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My mother has dementia and cannot control the screaming. This usual happens when she is left alone. I hate seeing her so drugged. However, the nursing home said if she does not remain silent, she will have to leave. Can they do this? What recourse do I have, as her daughter?

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This is so difficult for everyone. You mother can't control her screaming (this is not unusual). Drugs to calm her are really the only option and they often do make people too sleepy. Some homes will use more medication to control the screaming, and some will not for the reason you mentioned.

Perhaps there are different drugs they could try? You can see that it's difficult for the other residents to hear your mother screaming, yet you rightly don't want her over drugged. If there is a good answer for everyone here, I don't know what it is. But trying other meds may be useful.

Carol
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Excellent answer. I finally got a Dr. to listen to what I was saying. Mom was in pain, was screaming, being combative and then depressed as well. They kept upping her morphine and adding many different anti-psychotics. I started to keep a log of exactly when she started these behaviors and when they were not effecting her. The Dr. listened and removed some meds and added a new one and my mom is back!!!! I don't know how long this new med will continue to give us the right response, but I am eating up every minute of having my mom back! Good luck!
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Our nursing home forced my mother with dementia to an in-patient psychiatric hospital to get her medicine set at a level that would control her agitation and aggressiveness. Sadly, while in the hospital, she inhaled vomit and almost died. The medical trauma advanced her dementia and now she barely needs any medication because she's lost so much of her mental capacity. It's a sad story and I feel nursing homes have way too much power over their residents. Our hands were tied. She was either sent to a psychiatric hospital or she would have to leave the nursing home.
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Having cared for a mom with dementia for over 2 years now and a mother-in-law with pre-alzheimers, one medication that assisted the agitation of my mom in the beginning phase of her dementia is called "depakote". Her doctor prescribed this medication at a very low dosage so that she is able to control her agitation yet remain calm and not sleepy. This medication "depakote" is normally used for agitated patients with dementia. This drug has been a tremendous help with my mom's stability and functionality. Depakote in conjunction with "Namenda" (which slows down the progress of dementia/alzheimers), my mom's dementia has improved tremendously from the rapid deterioration of her memory.... You need to find a doctor who is truly an expert in this field of dementia & alzheimers....I hope this information may assist you...Good luck to you.....
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This kind of overmedication to "control" elderly patients' attitudes & nursing requirements is not limited to patients with demential or to nursing homes... I felt helpless & angry when a friend's 80 yr old father had a stroke which left him with partial paralysis but mentally completely bright. I visited him shortly after in the hospital and he was mentally alert, had a positive attitude about physical therapy & regaining his mobility, and looked forward to leaving the hospital. I visited again one week later, when I could get back up to the hospital, and this time found him strapped into a wheelchair & sitting by himself in the "lunch room", a tray filled with a horrible array of monochromatic mush in front of him. He was drooling, babbling, and didn't recognize me - "Ma'm? Where am I? Why are they keeping me here & feeding me pig food?" - I made a frantic call to his son, thinking he must have had another stroke or other setback, and was told the hospital staff was giving him "necessary" medications "they give to older people" to control his attitude because he was too hard to "handle". I was outraged - what was the problem? Did he expect preservation of some dignity if he soiled himself? To be treated as a competent adult when they addressed him? Unfortunately, I wasn't a relative - had no say - and could only tell his son he was allowing the hospital to take away the only weapon Paul had to fight with - his mind. Sadly, but probably predictably, Paul developed kidney and other issues, and the decision was made (??!) to discontinue hydration & nutrition and just let him lie there for three days until he died... This should be criminal! He just needed the same treatment and help that would have been routine and expected for a younger person - not to be drugged out of the world...
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When my Mom needed rehab several years ago, the NH immedialely put her on some heavy duty sleeping meds, and tried to get me to admit her to the alzheimer unit. A nurse took me aside and recommended a small dose of a med called trazodone to calm her anxiety, and it worked well. I got her out of there as fast as I could, and she is still home with me today, doing fine and her alz has progressed along, but she is content. So I feel blessed.
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Well My MIL lets just say isnt a stranger to Precription drugs she started aricept 2 years ago also for 2 years someone has went with her to dr. because she always wanted more pain & nerve pills. Now with begining AD she is on same dosage of all her meds Im taking her in JUne to revaluate all these meds. I think she needs stronger pain meds She complains & if I gave her one every time she asked we wouldnt have any half way thru. but glad I read these post because she is on xanax for nerves I say agitated I dont think it works any more but I looked online she isnt on high dose but I want her to be able to walk.
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Some administrators lack integrity as well as morals. Case in point: my father was falsely accused of "Assaulting" an employee at the nursing home where he resides. Though nearly 90 years of age, with Parkinson's, Dementia, pressure sores, and inability to walk, the head administrator said he had put his hands around the neck of the nursing home's van driver. The next day, this same person changed his story by stating that, "He reached for her". Nevertheless, a few days later my dad was "Involuntarily committed". Interestingly enough, the administrator was not "Aware" of this emergency until days later, which is when the sheriffs arrived to transport dad. Additionally, the same driver still drove dad to his medical appointment the next day! Add insult to injury, this nursing home overcharged me nearly $9,548.00. I was billed through to the end of November. I gave them a check for over $15,000.00. I paid them in person on October 17th. About 30minutes later, I was informed of their decision to commit dad. Did they give me my check back? They knew all along that they weren't going to take him back. However, they first wanted their money (and a 6wk advance at that). So, he went to the hospital (as it turns out, without merit), we're looking for a new placement, we don't have the money back yet, and I find out today that the nursing home took my father's belongings and put them somewhere else! There's a term for this; it's called "Grandpa Dumping". It's illegal. When a nursing home doesn't want your parent anymore, all they need to do is call the cops and tell them, So and So "Is a danger to themselves and/or others". Quick and easy. Wisconsin has recognized this problem already. Here in NC, they're kinda "Slow". But, I'm sure now the word will be getting out. At least my dad is "Safe from Them".
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Emergency departments here in SO. Cal are use to NH dumps as well. The NH will call 911 to have a resident transferred for a "change in status" and when the ED/hosp. is ready to send the patient back to the NH, they will refuse the transfer. Happens all too frequently!!
Wheelie :-(
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My Mom is now 95 years old I am her 66 year old son Guardian/Caregiver in her
home since 2004. She is stage 7 Alzheimer. Her aggression / agitation has increased it's two different people. I did not want to drug her up. However since
at home and more control..{i do understand the nursing home issue} I have been
giving her OrganicTea with flavored water BEDTIME TEA or NIGHTY NIGHT TEA .
it calms her somewhat i repeat somewhat . Womb to Tomb . Peace be With You
All.
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My husband was put into rehab/nursing home after his hip replacement operation. Soon I noticed that ALL patients fall asleep right after their evening meal. Still, I couldn't imagine that all of them were drugged! One evening I carelessly drank my husband's fruit drink, kissed him "Good night" and started driving toward the town 120 miles away... After proximately 30 minutes I became sleepy, very sleepy.. I pulled of I-95 into the rest area, turned off the key... and woke up an hour later totally disoriented... When I questioned the staff regarding sleeping medication being in the drink, they flatly denied it. I could have died that evening...
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What have you done about your suspicions, FloridaMom?

