Number of Meds per Resident

Rexie68 · Dec 1, 2007

I have mixed feelings on this. Yes, I think we can get rid of things like cholesterol meds and BP meds for borderline hypertension, but I see many pts do poorly when we try to decrease their antidepressants. We also routinely give Vitamin D to help prevent bone loss and Niferex for anemia. Many, many of our pts take some sort of routine pain medication.....anything from tylenol to dilaudid. When the x-rays are showing severe OA and such, and the pt is in pain, our goal is to keep the pt as comfortable and functional as possible. There has to be a happy medium.

CapeCodMermaid, RN · Dec 1, 2007

Of course some drugs are necessary and I am the first one calling the doc to get an order for pain medication. But most of these people take too many. No one needs 4 different vitamins AND vitamin D AND iron. Have you ever taken Niferex? The side effects of these things lead to nausea which leads to decreased appetite which leads to weight loss and skin breakdown. If you're in your 80's or 90's do you really care what your cholesterol is? Shouldn't we be more concerned about quality of life as opposed to lab results?

Sabby_NC · Dec 1, 2007

My thoughts are that there is way too much over medication in all areas of nursing, not just LTC facilities.

I look at trying to reduce (if possible) the amount of medications my patients may be taking.

These days I look at the medication themselves. You know the meds out there that have more than one action. So those are the ones I try to have my patients switched to.

CUT down the amount they ingest each day. Big money spinner for those pharmaceutical companies out there.

I am amazed you can buy a pill for ANYTHING. Beano's to stop flatulence. Heck we are made to pass gas aren't we? :uhoh3:

Color coded pill mania. Stop pushing pills, look at the interaction of them all and work out what is more beneficial for these people, especially the elderly.

You have to wonder if some of their confusion is simply related to their medications :uhoh21:

Long Term Care Columnist / Guide · Dec 2, 2007

You KNOW a lot of confusion is r/t meds---it's inevitable when an 80- or 90-year-old liver can only clear so much at one time!

Not to toot my own horn, but I am proud of the fact that I've gotten every single resident in my assisted living facility off PRN psychotropics except for one completely A&O gentleman who takes Ativan for sleep, and a hospice patient who occasionally needs an extra dose of Seroquel in the late afternoon when she starts sundowning and the usual TLC she gets from staff doesn't calm her down. We also have fewer UTIs since I initiated hydration programs for residents with a history of urinary tract problems; we give them 8 oz of water with each med pass in addition to any fluids they are already drinking (of course, this is on the condition that they are not in CHF or on a fluid restriction). One resident has even been able to come off daily antibiotics, and she has had only one UTI in the past six months.

So it IS possible to get elderly patients off some medications; what it takes is time, plus the willingness of nurses to assess them and work with their physicians to reduce the overall number of drugs they take. Unfortunately, our system is geared to the quick fix, and with the time constraints placed on nurses by increasing workloads and decreasing resources, it's not always possible to do thorough reviews of each patient's med regimen. "A pill for every ill" seems to be the motto of the pharmaceutical companies and the physicians who dislike treating geriatric patients and tend to dismiss their complaints with "You're X-years old; what do you expect?":devil: