While I certainly believe that alot of nursing homes don't do as good as a job as they should, their are certain things about this article that I would like to educate the public on:
1) the nursing shortage and staffing ratios mandated by the state prevent us from giving one on one care-we are really busy and tired and I encourage family members to come in and help feed, etc. We couldn't do it without them!
2) family members' presence and questions DO help - they know the resident better than we do and also, if they speak up in this crazy healthcare system, they can ensure the resident gets better care.
3) many families insist that Mother sit up in the wheelchair all day, and wonder why is she tired, sitting in the hall in her wheelchair, slumped over sleeping? Because you insist that she not be able to be laid down after lunch and she is 96, she is tired and I didn't want to disturb her. Also, I invite you to come sit in a wheelchair all day and see how darn interesting you think living in a nursing home is- all kinds of lovely sights and smells. And sounds, like "I want to go home and I want my mother" and "How do I get out of here?" Activities can only do so much to cut into the boredom and depression that come from getting very old and losing everything you ever held dear- like income, mobility, social contacts and roles, life roles like the grandmother, the boss, the sister, the bread winner.
4) the respirdol or ativan we gave your father in the am is due to his hitting the aids repeatedly, or your mother yelling at the top of her lungs such things as "Don't rape me!". I feel so much sadness for her and have tried EVERY intervention from touch and therapeutic conversation, but she has done this every night for the last 2 months and the Psychiatrist prescribed the medication: we will carefully monitor it for side effects, and yes, sometimes before we get the dosage just right, the resident is zonked and I call the MD right away to let him know and get the dosage reduced or the medication changed.
5) We are careful not to use medication as a restraint, and the state monitors things like this very closely. We want your loved one to be happy and safe.
Here is the article- please give me suggestions to respond in such a way as to help our elderly population and take away the negative connation that we all medicate our elderly to make less care.
http://www.post-gazette.com/neigh_washington/20021020watank4.asphttp://www.post-gazette.com/neigh_washington/20021020watank4.asp
Home > Local News > Neighborhoods
Think Tank: Nursing suspicions
Panelists believe patients are put in an overmedicated stupor so they're docile
Sunday, October 20, 2002
While good nursing homes bridge the move from hospital to home, bad ones are criticized for doing little more than warehousing the elderly. Visit a nursing home as patients in wheelchairs nod off around the nursing station and you get the picture.
Elmo George of South Franklin, Sam Cushey of Peters, Bill Brna and Maya Patch, both of Carroll, Bernie Hobach of Washington and Verteree Johnson of Clarksville discuss whether senior citizens are overmedicated.
Patch believes they are. She coined a term for the drug-induced state she's seen in some nursing home patients -- zombie-ized. She believes patients have been drugged into a zombie state to make them more manageable.
Her suspicions about overmedication were raised when her mother-in-law, Dora Patch, was admitted to the hospital with congestive heart failure. She was prescribed medication in addition to what she already had been taking, Patch said. After being released, her mother-in-law was readmitted and taken off all her medication -- about 14 pills at the time. The scenario made Patch question why all the medication was necessary in the first place.
The response she got from health-care professionals was "'We want to keep her comfortable.' Could they all be that sick that they have to be zombie-ized?" Patch asked.
Patch does not oppose drugs when necessary for illness such as high blood pressure or diabetes but questioned medication that makes patients lie in bed and sleep all day.
"That's what they call you're being warehoused," said Hobach, who cited a report in the Journal of the American Medical Association that of people older than 65, nearly 25 percent a year are overmedicated.
If a patient is not mentally sharp enough to inquire about what doctors and nurses are doing, George said, he has to have family members or an advocate to speak on his behalf. It requires constant surveillance of what the medication is, the dosage and the frequency, why it's being taken and how it interacts with other drugs.
George, too, finds patients are frequently overmedicated. When attending to the care of his wife and later his sister, George said, he made sure he knew when the doctor was going to be in the hospital so he could ask questions.
Brna suspects overmedication has a lot to do with American culture.
"We've become a drug culture in this country -- prescription drugs or whatever. Somebody goes to a doctor -- I don't care who it is -- they do not feel that they get any good out of the visit unless the doctor prescribes a pill," he said.
Often the doctor will not tell the patient why he's prescribing the pill or discuss its side effects, Brna said. He also faults doctors for paying too little attention to medications the patient already is taking.
Johnson, too, believes patients are overmedicated. She noticed it when she placed her son, Carlton, in a nursing home for a brief time.
"I could tell he was overmedicated because all he did was sleep," said Johnson, who noticed the same lethargy in a neighbor when she visited him in a nursing home.
Like the other seniors, she said, "I think they do use medication to keep [patients] quiet. Most of those people who are in facilities, that's a way of controlling them. They are almost like zombies, slowed down so much so they couldn't think straight."
Cushey said he, too, had been to quite a few nursing homes. He's seen patients sitting in the hall and hanging over chairs, leaving no doubt in his mind there are too few personnel to care for patients. Their solution is to put people near the nurses' station, where the person at the desk can watch them.
But when you make a human being a zombie, you're wrong, Patch said. While she did not want to demean everything about hospital care, she did say of health-care professionals: "When you feel you've gotten that way or you're not compassionate enough to do whatever you have to do or you're so hardened, you should get out of that profession."
Since the experience with her mother-in-law, Patch said, she's become leery of taking drugs just because a doctor advises it.
"That's because you have your mental faculties," George said, referring to those seniors ill-equipped to stand up to the medical establishment.
"I agree with you," Patch said.
George believes seniors, for their own good, should take notes and recall what was discussed when visiting their doctors.
Patch said that for people of her generation, going to the doctor was thought of as if you went to God.
"I hope that people that are younger than us will start to ask more questions and realize that this could be them. Would you like to just be put asleep in a bed because 'I don't have time for you' or whatever the reason is?" she asked.
Lynda Guydon Taylor can be reached at [email protected] or 724-746-8813.
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cargal
411 Posts
Konni,
Many of you here at allnurses.com have helped me be the nurse I am today.... and given me the courage to continue to fight. If I don't work in LTC ..... I may write that book some day! Thanks for being there.
Carrie