My mom, in a nursing home, often wants to go to bed shortly after dinner. She did the same thing when she stayed with me. At my home I know for sure it wasn't drugs, and I have no reason to think it is at the nh.

I am so glad you were alert enough to pull off the highway and rest! Have you discussed this incident with your doctor?
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The situation is strange to say the least . A sleeping or calming agent in a drink ? How could amount be ensured if as in this case , it was not even consumed. Check medical charts of your love one. Get acquainted with close aids ,ask him. Things do go on in NH that allow aids to tend to more patients .HBO has done a segment on NH. It might not be as bad as it appears. KEEP CALM AND STAY THE COURSE.
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It is illegal to give medications even vitiamins without the knowledge and consent of the patient, POA, or advocate [ as family member]. The medical chart or record should have everything given to the patient... Also the blood tests performed reveals everything.... If you suspect something, you should let the director of the nursing facility be aware of your concern. You can also report suspicious acts to the medical board of California or the state where you are in.... Here is the link : http://www.mbc.ca.gov/Consumers/ They can shut down any facility for any illegal act....
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FloridaMom, that's awful if its true they are doing this. Report, and possibly, consider seeing if it happens again (but have someone else driving) make sure you have not had anything else sedating. I once had a near accident because I had sedation as a side effect on ketoconazole, and it not commonly expected with that.

