does my fathers nursing home employ an incompetent doctor? (house, pharmacist)

[dad-care]

I know this can't possibly be an entirely unique situation... I just can't seem to find anything online that really addresses my specific questions.

First, a little background...
Dad has been battling complications from Diabetes for close to three months now. He is now an amputee and has bounced between the hospital and a nursing/rehab facility. The first stint in the hospital lasted for about a month and a half, spent a little over a week in the nursing home and then was readmitted to the hospital for almost another month.

Though depressed when first admitted he was mentally all there. Throughout the course of the many procedures and varying pain medications he did hallucinate and have a considerable amount of "crazy talk", but it would come show up with his latest dose and he would "come back" when the meds wore off and the pain began to set in. (meds included, morphine, methadone, diladin, some kind of patch and vicoden)

A couple of days before he was released to the nursing home this last time, he was rarely asking for pain meds anymore and was back to his old self for the most part (mentally anyway), had two excellent days at the nursing home... and then began talking crazy again... worse than ever because he was completely "there" and with it and would seamlessly talk about walking around the home, walking up stairs and down into the basement. He has yet to build the strength to even get into a wheel-chair let alone walk around on one leg... not to mention its only a one story facility.

The hospital had him on the smallest possible dose of Zoloft to lift his spirits...

After a couple of very scary days I asked for his list of prescriptions at the nursing home, figuring they would match the list the hospital supplied upon his release... turns out the house doctor added, Desyrel, Lyrica and Zyprexa to the mix.

I did an online search for drug interactions and right up at the top of the list is a description of what can happen when mixing Desyrel and Zoloft... pretty much describes his latest downturn to a tee.

Wondering why, when he was doing so good (my fiance and I visit 3 times a day religiously), this doctor would seemingly throw all of these other drugs at him? I am a graphic designer and it took 5 minutes to discover the potential ill effects of combining these drugs. Why would a doctor not know these things?

Is there any organization out there that could shed some light on my situation?

Are there any regulations in place for this kind of misuse?

Long winded, I know. Thank you for reading.

Please advise.

dad-care

[tiddles]

If you have POA you should request the meds in question be discontinued until your father is evaluated by another physician, preferably one who specializes in the elderly (if he is elderly). Also speak to a patient advocate at the hospital-they could advise you further.

[SouthAfrica75]

I would request a meeting with the following persons at the nursing home to discuss his care and what you have found and feel...... Ask them why he is on these particular medications.....

1. Administrator of the nursing home
2. Director of Nursing or as they sometime call them the D.O.N.
3. Social worker

You can also contact AHCA (Agency for HealthCare Administration) and file a complaint with them. www.ahca.myflorida.com or 888-419-3456

Sorry you're having to go through this.... hope things work out

[crisan]

Originally Posted by dad-care

Wondering why, when he was doing so good (my fiance and I visit 3 times a day religiously), this doctor would seemingly throw all of these other drugs at him? I am a graphic designer and it took 5 minutes to discover the potential ill effects of combining these drugs. Why would a doctor not know these things?

Is there a pharmacist at this nursing home? Don't they have a better understanding of drug interaction?

[dad-care]

Thank you for all of the advice given. Here is an update.

Since my initial post we had a "plan care meeting" at the nursing home (that included a social worker, director of nursing, nurse manager, administrator, dietitian PT & OT). We expressed our concern regarding his level of medication and the PT & OT agreed because of their interaction with dad and his inability to participate. The DOT was in disbelief of the amount of psycho drugs that dad was taking and wondered if he was abusive, disruptive or dangerous, but anyone that had been in contact with him agreed that this is not the case.

So a report was written to let the doctor know what was going on. A psych eval was requested (again) and they were going to stop one of the four drugs in question (one that wouldn't cause problems by being stopped completely).

The meeting was a week ago today. Still no psych eval. We have found that in fact it is up to the nurse assigned to dad on any given shift to determine weather or not to give him the drug we thought they were going to stop all together. Based on his level of lucidity.

Dad was given a chest x-ray on friday (because he had a deep cough we mentioned in said meeting) and in there words he now has "a little bit of pneumonia".

Very frustrated about the level of communication. Nobody seems to really know what is going on, what has been done or what is scheduled to be done. Every time I leave that place I have more questions than when I arrived.

[stacylee926]

I personally have no suggestions other than to continue being a pest. My dad was in the hospital for 10 days and then moved to rehab for 20 days. When we left that place we had 9 RX"S!!!!! I was furious but I chose to only fill the ones that I felt were necessary (I know, who am I to say what he needed, but I knew those RX's were crazy and he was fine in the end).

I do not understand the need to overmedicate the elderly. It is something that will send me off on a tangent in a minute.

Anywho - keep at it and my prayers are with you..