My mother in law has been on a tricyclic antidepressant for more than 25 years with NO ill effects and it works wonders for her. The nursing home doc took her off as it has black box warning. her depression is worsening agitation is increasing and she overall psychologically is doing very unstable. they have tried several others, keep increasing and adding more and increasing dosage. Just getting worse. she and we just want her back on her original anti0depressant. Now they are starting her on risperadone, which as a nurse I know is basically a chemical restraint in her case/ when we asked her to be taken off due to adverse side effects they suggested maybe she wasn't getting enough and wanted to increase dosage to 2x a day. she will be a zombie.
she asks for it, we ask for it and they will not honor our nor her wishes. do we have any recourse?
Set up a face-to-face appt with the NH doc. If not face-to-face, then a phone consult. Tell him in no uncertain terms that you want her back on her previous medicine. PERIOD. If he hems and haws, ask him how you go about changing primary care physicians in the nursing home so that she can change to a doctor who will put her back on the medicine that worked.
Please update us when you can!
Carol
I have a similar situation with my mom in an ALZ facility. The dr wont prescribe my mom a small dose of anti anxiety nor daily pain medicine for my mom and because my dad has POA, he has final decision and authority and wont enforce it with the dr,for reasons beyond my comprehension.
Can you call an elder law attorney and find out what legal action you cantake against the dr and NH if they ignore your requests? Good luck and let us know what happens. Take care
I'm hoping that when you speak of "doctors" here, you're talking about a geriatric psychiatrist in both cases. If your mom has been on a tricyclic for 25 years, she may need a dosage adjustment, or it may be causing side effects that are unrelated to the depression.
Changing antidepressants is tricky because they take a while to come out of the system as you taper them off and a new one takes 2 to 4 weeks to kick in. Have you had a face to face chat with the nh doc about why he's changing the old med? Even 25 years ago, tricyclic were "old medicine". Your mom's body has changed a great deal in that time.
As to the "fact" that nh docs are not "always" at the nursing home, that's why it's a nursing home and not a hospital. If your mom needs acute, inpatient care to switch meds (and she might) get her to a behavioral hospital unit that specializes in this sort of thing. The nursing home my mother resides at is staffed with nurse practitioners, RNs and LPNs. This is the proper level of care for someone who is chronic and stable.
It's never cut and dry. There were a lot of other factors with my mother's health. But I will always wonder if I had been more assertive or changed facilities if she would still be alive - or not have suffered as much as she did.
We all do the best we can with the circumstances at the time, so although you may wonder, i try to have faith that things happen for a reason at the right time and right way. I have had a hard time watching my mom suffer with such pain and anxiety and the dr and MC staff not convincing my dad to give her meds to make her more comfortable. It makes me very upset. But i have prayed alot about it asking God for guidance because i cant get anywhere since i dont have poa. She has no other primary care doctor and my dad wont sign tbe authorization form to let me take her to a geriatric doctor outside of facility. I have written him letters and asked him verbally why he made those decisions and he wont answer me. When i ask the m.c. staff why tvese decisions are made, the director turns it back to me with questions. infuriating. Thank you for yr feedback
My mom was given haldol at the first facility after breaking her hip and she was catatonic for several days. I begged them to never ever give her that again. The next place gave her risperadol and even worse reaction.