Number of Meds per Resident

onlyhope · Jun 23, 2007

most of my patients are on ten or more medications a day, but usually only one of these will be a multivitamin. most are medications for arrhythmias, htn, high cholesterol, and don't forget the 0600 nexium that EVERYONE seems to be on!

shoreh2000 · Jun 23, 2007

what a waste of time and money:angryfire :angryfire not to mention the many side effects....

paulla29 · Jun 23, 2007

what a waste of time and money:angryfire :angryfire not to mention the many side effects....

i agree. one pill gives them unpleasant side effects so the dr. orders another, and another etc. it makes you wonder if it is just making them feel more rotten. it's common where i work for res. to have close to 20. it is ridiculous. for 26 residents, the morning med pass takes 3 hours (on a good day).

CapeCodMermaid, RN · Jun 23, 2007

This is one area we need to change. We can advocate for our residents and tell the docs about polypharmacy. By the time many of the residents have come to us, they have seen 3 or 4 docs who might not be aware of what the other 3 or 4 have prescribed.

It's a cost issue, a quality of life issue...you name it. Did they get put on an antihypertensive 15 years ago and are still taking it even though they are no longer hypertense?

I don't think old demented people need to be taking vitamins. Will it extend their lives? Doubtful. Will it improve their quality of life? Nope.

I had an 89 year old woman in home care. Every morning she was supposed to take 19 pills...5 at lunch, a bunch at supper and more at bed time.

She told me one day, "Honey, old ladies don't need all this medication." "You're probably right", I said. "What DO you need?"

In all seriousness she replied, "Someone to talk to for half an hour a day and a hug...that's all."

UM Review RN, ASN, RN · Jun 23, 2007

I disagree that the elders don't need vitamins; I think they do. Vitamins promote wound healing in the resident who simply hasn't the appetite to stay healthy, and I think they do help prevent decubs and stasis ulcers.

I do wish that these vitamins could come in a 120-ml drink that they could take their other meds with as most don't drink enough.

This is why SNFs have Care Plan meetings. If you think a resident is overmedicated, it's always important to have your input in the patient's Care Plan.

NBMom1225 · Jun 23, 2007

I was a pharmacy tech for several years, and we had several elderly patients who would call in 15+ refills at once. One gentleman in particular would see an advertizement for a new drug, ask the pharmacist about it, and show up a few days later with an Rx for it! I think the biggest issue with multiple Rx's is having multiple MD's prescribing for one patient, and the drug companies plastering advertizements everywhere. :trout: Remember the good old days when you could read a magazine or watch TV without the constant marketing ploys!

pnurseuwm · Jun 23, 2007

Good grief, doesn't it take forever for the residents to SWALLOW all of those pills. Just thinking about swallowing more than 5 pills makes me nauseated! :uhoh3:

shoreh2000 · Jun 23, 2007

i agree. one pill gives them unpleasant side effects so the dr. orders another, and another etc. it makes you wonder if it is just making them feel more rotten. it's common where i work for res. to have close to 20. it is ridiculous. for 26 residents, the morning med pass takes 3 hours (on a good day).

as an x-surveyor....we always looked at psychotropic meds closely.....now with the new federal regulation changes with pharmacy tags....surveyors are looking really closely at all the meds and the justification for them....they are calling immediate jeopardy (ij) with the help of dhs pharmacy consultants!!!!.....what we need to do is to look at all the residents meds....assess the need for the meds....and keep on evaluating them....until the resident is almost drug free!

look at all the time and money the facility would save....not to mention decrease in falls, incontinence, behavior, etc., brought about by polypharmacology!

shoreh2000 · Jun 23, 2007

as a nurse consultant and an x-surveyor.....i disagree with giving our residents multiple medications....we....are so wrong as a society.....to treat what hurts with another pill....other cultures choose not to do that....and guess what.....they live a happier lives....our culture and practice in ltc has been to crush the 20+ pills....mix it with apple sauce....then shove it down a residents throat!!!!!!!.....what is the alternative???....get the resident involved in activities, social dining, assign a volunteer to them, offer them fluids, start a "happy feet" and walk and dance with them to the beat of spanish music, etc.

we have a spanish speaking resident who was admitted with g/t, none verbal, depresssed.....guess what.....she has come along way....the other day she was dancing the salsa during our "happy feet" program....she out danced me and i am a very good dancer!!!!....and she is strating to speak english!!!....wow!!!

i am just sooooo against treating our beloved residents as a garbage disposals and not a real human being!!!!!

flashpoint · Jun 24, 2007

I just cringe at the amount of meds some of our residents are on. I would love to be able to sit down with our medical director and go through everyone's list really carefully. One resident takes 18 meds every morning...and we get frustrated because he has a lousy appetite and is losing weight!

Balder_LPN, LPN · Jun 25, 2007

Good grief, doesn't it take forever for the residents to SWALLOW all of those pills. Just thinking about swallowing more than 5 pills makes me nauseated!

Now try being 90yo with no teeth or dentures, taking 10-15 pills that have been crushed and added to 30ml applesauce. And some of it is for things like your cholesterol, crazy.