Discussions that mention seroquel

Incontinence board


Deb,
I got a good laugh out of the pink cadillac, but it immediately brought something else to my mind. There is a woman in the nursing home with mother that says she was married to Elvis for many years and divorced him. So many of the other residents believe her and she tells them stories about their life. Did he not own a pink cadillac?Hmmm!
I had watched for sundowners in mother long before now and never seen any signs of it until now. The time is usually about 1:30 to 5:00 in the afternoon, but sometimes that is much different. There have been days that she remained that confused all day. There have been a couple of mornings that she has awakened around 2 am and not settled down until lunch time or later.
The latest change is her insistence on pulling her clothes off. This one is really out of character. When she left the nursing home 6 months ago, she would not allow the male nurse to do anything for her. When he saw her light on, he would smile and tell me that he would find one of the girls. Now she has been found sitting in the bed three mornings without a stitch of clothing on!
The NH has an inhouse doctor. This part, I'm not crazy about. When she was there last time, mother was put on two medications without me being aware of it. I let them know that I preferred to know of medicine changes. The nurse called me yesterday afternoon. She had returned only two weeks ago from 5 days in geri-psyche evaluation for the purpose of trying to find a helpful medication to help calm her but not put her in more danger of fall since it is of utmost importance to try and keep her walking at this time. Seroquel had been tried before she was admitted, and it caused total chaos. She would say that she was tired but never go to sleep. Instead, she was turning a walker upside down and backwards trying to walk on it. At the end of the five day stay, they came to the conclusion that any antipsychotic was going to cause more fall danger than helping confusion. On the last day they decided to put her on 2.5 mg of Xanax twice a day.
The NH called me and asked me to talk with her nurse when I came in yesterday afternoon about a medicine change that they had orders to make. I found out that she had been put on Depakote two days earlier by the NH doctor, and they were now asking to up her Xanax from 2.5 mg to 10 mg twice daily with even more for PRN in case of a really bad day. I had to veto this one! That seemed like too much change with a new medicine just added. I asked them to call the geri-psyche doctor and talk to him about the use of both medications because it had been only two weeks since her evaluation. They just called me saying that he agreed to try the Depakote but not to raise the Xanax dosage at all. Thankfully, the nurse was also in agreement. She thought that to be a too much of a dosage increase at one time also. I hope I did the right thing. I want her as comfortable as possible also. What I don't want is to increase the fall danger or see her zonked out all day.
Every day brings a new challenge. I already see the next one coming, but I don't know the answer for it! She is eating anywhere from 2 bites to 25% of meals. After the IV for dehydration, I was told to try to get at least a quart of liquid a day in her. This is not working no matter how hard I try. I doubt we're managing a pint a day without her spitting it out. Oh well, a new challenge every day.
Deb,
Thanks again for help. Do you feel used yet? Got a new one for you this morning! As I've told you, mom spent five days at a geri-psyche unit a couple of weeks ago being evaluated for possible medication to help with confusion. Seroquel had caused havok. After many evaluations and tests, it was decided that no antipsychotic would be of benefit at this time and could prove more dangerous. They are still hoping that she will stabilize with her walking. She will walk about 15 steps fairly well still on a walker. Everything they considered also had the effect of making her less stable if she got up unexpectedly.
I have now entered the NH five days in a row to be hit with medication questions. On Tuesday afternoon, I found out that they had put her on depakote two days before. The next day, I received a message that they wanted to talk to me about medication. When I entered the nurse's office they already had an order ready to increase Xanax to four times the amount she was put on in geri-psyche. I would not okay it until they called the physician that had seen her. He absolutely refused. He agreed to trying the depakote for a while. I asked one male nurse upon this questioning," what would he do if this was his mother?" He quickly replied that if it was his mother, she wouldn't be there anyway. She needed 24 hour care. It cut through me like a knife, and I said nothing. By the next day, it had got to the second in line of the nurses on staff. She called me outside and apologized. She said that they were a 24 hour a day facility, and if he didn't like it, he didn't need to be on the staff. The next day another young female nurse complained that she was taking up too much time. She was the one who had requested the order for 4 times xanax dosage increase. She said that it was frustrating to the staff working eight hours to be constantly answering a beeper on her chair to make sure she was alright. As I followed her to the office, she was met by her superior. The nurse overheard the conversation. She told the nurse that it was her job to answer the alarms! When she saw the order, she couldn't believe the increase requested. That's when I refused, and they called geri-psyche. Both of these orders were written and the first administered for two days, the upped xanax had been given only one time when I was notified. Is it out of line to request to be notified before mother is put on new medication. I realize they know more about meds than I do. However, they really pushed the geri-psyche evaluation, but now don't want to abide by it. If she thinks she was frustrated, she should be standing in my shoes and watching the changes day by day only hoping you are doing the right thing. The worst part, from what I understand, these orders are okayed by the DON and signed by a doctor AFTER administration when he comes in once a month or so and signs all orders for medication that have been written without even knowing histories of patients. Is this the NORM?