Arrgh, filling out complaint forms for my cousin P in assisted living

[TerryJ2]

I hate doing this, but I am filling out a complaint to the state board of medicine against the assisted living ctr where P is living. This past wk, for the *6th* time, they ran out of her medications and she was sobbing in pain. (I can only assume they ran out and that they are not taking them and/or selling them.) I have met with-the staff and the director and tried to implement a system where they re-order 10 days in advance, but it is still a game of hot potato in regard to the dr saying she doesn't get the fax in time and no one follows up with-a phone call, the staff blames it on the dr, who only visits once a wk but supposedly checks into her main ofc every day and checks her faxes every day, and the admin, who listens nicely and takes notes but I have no idea if she is really doing anything.
So I have to fill out a separate form for EACH individual.
It doesn't mean anything good will happen, either, but it's the only thing I can do at the moment. Word will get around the staff and maybe they will all be more observant.
I just can't figure out why the staff is tired of hearing P cry and ring the bell repeatedly when it would take much less time just to put a Post-It note reminder on the file to remind themselves to re-order in a timely manner.

I am also going to spot-check the drugs once a wk. I am such a pain in the *ss ... but heck, they're supposed to be professionals.

Thanks for listening.

 

[AnnieO]

SIX TIMES?!

WTH are they DOING? I'd help you fill out those forms if I could! Also... If they're running out all the time... I'd insist on an accounting, because you can only assume they're not being, ahem, appropriated, but...

 

[InsaneCdn]

Absolutely insist on an accounting - the problem person may not be any of the ones you are doing the complaint on... but medications DO go missing. Unfortunately.

 

[DammitJanet]

I dont know what medications P is on but that is not even close to logical. Six times is way too many times considering how long she has been in this place. It hasnt been that long. I realize these medications cannot be on a refill type basis...unfortunately. Ugh. However, the prescribing doctor can give multiple scripts with the "fill when" dates written on them. Now that I only go to my pain doctor every two months, that is what they do for me. I get two scripts and I just give both to my pharmacy.

I think I would talk to the doctor and ask about getting that done for P and then YOU go fill the scripts...count them before you take them to the place. PITA yes. I can get mine filled one or two days before, no more unless something like the hurricane was coming. They filled them 4 days then.

 

[TerryJ2]

Yep. We get difficult child's scrips post-dated. But the nurse at the assisted living ctr said that these are controlled substances and cannot be written that way. Oh yeah?
We'll see.

 

[hearts and roses]

No, you are not the pita-THEY ARE!

Six times is more than unacceptable. I'd be writing everyone all the way up to your states commissioner for the aged z(if there is one). That's just deplorable for a facility whose job it is to care for the elderly! My God!

 

[InsaneCdn]

Your cousin is very fortunate to have YOU on her side.

You can imagine what its like for those who do not have family to take up the slack like this.

 

[susiestar]

This is beyond outrageous. Six is cruel and unusual punishment and someone's head should roll like a bowling ball and be used to knock the rest of them around!!!!
It is way past time for an accounting of all the pain medications and for you to make a complaint to the state bureau of narcotics. You can call them, if it is anything like it is here, and have them tell you the dates the rx's were actually filled on - it took me two minutes to do this when mine didn't arrive. Now I don't let them mail them, because we had problems twice. BUT it took me less than 5 min on the phone to be able to prove that I didn't fill them and beg for more, which is what the idjit nurse accused me of.

Get that report, then include it in reports to the state board that you are complaining to. It is PROOF that they are allowing her to go with-o her medications for days at a time. If you had her at home and allowed this there would be social workers all over you and possible charges for elder abuse.

You have been nice long enough. Now is time to let them know you have teeth. Wonder what a letter from P's lawyer saying that if this happens again a full investigation into their medication practices and a lawsuit for elder abuse will be filed on P's behalf would do?

Even if you don't get the atty involved now, figure out who owns the company that runs the place. Not the head of the place who is on site, the CEO of the corporation, and if it is a subsidiary of another corp, find the CEO of that corp. Call THAT person and name that person in complaints. You get a LOT more attention when you go to the biggest boss.

I do think that you need to fill them yourself if this is how unprofessional and irresponsible they are. There is no excuse. I am willing to bet that someone there is taking at least some of her medications, and that maybe part of the problem is taht they are running out early because of this. Then they blame the doctor or the pharmacy or whomever. I know more than I want to because exsil once told me the tricks she used to get the medications she is addicted to. This is one of them, sadly. They figure old people, esp with no kids of their own (you are not her kid, so in their sick minds you own't get as upset or do much) can't and wouldn't if they could make a big stink. And who would believe the old people, esp the ones with some degree of dementia. I was thrilled wwhen I learned exsil lost her license - I am sure you can imagine why.

You are NOT being a PITA. You are being a responsible caregiver to P. Be PROUD that you are standing up for her!

 

[TeDo]

And who would woulda thunk that warrior mom "training" would carry over like this. Time to don your armor again!!!!

 

[InsaneCdn]

And who would woulda thunk that warrior mom "training" would carry over like this. Time to don your armor again!!!!

I'm not sure she's taken it off much lately...
But it WILL be a good thing to have on... the whole mindset.

 

[Shari]

That's crazy... just crazy.

