My mom has MS and is in care of a nursing home. The past three months her pain management has been great, the new doctor found a combination of meds that helped my moms pain and spasms. Just yesterday at 3pm my mom called in extreme pain with her legs spasming. I’ve called several times yesterday and the nurses say all they can do is give her ibuprofen on top of her meds, even after they called the nurse practitioner. My mom has been in extreme pain all night long and can’t take it. Is this treatment allowed at a nursing home? I feel it’s neglectful. FYI her meds are oxycodone 5, fentanyl patch (62.5), cymbalta 20 in the am, and neurotin 100 in the pm.
I certainly think you should address what to do in this situation at the next care meeting!
We learn from each other here and I think that this is a question that is valuable to many folks here!
I struggled for a long time over the fact that my mom would complain only to family about her pain. I would call the Nursing Station, telling that my mom was in pain (because she had told me or SIL this on the phone); but when staff arrived, she'd say "no, I'm not in pain". (OY, dementia!!!!)
I got them to schedule all of her pain meds; many of them were PRN, i.e., if patients requests. It was clear that my mom was past the requesting stage, just not past the "weeping in pain" stage.
You state "Just yesterday at 3pm my mom called in extreme pain with her legs spasming". Did something happen to cause this sudden onset of pain? Is the pain different from the pain that your Mom usually has due to MS? Has your Mom had these spasms previously and did the routine medications prescribed help relieve the spasms or were additional pain medications required for the spasms to decrease?
I agree with MargaretMcKen that the pain medications are "very strong pain killers". Did the doctor's prescriptions allow for PRN Pain Medications to treat UNEXPECTED intense pain episodes as well as a routine scheduled pain medications? All of these medications are usually given on a schedule, although the oxycodone sometimes is given routinely and PRN (As Needed).
Please understand that the nurses are human too and that many of them will NOT leave your Mom in extreme pain ON PURPOSE. They have certain rules and regulations that they have to follow and sometimes those rules and regulations hinder or prevent the nurses from doing their job of relieving pain because of the way the pain medications have been prescribed.
Most nursing homes get their medications from a pharmaceutical company (which may be in a different city several miles away) who delivers the medications at a specific time of the day and rarely are willing and able to make an emergency trip to deliver medication to the nursing home. Also nursing homes cannot legally stockpile routine medications nor can the nursing homes stockpile extra pain medication other than the 30 days worth of medications prescribed for the resident(s).
I hope that the nurse practitioner is able to prescribe medications to decrease or minimize the spasms. Please keep in mind that sometimes it takes time to find the right combinations of routine pain medications and PRN pain medications to get the pain and spasms under control.
She has been sent to the er for this in the past, she refuses scans because of the pain of transfers and laying in them, so they won't do anything for her at the hospital but send her back with a note saying the nursing home needs to provide her comfort care.
Reading your responses helped me take my emotions out of this a little and remember the nursing home is not a hospital. It just upsets me so much knowing she's in so much pain and I feel so helpless. But it's not necessarily the nursing homes fault. If I cared for her at home I'd be even more helpless trying to figure out what to do.