Monday, January 26, 2009

Medicine - to Take or Not to Take

A few weeks ago, I arrived at my grandmother's and began dispensing her medications into her daily pill boxes. She said, "I haven't had any of "Such-and-such" pill for several days now. I questioned her, and she could not tell me WHY that pill was not in the compartment, but she said, "So I haven't taken that pill in about 3 days." I asked, "Why didn't you get them out of the bottle and take them?" (since she is always telling me that she could put her own pills in the boxes and doesn't really need my help). Her answer... "Well, since they weren't in there, I figured you didn't aim for me to take them!" I have to admit, I was dumbfounded by this, and assured her that yes, I did intend for her to take them, and regardless of WHY they weren't in the boxes, she should have gotten some from her bottle and taken them - or called me to come fix things!

So, I had to laugh when I got this post from my friend Beka, whose mom JoAnn has been hospitalized for probably 8 weeks or better now. She discovered that her dad was not taking some of his medication. She writes...

  • Dad stays on his regular routine and is doing well with only the occasional glitch. For example, we thought Dad was taking all of his medications until this conversation yesterday. “Are you taking all of your medications, dad?” “Yes, darling, I am . . . except for one. I don’t know what it is for, so I don’t take it.” “Dad, have you ever known what all your medications were for?” “No. But JoAnn knows what they are for, and she usually gives them to me to take. When JoAnn is well, I don’t need to know what they are for.”

    So, Dad and Uncle Warren are going to swing by his doctors office to pick up a list of the medications he is suppose to be taking. Mom is much more responsive now than she has been, but she is nowhere near ready to start answering our questions about dad’s medications. We are just happy when she smiles.

As if this weren't bizarre enough, last week I was driving my grandmother home from her beauty shop appointment, and we were talking about someone we know who suffers from neuropathy. Mam-ma said, "I told my friend Ruby that she has pain pills from her doctor, and when she hurts, she ought to take one. That's what I do." I asked, " take what, exactly... Tylenol?" "No," she replied, "I take one of those pills the doctor gave me." "What doctor? When?" I asked. "Well, long before you came on the scene!" she tells me. "The doctor gave me some pills for when I hurt so bad, and I just take a half of one." I didn't ask any more, but I didn't know what sort of pill she meant. We got home and I was unpacking her groceries, and she opens a kitchen cabinet and fishes behind her dinner plates and retrieves a pill bottle. "This is them," she says, handing me the pills. The label is so worn I cannot make out all of the date, but I know we have not used this pharmacist in several years. Thankfully the bottle was about 2/3 full, and I could see a half a caplet inside - she had said she only takes one half caplet at a time. I read the name of the pill, but it didn't mean much to me until I looked it up at home on the Internet. It's Darvocet!

I don't know if you have experience with this drug, but my maternal grandmother took them like candy, and she didn't know what planet she was on much of the time. My Mam-ma also takes a "nerve pill" - Ativan - as needed, and I don't know whether she combines this with the Darvocet, but probably. There is nothing I can do... obviously since she hid them behind the DINNER PLATES, and didn't keep them in her pill box, she didn't intend for anyone to know she has them. And my consolation is that 1) the bottle IS 2/3 full, so she isn't taking much, if any, and 2) they are old enough they probably have lost much of their potency. But I can no longer show the list of medications I have for her and say with certainty, THIS is all she is taking! I have no clue what other "hidden treasures" she has in her home. When my mother's parents moved to a nursing facility, she found random pills all over the house - even in a shoe in their closet!

I know others of you have similar stories, so c'mon... SHARE!


Anonymous said...

My father was admitted to the hospital the first of Dec.for congestive heart failure. He was having trouble getting comfortable so he was given ativan (injection). He was having trouble breathing due to the fluid build up. He also had glacoma. Ativan is not supposed to be give to anyone with these conditions. We could not wake him for all most three days. He was not give food, water or any of his meds for three days. He could see, talk, and walk before... after the ativan he was bed ridden, could not see as well, having trouble swallowing and his mental state had drasticlly changed. He was 81 years old. This has been a nightmare for our family. The hospital sent him home in this condition. It seemed they really wanted to get him out of there. He died January 14. We feel he had a stroke while under the infulence of the drug. We
would like to see ativan banned from being given to the eldlerly.

Debbie Robus said...

First let me say how very sorry I am for your loss. I know you are heartbroken, and my thoughts and prayers are certainly with you.

This is a great example of WHY anyone who is hospitalized must have an advocate with them at all times. Like my grandmother's Home Health nurse told me, we are going to have to toughen up, and if doctors don't like it, too bad. We are looking out for our loved ones. So... we must ask questions - about EVERY drug given. Last winter, my grandmother was prescribed an antibiotic dosepack - Zithromax. She is allergic to this family of drugs. I cannot explain why her family physician ordered this drug for her - and over the phone, to boot! - but we refused it. Same thing this past fall with a pill for blood sugar that she didn't need.

I'm not saying you did anything wrong. What I am saying is that, sadly, we cannot rely on doctors and medical staff to always do the right thing or be paying close enough attention. Sometimes we know ourselves and our loved ones better than ANYONE else. There is NOTHING wrong with asking questions, asking for a second opinion, or just flat out refusing the advice/prescription you are given if you feel it is in error.

Again, I am so very sorry for the loss of your father to this unfortunate situation. As for Ativan, I must say I will be doing more research on this drug. I know my grandmother takes a very, very low dose. I also know it was a very helpful drug in treating my father's agitation when he was suffering from renal failure. Beyond that, I have to admit my knowledge about this drug is fairly limited. But I WILL be giving it a second look.

May God bless and comfort you in the days ahead.

D. Robus