My Dad's (88) meds are questionable, family member gave permission for deadly cocktail, Dilaudid?
I don't know how to begin.
My father has had moderate back pain his whole life. It was controlled well with Tylenol #3 as needed, only 4/day, 300/15/30mg and on a recent visit to my house (reluctantly by his POA) per usual I was given his blister packs and without my knowledge my dads prescriptions have been dramatically changed.
He is taking *1000mg of Tylenol three times daily. Along with, *1mg DILAUDID *three times daily AND *3mg of long Acting HYDROMORPHONE at *bedtime.*
I noticed an immediate change in my dad when I saw him and I'm mortified by this change.
He suffers from TIA's, mini-strokes. Is this cocktail going to harm him? I've read about all I can in reference to these drugs and I only surmise that someone is sending my dad to an early grave. I can't believe I just wrote that but it is how I feel about everything surrounding my dads POA.
My dad is a small 5'9, maybe 150 pounds, who slept all day at his long term care facility prior to this change in his medications.
I DONT KNOW WHAT KIND OF MD/DR WOULD PRESCRIBE THIS TO AN 88yr old especially given that he suffers from TIA's.
I'm getting zero answers from the POA, I've been banned from seeing my dad bcuz of my inquiries.
The Dr. won't take or return my calls.
IN DIRE NEED OF GUIDANCE, HELP, AN EAR...this is all-consuming. I've been through a lot of nightmares with the POA pertaining to my dad but this one is far too much to bare on my own...
It sounds like your father is going through a lot of pain in his back. My mother also has a lot of pain and sometimes the Tylenol III isn't as effective as needed. If her pain were more severe, we would have to add on some things. That may be what happened with your father. Severe back pain is terrible to live with.
Tylenol - which is paracetamol, yes? - is at its most effective when it is given as a continuous background pain suppressant. 1000mg three times per day sounds an awful lot until you remember that that is 2 tablets, three times a day. It's not a big deal. The standard over-the-counter dose for any adult with a normal liver function can be up to four times per day without ill-effect, although everyone must be careful not to exceed that.
The two morphine formulations appear to be adapted for day and night-time use, which makes sense. Morphine is used to control severe pain. Perhaps your father's back problem deteriorated to the point where without adequate pain relief he would have become immobile - as a risk factor for TIA's, by the way, immobility beats morphine into a cocked hat.
I'm not impressed that the POA is refusing to answer sensible questions coming from someone (you) who has been entrusted with administering the medication - he or she can hardly claim that information is confidential, and at the same time hand over responsibility to you for acting on it. But there are ways and ways of going about querying a prescription, and you need to tread carefully.
Personally, I'd have started with my friendly neighbourhood pharmacist. They don't just hand out pills without knowing anything about them, you know. A quick chat with your nearest one could have told you whether there was anything to worry about or not.
You did give the medication as prescribed in spite of your reservations, did you? I hope you did. How long was your father staying at your house?
Your father's doctor can't answer your questions, not just won't. He really is bound by rules of confidentiality. Doesn't explain why he can't return your call and tell you that, though - bad manners, but sadly common practice.
Reference the ban on your seeing your father, the refusal to discuss his condition with you, and so on… Ok, who is the POA and what are the issues between you?
Call Adult Protective Services on dad and perhaps they'll open an investigation.
I would ask you to remember, though, that your dad selected this person as his POA which most certainly indicates a certain level of trust. Reading between the lines indicates that you and the POA have a terrible relationship. That does nothing to promote dialogue. Perhaps working on THAT relationship would help you to understand your dad's care a bit better.
I think it would be irresponsible to inadequately control his pain because of some misguided fear of the dangers of narcotics, especially considering his age. The biggest downside to this class of pain relievers is the constipation issue, and that is the one that has kept me from using them for my mother, but since he has already been using tylenol 3 I think that ship had already sailed.
If you think this POA is over-medicating your dad call the police.
Sometimes my Partner seems to be so drugged and other times, he is alert. I think it is also the disease that causes the deep sleep he gets off and on. Personally, I would be a bit upset with someone calling the authorities on me and having an investigation started. Until they have walked in the Care Givers shoes, they will never understand how just "one more thing", will make their job even harder. That is not to say if you TRULY believe this is happening and this person is "killing" your dad, of course, you should do something. But, be careful. Love your DAD, his time may be short. You need to be able to see him. The POA will come around and you will be able to see your dad.
Maybe your POA would do you a favor and add your name to the list of people the doctor can speak to. There are so many things going on here and I hope that you can find your answers. I doubt the doctor is doing anything illegal. But, again, if you TRULY believe this, then report it. But, get ready for a battle as it will not be easy on your dad or the POA. Good luck and let us know how this turned out.
Even so, you are seeing that he is having classic side effects to having too much for his system to handle. What are the staff at the assisted living telling you, are they seeing this as a problem as well? I think mentioning what you observed and presenting this as a concern that perhaps his medication dosage some tweaking would be the way to go, and if the staff at the assisted living express the same concerns to the doctor and poa it can only add reinforcement to your observations.
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