I received some good feedback from my post [I Must be Doing Something Wrong…] about dad’s medication problems. Most agreed that I needed to stay involved and make sure the assisted living facility gets dad the medication he needs and gives it to him as the doctor ordered.
I also discussed this issue with friends in my community including several who are retired nurses. None could comprehend why the nurse at dad’s assisted living facility refused to take his blood pressure without a doctor’s order. Dad had been without his blood pressure medication for awhile and I wanted the nurse to at least monitor his blood pressure while waiting to straighten out the issues with the missing prescription.
Thursday the nurse had told me that the doctor would be in dad’s facility on Friday morning at 8:30. Therefore, I was there at 8 on Friday. I waited until 8:30 when the nurse told me the doctor had called and wasn’t coming until “after 10”. I left to purchase a blood pressure cuff and to have a cup of hot chocolate break. I came back at 9:30.
I asked if his medication had come in the evening before as they had expected and they said “yes”. He was given the first dose of the renewed medication earlier that morning. (I bet they hurried for him to have it very early so it would look better before the doctor got there as dad rarely even gets up before 8!)
I just sat in the lobby reading my blogs waiting until I saw the doctor arrive shortly after 10. I asked that dad be brought in first and went in to speak with the doctor as well. Dad took a seat near the door and I sat across from the doctor. His doctor took his blood pressure and it was very good (better than mine!)
She asked about my concerns and I told her. She said according to the nurse, dad had only missed 4 doses (days) of his medication. I said according to my understanding it was more like 2 weeks, but I had no documentation on that. And I wondered to myself if they would fake a paper trail to show he missed less than actual. I feel frustrated to know that I don’t trust his ALF whereas I picked them because I thought they were the best.
Anyway, the doctor checked dad briefly and said he looked good. In fact, he looks much better than the last time she had seen him after his hospitalization. In the meantime he had been seen by a nurse practitioner from her office, but not by this physician.
I told her I was upset that the ALF refused to take his blood pressure without an order and asked that she leave orders to monitor his blood pressure. She said she was writing orders to monitor his blood pressure several times a week for the next 2 weeks.
I told the doctor I was also concerned about having him go back onto the high dose of his medication when he had taken nothing for at least for days (and I suspected more). She said she thought he would be fine, and even my nurse friend agreed that going back on his extended release medication would probably not cause him to pass out. I am afraid his dizziness will be increased short-term and this could cause him to fall and break a bone. Hopefully this is just my imagination running away on me.
Interestingly, the doctor told me she did not know they were waiting for a response from her office, either for the medication renewal or for orders to take a blood pressure reading. She had responded by phoning in the prescription twice, but wasn’t aware that the ALF had returned the prescription when it came under a brand name they didn’t recognize.
All in all, the day was anticlimactic because his medications had finally arrived and he was back to taking them as scheduled. Still, I believe he missed more than 4 days of medication though he seems to be fine so far. I left after talking to the doctor and took dad back to his room. He asked me what was going on as he was confused with the whole visit. I explained that they had run out of his blood pressure medication and he didn’t take it for a week. Now the doctor was just checking him to make sure he was OK. I told him I would see him the next day and he was OK with that.
Next week after I calm down some, I will speak with the manager of the facility and tell her about my concern with this whole episode. I want to know how it was possible for them to run out of his medication and not immediately get replacements. I want to know how to prevent a repeat of this scenario in the future. I know it is impossible to operate without making any mistakes. But I also believe they took this far too lightly.
They should have made greater efforts to get his prescription renewed immediately, even if that meant someone got into their own vehicle and drove to the doctor’s office and then to the pharmacy. That is what I would have done if I had known sooner what the issues were. Instead they just waited for a response from the doctor’s office after they sent a fax and did nothing when there was no response.
Then yesterday (one day after he started on the medications obtained at the local pharmacy) his prescription arrived from Medco! I am noting the date on my calendar so I can be sure they renew it in 3 months. I hate to take on more management issues but I don’t want to go through this again!