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...
http://www.nccafv.org/state_elder_abuse_hotlines.htm
Dad is living in AL. The staff, well, it's as though almost all of the medicals are on a gag order, except for a few lovely PRN's who've said it all re: his meds through a wide eyed look or a gasp of air or shaking of their heads...no one has come right out and said anything but a look is sometimes worth a thousand words.
The onsite doctor was removed (that's what was told to us) and a new onsite is the prescribing physician, who is absolutely unreachable~
Oh my goodness, I'm guessing that I should stop perseverating on his meds sheet, *yep you are right and thank you again* for clarifying the doseage, 6mg's it says and is BUT there is an extra pill in the bedtime slot, (I photocopy everything, is that weird? I'm sure it is along with multiple other things I mistakingly do, eh, I'm only human) though the prescribing information is 1 tab, by mouth, 3 times a day (1,2,3,4) ---that's what written by the pharmacy...along with 3mgs being long acting.
You know @cwillie, what I wouldn't give to talk like civilized humans beings with my sister, love her just don't like some decisions she's making for our dad...in all honesty, on my life, the staff are afraid of the poa, or another explanation cuz they hear me but it stays between us...nothing is ever forwarded onwards.
Don't know if it's terribly important or if it might help but I am on the POA should she be unable or just does not fulfill her duties for our dad...
I can't thank you both enough for your help, hugs of strength and understanding to you both (I know we're all going through or have gone thru personal nightmares or grievances, my heart aches for any and everyone in a caregivers position)
Talk to your dad about getting you a Healthcare POA on a day when he is not taking the narcotics. Pay a lawyer to come to you it is worth it and most likely to give discount cause hell see the overdose. That is what saved me.
I was on fentanyl lollipops x6/day 1mg dilauded for breakthrough pain 20 count/day and 125mcg Fentanyl patches. I was a zombie homebound and need a nurse to feed me. My POA &HEALTHCARE SURROGATE took all the meds to a single pharmacist asked the narcotic load and stroke potential. He was shocked I a130lb man was alive.
Get all your meds filled at one pharmacy. Go to a cancer pharmacy and get your meds pre packaged daily so you don't screw up. If you take more than 5 meds is very impt.
Best of luck
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.
I posted my question because I FEAR FOR MY FATHERS WELL-BEING and I feel exhausted in my resources and my emotional being, reaching out for help, an ear...
I'm in my 50's, knowing a thing or two about severe pain having undergone knee surgery, hip replacement, coupled with three degenerative disks, I'd go on but this isn't about me, or my relationship with my sibling.
My aged father is presently taking:
3000mg of Tylenol per day
16 mg of Morphine per day,
THE LATTER IS NOT TYPICAL DOSING FOR THESE MEDICATIONS.
The differences that we saw, my husband and friends who've known my dad for decades were delirium, absolute confusion, falling asleep sitting at the dinner table with a fork in his elevated hand, significant sweating, shaking/tremor like, random acts that I've never witnessed my dad doing and because the medications are new, he didn't act this way 3 wks ago,5 wks ago, 8 wks ago leaving me questioning why, what's new in his life, the meds are new.
My father has pain, he's lived with me, I know he hurts but the dosing of the new meds are ridiculous and are doing more harm than good. (My dad was never constipated from Tylenol 3's, we discuss everything, we speak daily, we've been close as father daughter since I can remember.
I'm terrified...
(My post in by no means was meant to undermine other POA's and the copious, unending things they do for their loved one, my sister doesn't see my dad, there's a book to login upon visiting her name is never there,and the staff have told me I'm the only family member who comes to visit. To clarify, I'm not banned from seeing my dad, impossible HE WANTS TO SEE ME SO HE DOES, I can't take him out without the POA's ok, no one could if he still had his friends but that is another story for another forum.
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.
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.
You say elsewhere that you are not a "drug pusher" and I can understand why this issue is "all-consuming" for you. There are people who believe in and rely heavily on the power of medication. There are others who are suspicious of drugs and try to avoid them at almost any costs. Among my three sister and me, there are both points of view. We discuss medications for our 95-yo mother calmly and respectfully and, in spite of our different outlooks, we agree on what to try.
In your situation, you and POA (your sister?) have different outlooks on medicine. That is not unusual. There is no particular reason people in the same family would have the same point of view on this topic. Someone has to make decisions. The POA has that responsibility (if she is also medical POA), and you don't. Your father selected her for this role. Perhaps (?) because he knew her point of view on medications.
If you think your father is deliberately being drugged to death, take the suggestions in vstefans post. Have authorities investigate. But it may very well turn out that the medications are reasonable under the circumstances and nothing will be done.
I think the most productive thing you could do is try to make peace with the POA. Accept that she (he?) has the authority to make decisions and that her point of view is simply different than yours. Agree not to make fusses at the care center and not to question your father about his medications. Talk calmly and privately with her about your concerns. No accusations, please. Say that you'd like some input when decisions are being made, but acknowledge that she gets to make decisions.
I think getting back visiting rights to see your father often is the best thing you can do for him now. Try to make peace with the POA. If you sincerely think she is a murderer even after reading these posts about the medications, then report her and the doctor.
But, if you still think your father is being deliberately drugged to death at the request of his current POA, your options include contacting the office of long term care and the ombudsman, and possibly the state medical board. Ultimately, the doctor doing the prescribing is more responsible than the POA because they can refuse unreasonable requests. The doctor is not legally able to call you in all likelihood because the POA controls communications. You state he was sleeping all day even before though, and he had pain even before; and I can tell you the amount of Tylenol #3 he was getting would knock me out unless I could drink a pot of coffee or two with it - it really may not be a bad adjustment to his medication plan after all. Sorry this is happening and you can't visit - I hope you can work something out!!
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?
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.
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.
If you think this POA is over-medicating your dad call the police.