A recent conversation with friends of mine was a critical reminder about the importance of prescription management.
His 80-something year old mother had been living independently. She wound up in the hospital due to an infection. A neighbor found her on the floor, unconscious. After a lengthy hospital stay and no conclusive diagnosis, she was transferred to a nursing home for short-term rehab. She declined quickly, both mentally and physically. My friends decided to bring her home to live with them. He quit his job to take care of her.
Initially, weak and very confused, she was taking enough prescriptions to knock out an elephant. After considerable research and local medical consult, she has weaned off everything but meds for her blood sugar. She is her snarky self again (sooo reminds me of my mother) and is readying to teach a painting class at a nearby senior center.
From the book –
After a short hospital stay (from a fall), Mom was discharged to a nursing home for follow-up rehab. At some point while still in the hospital, she was asked if she was a smoker. This information was added to her chart. Upon discharge, rather than inquiring how much she smoked or asking if we thought it was necessary, she was given a nicotine patch and prescription. She weighed less than ninety pounds and only smoked about four cigarettes a day. Even the lowest patch was too high a dosage. We were not informed.
On the afternoon of her discharge from the hospital, my cell phone rang.
“Your mother has been taken to Rockville Hospital.”
“Hospital? No! She was just discharged from Hartford Hospital. She’s at Vernon Manor for a week of rehab.”
“This is Vernon Manor. Your mother had a fall.”
She’d been admitted to the nursing home that afternoon and was there no more than two hours before she decided to get out of bed (without assistance) and fell again. It wasn’t a bad fall, but they wanted to be sure.
When I arrived, she was still in the emergency area, surrounded by curtains and fitted with a neck brace. The brace was too large for her tiny frame and she looked a bit like a Pez candy dispenser. She recognized me, but other than that, wasn’t making much sense.
“Mom, why didn’t you ring for someone before getting out of bed?”
“I wanted a cigarette.”
She hadn’t smoked all week while in the hospital and thinking it was a good time to help her quit, we’d tossed her pack. “You don’t have any cigarettes.”
“I was going to smoke one with Joey. He has some.”
I sat down hard. Joey (my brother) had been gone for two years. Yes, he too had been a smoker. “Mom, you know Joey is dead, right?”
“Well, how was he going to give you a cigarette?”
“Where?” I looked around.
“Right there and he looks pretty good.”
“Ma, what are you talking about?”
She pointed above her, telling me he’d put on a bit of weight and it looked good on his face. His hair had also grown back. “Whatever shampoo he’s using makes it shiny.” My heart pounded and yes, I had goose bumps. It was eerie to be standing beside her bed, while she looked directly at my dead brother, who possibly stood (or floated) across from me.
She rambled on for the next few hours (sometimes to me, sometimes to Joey) while we waited for x-ray results of her head and neck. I sat and held her hand and even said, “Hey” to my brother. Eventually, she was discharged and they allowed me to drive her back to the nursing home, where I tucked her in for the night.
Before leaving, I spoke to the nurse in charge and asked what medications she was taking. Up to this point, it had mostly been breathing treatments and vitamins, along with a low dose of an anti-depressant. The nurse brought out her chart and the one noticeable difference was a nicotine patch.
We discussed the past few hours and she agreed. Even the lowest dose was too much. It would account for the hallucinations and extreme behavior. The patch was removed and the prescription discontinued. The next day she was more coherent and in less than two weeks was discharged. Joey will have to smoke alone.
And here’s a good read from ‘A Place for Mom’ – http://www.aplaceformom.com/blog/common-but-surprising-cause-of-dementia-symptoms/