My mom stays with me and is 92. she gets around well just using a walker, but her major downfall is the oxy codone pain killers and the tromodol pain killers plus she takes 3 Xanax a day also. She gets up at 3am thinking it is 8, gets her mind all mixed up, but says the pain killers are needed because her left hip is sore at night. She has had cortisone shots in an area of the back to help the hip and leg and that is the dr who prescribed the pain killers. I am wondering should I call that doctor and have him either call or write to my mom and say she should not take those pain killers? The Xanax has been ongoing over 20 years so I do not think I would get her to stop those. Any ideas? I have even considered asking her family dr. if he would prescribe some placebo pills for her.. thank you.
When it comes to pain, the American patient is woefully undermedicated due to the continual fear purported by the AMA and the DEA about addiction. That is how the specialty of pain management evolved. Studies have proven over and over again that pain medication given to the level of controlling true pain do not make a person high and that is generally a person feeling high and wanting more that leads to addiction. It would be very difficult for a 92 year old who is not managing her own medication to take "more".
While I agree that xanax 3 times a day should not be needed for sleeping and that melatonin could help her sleep, xanax is also used as an adjunct drug to pain control, particularly when the pain is exquisite. I personally use then accepted time for sleeping otherwise I don't go to sleep. When my mom had eye surgery which exposes the nerd on her cornea area, she was already taking vicodin but the ophthalmologist prescribed xanax in addition because he said the Vicodin on its own wouldn't be enough for this is your pain she was going to experience.
All I enable to do is share information about this based on years of personal experience in my own case, Jen in the care of others as well who had pain. And I can only reiterate to you that you (a) get her evaluated for dementia (b) seek the expertise of a pain management specialist and (c) in this case, don't do any adjusting on your own.
I think as you get older your ability to handle pain decreases.
The patient say she has pain so she is to be believed.
The Dr believes she has pain therefor he prescribed medications to relieve it.. Confused about the time so am I in the middle of the night, my eyesight is poor die to a cataract and mistake the long and short hands. maybe I should get clock with Mickey and Minnie on the hands. Oxycodone is a serious narcotic BUT it is better to be taking that than overusing Tylenol and damaging her kidneys.
Mom is 92 and pretty functional, so she gets a little confused - there are lots of reasons for that.
If it ain't broke don't fix it. Would you put her through a hip replacement?
Also, I don't know where I got the idea that she was taking xanax 3 times a day. I must have mixed it up with some other post. Is she taking this annex at bedtime to help her sleep, as it does me? I have had either valium or xanax at night for sleep for over 20 years, so I don't find this unusual. Like many others, I tried melatonin years ago and got no results (you don't know me but I am a nutritionist with years of homeopathic background; my natural bias is toward alternative health products - the use of medical medication is never my first choice unless the condition is life or death). The Life Extension Institute recently published information that the many people who are not getting results from 1 to 3 milligrams of melatonin is because results for often not obtained until people had between 6 and 24 milligrams. I'm going to be trying this soon on an accelerated dosage and I'll let you know (the FORM of melatonin is important, never pills or quick dissolving, only sublingual liquid or tablets).
I don't you can cure her of an addiction (if she is addicted) to pain medications on your own.
Seek out a pain specialist and make sure that person knows EVERYTHING Mom is taking.
Good luck.
Second would be to talk to her doctor about it. **Do NOT try to just take her pills away or "give her sugar pills" as another member advised.** She could have some very, VERY nasty withdrawal symptoms that would leave her in a much worse position than the 'confusion' that the actual pills are causing. At her age the shock of doing something like that may very well be too much for her system to take, and I'm sure that's not what you wanted.
(As a side note, my mother thought it was 'ok' to just stop her Xanax after a year, because she felt better... I came home to find her wedged under her bed, screaming that "they were trying to eat her". She has permanent nerve damage caused by the incident, and a deathly fear of any long term medications now.)
As other members noted, there may be other reasons for the confusion, it could be dementia or it could just be frustration about other health issues that she is having a hard time communicating to you. Sit down with her and tell her why you are concerned, maybe she hasn't thought of that, or doesn't see it that way. You won't know until you actually speak with her!
As I previously posted, my mom was elderly (90s) AND in pain. She was switched from a PCP internist, who gave her great attentive care, to a board certified gerontologist, who was detached and nonplussed about everything, essentially providing no significant contributions to my mom's health and wellbeing over the last 2-1/2 years of her life. I was my moms live in caregiver but my sister was her conservator, so I had no say in the matter of the choice of doctors. Please believe me, it was hard to live with an even harder to watch.
There is nothing wrong with trying to interface with a gerontologist but if you are dealing with issues of pain, please, as suggested before, ALSO see a pain management specialist. You can probably find one who has gerontological experience and that would be ideal.
Good luck to you and a pray for your mom to not be so tortured by the pain and confusion.
I do know my mom was on lots of Vicodin along with her other prescriptions and I and she was 90...I was furious that they would renew prescrips without seeing her or coupling with PT. I threatened to sue if he continued to do so. That stopped the prescrips. Then her regular dr went back to weaning her to Tylenol, ice therapy, and exercise. Her mental state got better. She went off other anti anxiety meds too and has been off 9 mo and is more mentally sharp than in 18 mo prev though she still has dementia. IM NOT ADVOCATING without doctors knowledge and physician mgt because this has to be done carefully and under medical supervision, but from my experience! there were too many meds easily prescribed with little follow up and understanding of an elders needs and first hand knowledge of the drugs impact. Seniors also aren't always able to articulate or are afraid to articulate how they feel under the drug. They either like the numbness or believe whatever any dr tells them is right.
Don't listen to the naysayers spouting fears of "addiction" to pain meds for an elderly person - that is a load of BS! It's medically necessary, not a psychological addiction like some druggie out on the street. The objective of pain meds for the elderly is to keep them comfortable in their final years - surely they deserve NOT to suffer.
Also, it is true that pain meds can cause terrible constipation. I found that magnesium oxide tablets work wonders to keep the bowel soft and things moving along nicely. It is a natural muscle relaxer (including the bowel and sphincter muscles). Most people have magnesioum deficiencies anyway, so this is a good supplement. If diarreah starts to occur, then the dose is too high, and needs to be reduced. My Mom takes one 250mg a day which works for her.
I urge you to research and learn and question - and be your Mother's best advocate.