianship and in my little county, they do not grant emergency guardianship. So she right now is in the nursing home as her own POA. She was admitted to the Nursing Home on 2/18/17 and they could not get her to do any rehabilitation due to her screaming everytime they move her including rolling her to change her, putting her on the toilet, moving her to a wheelchair. So for about a week she was just screaming. Then the doctor decided to put a medication in her ice cream at night stating that should reduce the anxiety. Now my mom has never taken any drugs what so ever unless they were vitamins. So she appeared to have her anxiety reduced. Tonight I was in and she was screaming at the people in the hallways and getting got out of the wheelchair and fell. The nurse on duty stated that she has been like this all day. I asked if she has been getting the medication and the nurse stated that she has figured out in the last couple of nights that they have been giving medication in the ice cream and she will not take it. It was so bad tonight, I never seen her like she was. She was horrible and she was very combative. I asked if they can just not give her the medicine. It would seem to me that not giving her the medication is going to be more detrimental to her health than some how giving it to her. I asked them to give it to her while I was there, and they gave her the medication in the ice cream and she took it with no problem. So is the nursing home not giving it to her when they are suppose to or what. My hearing is on Friday, but I do not like the fact that they may not be giving her medication when they are suppose to. Now you may ask "Why would they not be giving her medication, because when she does not have it she tries to get out of her wheel chair and she has fallen. I kind of get the feeling that the nurse wants her to fall and break something so she has to leave their facility due to her attitude. She has fallen about three times with this nurse on duty. My mom cannot stand this nurse and has called her names and not nice names. How can I check to see if she is getting her medication at the same time every night if I do not have guardianship yet? I have gone in at night when the other nurse is on and she is already out and has had the medication. That is about 7:30 p.m. Tonight when I went in it was 8:15 and she was still up and just a terror yelling at people and having big hallucinations and the nurse stated that she has not had the medication the past two nights. So she was out there and just yelling all kinds of terrible things to people in the hall and she thinks she owns the nursing home. I want her to have the medication on a regular basis or figure out something else. It was terrible tonight. The medication she is on is called remeron.

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Remeron is an anti-depressant. It will take several weeks of regular doses for it to get to a level in mom's body that it will provide any effect at all.

You need to get hold of the doctor and tell her/him that mom's rages and hallucinations are continuous. She needs a different medication, I think. Sometimes antipsychotics are used in situations such as these. These are very powerful drugs and they come with very serious warnings about side effects. But right now, it seems as though the possible benefits (having your mom calm and lucid) outweigh the dangers.

I would also ask them to do another urine culture. There might have been a false negative.

It might also be suggested that it's time to move mom to a Senior Behavioral Unit or psychiatric hospital. That should also be welcomed! A thorough investigation into what has caused this sudden change in her behavior would be a great relief to you, as her daughter.
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When you say they stated, following a CT scan, that "all was good but her head" - what did they find in her head?
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My mum does not always take her meds and gets this way! They cannot forcefully give them to her! It's against the law! I know how you feel! It is very distressing when my mum gets abusive and hallucinates!
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hi the nursing home only give the patient medicine ,, but for the most part it is for there own good like my mom ..she has a catheter when she was in one & they had pescribe a pill that would control her bladder. her urologist told me to never give her them kind of pills .they would have gave her some if she wet the bed.they have there own doctors that will evaluate them & give them what they think she needed not what she is to be on ..need to tell them to treat her right with the medicine she needs to be on !!! or put up what she is doing & do what they are suppose to do ..it is there fault there not treating her with the meds ..i think they do not want to treat them right to save money ...
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Remeron is an anti depresssant and would not really work with the screaming and yelling. Sounds like your mom should be on Seroquel which is for behavior and combativeness in alzheimers/dementia patients. My Mom takes remeron but it was prescribed because she had terrible anxiety and was not sleeping and its worked well for her but its not a drug they typically give for behavioral issues. You may want to ask the doctor about trying another drug.
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I might locate a psychiatrist and try to have her admitted to a psychiatric hospital to get an actual diagnosis and medication regimen established. It sounds like she needs immediate relief from her mental distress and that's not working with what the NH is doing.
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I agree with re-testing for a URI. You describe behavior that mirrors my mom's exactly when she had one. She was so combative she wound up tied to the bed in the hospital because she kept pulling her IVs out. The facility where Mom is at is not your enemy. They don't hold medications back to "save money". There are some patients who will focus on one staff member as someone who is against them and trying to hurt them. If you have not had a Care Conference meeting recently with medical and administrative staff, you need to call one immediately. Write down a list of your concerns and go in with an open mind and the idea of solving this. Mom needs help and it's up to you to advocate for her.
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Depending if she is competent or not the power of attorney can ask for a copy of her file. The nursing home must provide it in Pennsylvania with in 24 hours, but you must pay for the copies.