The short answer to the orignal question is no, of course not - granted there is distress that ought to be relieved, but failure to try using lower doses of alternative meds plus any non-pharmacological means e.g. chamomile tea, music, aromatherapy, the right lighting for that person, rather than immediate resort to heavy antipsychotics is just poor practice.
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@Florida Mom - is he still in rehab? I wonder if you can get some of that drink and put it in a container and have it tested. I, too, am in FL and I'm beginning to think something isn't right down here. They told me that they can't have railing on the rehab beds because of a law. Yet if a patient falls out of the bed (my mom broke her pubic bone a few days ago and has dementia to a point where she wanders) they get written up.
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The law is against behavioral restraint. You can have a reminder or an alarm but not an actual physical restraint. For example, if a person can unfasten their wheelchair seatbelt it is a positioner or a safety device but if they can't it is a restraint. So, a lot of times it seems easier to not run afoul of the law and just fail to use anything at all for safety and make the family pay extra for a full time sitter. That's where a side rail that the person can put down themselves and a mat or pad near the bed plus a bed alarm might be the sensible solution, but asking bureaucrats and people who are terrified of them to be sensible is another challenge altogether.
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It is important to realize the Nursing Home is not prescribing the medications, The Doctor assigned to your care receiver is responsible for that function.Talk to the Doctor. Or find another Doctor.
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If the nursing home is giving sedatives in the manner suggested they must be reported. I like the idea of having the drink tested but that's not always easy for a private citizen. You could report this to your ombudsman or even the county. This is the kind of thing you read about in a detective story but don't believe could really happen. It it is happening, it has to be stopped. All medications should be prescribed by the person's physician as noted by Carespeaker1.
Please keep us updated.
Carol
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Do you think mom is happy screaming at everyone? I don't. I think she is living in her own private h*ll when her body betrays her in that fashion. If it were my mom, I would be concentrating on narrowing down the LEAST medication she needed to achieve the same result. Even 10 mg of some drugs make a difference. Sometimes a startling one.

Tell the doc you want her dosage on these meds gradually reduced until your mom is "back." "It breaks my heart that she is so sedated. Will you work with us on gradually decreasing these meds to see if mom can still be okay? Please..."

Monitor the medication. Ask to see her med chart every few days. Give the meds a full week at lesser dosages before you pass judgement. It's doubtful she's at the bare minimum dosage for her own little self. Docs prescribe based on recommended levels. And everyone is different.

Good luck. I hope you don't have to lose your mom one second before its absolute reality. BUT you can't keep her in misery for your own motivations.
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Oh, for heaven's sake. This post is from 2010. How on earth do these old posts get resurrected?
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Maggie, it's usually newbies to the site commenting on something that speaks to their current issues without realizing how old the thread is or how to post a new question.
I have noticed on other forums that old threads cam be closed to new comments, maybe should be considered here Admins??
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Another suggestion regarding meds. In my case, my wife made the circuit from the Home Health environment, ICU, NH and back home. A plethora of medications was prescribed at each facility. I kept a running list of meds to have available for the final destination (back home) Doctor to review when she arrived home.

Our investigation indicated she did not need two mood altering drugs. Be Aware!
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I think even though the original posters comment is old...this is something that sadly does occur in NH's...so maybe it's good it popped back up...there may be a reason..someone out there may be going through a similar situation...as much as I want to believe that everything is as directed and according to the prescribed laws, reality tells me different. I was a claims investigator most of my career and actually handled claims involving some of the more "upstanding" facilities and realities were there were issues of malfeasance...It's not something we want to think about, but a heads up or cautionary note is always good.....
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I do know from personal experience with Mama, at the time 87 and never taken meds in her life, but during her stint at rehab after an inhome accident, upon her dismissal from the facility, we found she had been put on an anti depressant...I asked who prescribed it and was told that it was standard procedure for patients "like my mother"....I was livid...her doctor never prescribed it...I asked. So it does happen, and that is frightening...Under her doctors supervision she was weaned off the anti depressants but just saying.....
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Cwillie, I think closing threads to new comments is a GREAT idea. On other forums, the threads can be retained as read-only threads, but no new comments are accepted. There's a caveat stating so and recommending that posters start new threads.

I too get waylaid checking posts that interest me only to find that someone has pulled one up and posted something relevant, or started a completely new topic.

Other forums also generally have a section for technical issues. Perhaps someone could start a thread on forum suggestions? We can always keep it close to the top by bumping it.
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GA, feedback forum. Great idea!
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I wish there were a feedback forum right now...see that Dorothy Avatar? That's not mine. Really??? What the . . .
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Maggie, I see the Dorothy avatar over Litldogtoo's screen name. I don't see anything above yours except that magnificent German Shephard (love those dogs!)
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Our nursing home also does not use the railings... and no more rubber mats on floor by the bedside either. What they do is lower the beds as close to the floor as it will go... so if they fall, it will be less impact.

The NH is now lowering the strength of my mother's Fentanyl patch, wanting to have her weaned off totally within 12 days. They are replacing it with Cymbalta - an anti-depressant/pain pill. I do not want mom taking any anti-depressants. I told them to hold off on that and that I would call them back... they did it anyway. So now, I will go in on Monday and be blunt with them - though always kindly - they have my mom! I will have to ask why the change? She was fine. Now she's feeling pain again and is not as lucid as before. So... time to engage the powers that be...
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