Any chance you have a small mom-and-pop pharmacy around that would work with everyone to help them remember?

 

[DammitJanet]

I would bet she isnt on anything carrying much of a higher class narcotic category than I am unless it is injection. I would be threatening them with a lawsuit myself. Elder abuse is all the rage these days. Heck, my mothers nursing home wanted to charge me with it for not coming to see her often enough!

 

[TerryJ2]

They have run out of Percocet once (that I know of) and her Fentanyl patch 5X.

I've got the paperwork here. I've got a cold and was too out of it to fill it out today. Sheesh, this armor is getting heavy!

I guess I forgot to tell you all that I called the nurse's station at almost 1 a.m. the other night and asked if the promised medication had come in. (It was due in at midnight.) T
he nurse said yes, but she had to ask the dr's permission to administer it. I. Hit. The. Ceiling.
"Why do you have to get approval from the same dr who authorized the medication? My cousin has been out of the medication for 3 days now. You give it to her right now! In fact, I am going to call and wake her up and make sure that you are in the room and I can hear you when she is on the phone!"
I called P and woke her up. She was sleeping rather nicely, sad to say, but when I told her what was going on, she was happy to engage in all the drama. The nurse came in and said she was going to get the medication. But she didn't have it with her. Grr.
P called me back about 5 min. later and said she had it. We chatted and laughed a bit, and she said I didn't have to go to all that trouble. (Oh, yeah, right.)

The next day, I called and spoke to S, the companion from Visiting Angels. She said "There is a world of difference in P today. She's like a regular human being!"

Sigh.

 

[susiestar]

Terry, you have GOT to follow up on the complaints. GET A LAWYER INVOLVED.

Going cold turkey off of fentanyl is VERY hard on the body. It could kill her. How do I know? I was on it for a year. The docs, the pharmacy, EVERYONE warned me to NOT go cold turkey. When the pain doctor changed my medication to another it took MONTHS. Had to go up slowly on the new medication and down slowly on the fentanyl to not trigger all sorts of problems in EVERY system in my body. There is a REASON P is out of her mind with-o the medications.

in my opinion THEY ARE GOING TO KILL HER by running out of her medications this way. IF this was a child, you would be in court losing custody for doing it a second time. I am not joking here. in my opinion you need to get a lawyer involved to let them know that they are going to pay a TON of $$ for every MINUTE that they let her be out of medications. Tell the doctor, the facility, the individual nurses, all of them that you will sue them all and WIN if they do this for even half a day.

If it would run the risk of killing a 40 yo woman, it is far worse for a much older person. Do NOT let this slip by. Make SURE they KNOW that you are done mickey mousing around with them and you will have them ALL in court.

It is one thing to run out of percocet (oxycodone and tylenol), a whole other to run out of fentanyl. Esp as they have a few days after they use the last patch. this is unforgivable. P probably has incredible muscle pains, bowel spasms and diarrhea, vomiting (both nonstop the days she is out of medications - not using a toilet doesn't make it less painful!) and any little ache hurts about 100 times worse because her body is freaking out. I ended up in the ER two times in under a week when the rx's for my medications got lost when I was on fentanyl. Both times they were very worried about my heart and dehydration.

 

[Liahona]

She is so lucky to have you. Go get um.

 

[TerryJ2]

Oh, dear, Susie, that never occurred to me. I just thought it was painful, not dangerous. Thank you.

 

[DammitJanet]

Susie is right Terry. Fentanyl is stronger than morphine and I dont know what strength she is on but there is absolutely no excuse for running out of a medication that comes in a patch and is changed every three days! You definitely have time to notice when you get down to two patches in the box and realize it is time to make a call into the doctor that she is about to run out of the medications. I fill a weekly medication box and when I fill mine and realize that as I fill it and run out of the medications, I know its time to call the pharmacy and place a call to have my refills ready to pick up...certainly a nursing home can be as on the ball as I am!

Maybe you need to be notified when they fill her prescriptions each month and call them 10 days ahead of time to make sure they are getting the scripts ordered. Just set your phone or email calendar and it will send a notice to your phone.

I know her percocets are her breakthrough pain medications but as long as that fentanyl patch is on, I would breath easier. At least that would keep a steady dose of narcotic in her blood. I know you have seen addicts on TV going through withdrawals and would never think of it in relation to P but that is exactly what could happen to her without her patches. I have forgotten to take my morning morphine pill and Im not even on a strong dose and by mid afternoon I have diarrhea. Just think about poor P. I can realize it and take a fast acting dose and get over it. She cant. Dont let this go and happen to her.

 

[DDD]

If you have continuing problems contact your State Ombudsmen's group. They specialize in nursing home oversight as volunteers and "know" when there is a pattern of unacceptable care. Sorry you all are having problems. DDD

 

[susiestar]

Terry, I was pretty sure you were not familiar with the medication and the dangers of withdrawal. She is very much in the same situation as any addict going off of opiates when they run out. It is inexcusable.

Be sure to tell them that if you even have a HINT that her life has been shortened by the recurring withdrawal due to their NEGLIGENCE then you will sue them and own everything they ever even thought of owning, or that their kids thought of owning. I don't sue people, but this is just. plain. cruel.

 

[TerryJ2]

Got it. Thank you!
Sigh.