Also if her medication is not helping they can do a re-eval on the resident to see if either a up in dosage is appropriate or change the medication all together. Sometimes the body becomes used to the medication which numbs the effect of the prescription.
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Jaultzs comment above is on the right track by mentioning the actual " power of being "power of attorney" ... now, because medication being in her system is in serious question, her behavior is clearly warranting an actual hospital stay. If you can get her admitted they can start an IV and administer medication to "calm her, and then re-evaluate her status thru blood tests, MRI, psych tests, etc. and do not admit her to a psych hospital, no way, that would start a very damaging future for her... try to admit her to a standard hospital under the reasons she is not resting and is e periencing very high anxiety due to not being properly medicated. Also, I will impress the fact that just because she has a physician does not mean it's the "right physician. Anyone with dimentia (sounds as if she is heading in that direction) who goes on and off meds will actually go thru very uncomfortable "withdrawal" (depending on time being on specific meds and then the amount of time being off of them) and experiences serious anxiety and sleeplessness, exasurbating the actual dementia in such a way that mental diagnosis can be wrongfully diagnosed. Many questions would need to be asked and answered about her, but only the "power of attorney" (if this is what you are calling guardianship) is the only one that can move within the system for her as if you were her within her rights as an individual, and if you are going in front of a judge to grant that, make the fact known to the judge that your concern is her care including her medications are not being given correctly and she needs an advocate on her side to help speak for her to keep her health and safety at an acceptable level. (That will help you gain the needed power to actually move within the system) ... The situation about them hiding meds in food will only last so long, and yes as her power of attorney or guardian for health care, you can then demand to see her med list and their accounting of dispensment of her meds. You would also then have power to hire or fire physicians, and also have the power to discus with the physicians the needs to change her medication remove medication, add medication or change dosage of medications as her needs call for. But for the immediate; There are far better ways to talk and create environment for progressing to a calmer state for her, and ways to calm her placing her at ease to trust a calming med and better explain to her of how the medication will only help to remove her anxiety or at least lower it to a manageable level ( she just may need to be more informed about the medication itself to calm her down about it . she may also need a more appropriate medication  One that activates quicker one that is more safe and more effective for her specific needs ) ...and yes first being properly medicated would perhaps be needed to even allow her to absorb any discussion, or at the least create a very relaxed trusted mood to have her understand to take the meds so you and she can have a very progressive discussion ) .. Also if a person with potential dementia has a care taker (aid) that they do not like, you need to end that situation by demanding removing the aid from her care because the distrust and bad "vibes she has with this particular aid will only continue the anger and anxiety (speak to the curator and have the aid removed from her care and bring in another who she will at the least tolerate so she can remain as calm as she can while you are trying to get her entire situation under control for her.
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The nursing home isn't doing their part - either make 'em or put your mother in a different facility. I would not put up with any crap that the nursing home gives you if I were you
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My mother was admitted to a hospital due to a reaction to Bactrim, an antibiotic for a possible UTI. The doctor did not order a urine specimen without prescribing this. Four days later she had terrible in voluntary arm and leg movements and we found that she could possibly be allergic to antibiotic for a possible UTI. The doctor did not order a urine specimen without prescribing this. Four days later she had terrible involuntary arm and leg movements and we found that she could possibly be allergic to this particular sulfa drug. We found also that her brother had had the same reaction to this medication but his health was not dementia but Parkinson's. When this particular sulfa drug. We found also that her brother had had the same reaction to this medication but his health was not dementia but Parkinson's. When we brought her to the ER they gave her Benadryl and Ativan. And I believe they were giving it to her in the hospital as she stayed there for two days. She then went to a nursing/rehab home and ended up being there for about four weeks. At the beginning I think they were still giving her Ativan because she wanted to sleep a lot and they probably didn't want her to try to get out of bed because she was confused and trying to get up a lot. All I can tell any of you, is that you check with the nursing homes to see exactly what medications they're giving because the transition from the hospital to the nursing home had everything completely messed up. God knows, if it wasn't for me checking, they were going to give her that medication again that she had the reaction to. The scripts didn't go over right from the hospital to the home. And heaven knows, my sibling knows nothing about the medications or was there half the time so it was all on me. I pray for all of us going through this.
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Does this medicine or a similar one come as a patch that absorbs through the skin? - the nurses could slip it on her without her knowing - worth checking it out -

Good luck on the court date & we all hope so, at least that issue wil settled for you - let us know how it goes & if the dr finds a patch medication
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Sorry if my last comment was repetitious. I use my microphone and didn't recheck my texts before posting.
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She may not be getting it on time. I use a place for respite care and after the fact found out they have one nurse giving out meds...So to me there is no way anyone gets it on time. I feel for you. I put dad in for 10 days and when I picked him up he looked worse then when admitted. Come to find out, his primary care left off an important med that he gets four times a day. With Parkinson's, it is very important to keep same pill time 4 times a day). This med was a wean off med, which obviously did not happen. When he got home, I returned to his scheduled pill time. It took me a couple of days to realize he never got it...(was in primary's computer that it was discontinued...Clearly a clerical error. By the time I realized it, the restart caused him to be very confused, followed by a Dr visit, right to er, right to admission. My lesson learned is triple check everything medical personnel do. Hope you get all this settled and your mom gets on the right regimen.
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I agree. They cannot force her to take medication. I would ask to speak with the Supervisor and let the person who can get her to take meds explain to the one who can't what the trick is. Maybe, one of them is not as experienced or charming as the other one.
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