This is so hard to watch, and for the family too. Some LTC facilities are very opposed to controlling it because of the sedative effect the meds can have. I almost think I'd rather have physical pain!
Patient is on ativan 1mg Q4, valium 2.5 TID, no relief so far. Have you had a patient like this? What helped? Resperidal? Haldol? Add Xanax to the already antianxiety meds on board???
We are using soothing music, volunteers to come hold her hand etc...
Specializes in BNAT instructor, ICU, Hospice,triage.
She is finally more restful now. We have the xanax .5mg QID and risperdal 2mg BID. Plus the fentanyl patch for her generalized pain, and headpain, and abdominal pain. Pain is controlled at this point and bowels and bladder are doing good. Its just the terminal restlessness, but she has improved tons since the ativan is out of her system. It was a paradoxical effect of the ativan I'm pretty sure plus the terminal restlessness.
Glad your patient is better. Did I miss this patient's Dx and co-morbids? Can have big impact on which meds to choose especially if has dementia or Parkinsons. Also agree with other posts that duragesic may not be the best choice for LA pain control. Does the patient have enough SQ fat/muscle for adequate absorption? How much BT is she requiring per 24h? Also watch the risperidone dosage- I usually try to use no more than 0.5mg tid.
tgrosz
17 Posts
it seems to me that your lady is on a whole lot of pain meds
for a headache and tummyache unless i've missed something.
i also question the patch although i understand in ltc. any chance
getting her into a ipu to closely monitor her and get symptoms
under control? if not, may suggest getting off the patch and
try just using the hydocodone preferably on a prn basis but
if you don't trust ltc staff on a schedule basis and see. is she
eating? i've not had experience with risperdal for agitation, haldol
has worked most of time, and much cheaper. you got your hands
full, but you've gotten some good advice here, keep trying, it will
come. best wishes?