My MIL is on gabapentin for backpain and nerve issues, no idea what her dose is; my dog (yes, canine) was also on gabapentin for his degenerative spinal myleopathy, before he died – apparently it is one of those drugs that works across species. For my dog, it was really more about his anxiety than pain, but regardless it really helped him. I assume its making a difference for my MIL or she wouldn’t be continuing with it.
Dosing on Ativan has really been decreased, esp for seniors. Too addictive.
100 mg of gabapentin for seniors, sometimes several doses a day.
I do know one resident on 300 mg gabapentin 3X/day (so the 900 mg). But this person needs higher level of other medications.
I have some residents that use tylenol with their other evening medications to sleep better; some take a Narco at bedtime…key is to stay comfortable enough.
Just attended a NP meeting with a session on the new drugs. The Herpes zoster vaccine Hingrix is CDC preferred/recommended, age 50 and older, non-live vaccine, 90% efficacy over 4 years, two dose vaccine (day 0 and day 2 months to 6 months). An additional recommendation is hep B for all individuals with liver disease, including fatty liver (25% of obese adults have fatty livers). A new drug Abaloparatide (Tymlos) is for treatment of postmenopausal women with osteoporosis at high risk for fracture - however it is an injectible (80 mcg subcutaneously once daily for two years)…it helps build bone; expensive $10K/year and medicare is covering…saves money if it prevents fractures.
Gabapentin 300 mg at night is my “go to” for sleep and pain for older folks. But, you want to start at 100 mg. Max dose is 800 mg three times a day but that is usually way too much for the elderly population.
Dealing with credit issues with the folks. I received a credit card statement in the mail yesterday. Unknown account that looks like it was taken out with dad’s identity recently. I asked the care home to make sure any identifying social security numbers is kept under lock and key. Of course, the credit card company wants my POA papers and it will take a “week or two” before they can talk to me once they receive them. So frustrating.
Wow the gabapentin (100mg three times a day) works miracles for my mother’s breathing with exertion. Unbelievable! I guess this means there was an anxiety element to her extreme breathlessness. She does have afib and congestive heart failure but it was explained to me that the excess CO2 triggers anxiety which makes breathing harder.
She says she feels “great.” They stopped the Lunesta for sleep- another plus.
Today she told me she was nervous about going to “that new place” upon discharge. She has forgotten about her apartment at assisted living, at least for a time today.
I appreciated the comments above about routines hiding memory issues. So much has been revealed with this one week stay at the senior adult psych. unit.
@GTalum, been there, too. Someone opened several credit cards at once. Amazon was surprisingly the easiest to deal with. Chase was horrible and mean about needing the POA, the guardianship, and blah blah blah. I went in with my documents in person, but no, the credit card has nothing to do with the bank so they couldn’t help. I said to the last person I called that for their protection, they’d better put a fraud hold on that card because I’d never pay a penny.
I put a freeze hold on Mom’s credit reports after that. She was never going to need new credit again so why risk it. It is simple enough to do, even with the POA tap dance. I highly recommend doing that to / for all elders. (and my generation, too!).
Thanks @esobay , I have a freeze on mine and have been meaning to do a freeze for my parents.
Glad your mom feels so much better @compmom. Amazing the Gabapentin worked so well. Glad she is off the alcohol and Lunesta.
Another vote for credit freeze. My mother already had one when she applied for subsidized housing; it was a no-brainer to do a temporary lift for the agency to run her, then everything went right back in place.
YES to the credit freeze. That is something I did for my aunt and mother almost 6 years ago. We, (husband and I), also have credit freeze in place. It is important to make a police report for the record on any fraudulent accounts. Keep a record of every account, business, bank, and offering of “free credit” cards that they receive.
My fil had his spinal tap on Thursday and did show improvement in his walking as a result. Which, of course, will only be temporary. A culture has to be run on the CSF which they said would take ten days. As long as that is fine, I assume he will be referred to a neurosurgeon about shunt placement. I’m a bit concerned about timing as he and mil are planning to attend commencement halfway across the country in mid-June. I have no idea how long it will take to get him scheduled to see someone, how long after that to get pre-op done, how long the recovery is, if he will need PT afterwards, etc.
Fil has been experiencing declining mobility issues for some time. I had strongly suggested they join us when we visited ds on campus at Thanksgiving because I feared he would continue to get worse and graduafion would be too much for him, but he was bound and determined to attend graduation. Then he waited so long to see anyone that now the timing of any fix may preclude their attending.
I dragged my parents with mild dementia to daughter’s graduation as it was important to them. I’m not sure my daughter appreciated them being there. But, IMO, graduation is certainly not worth a decline in health.
Well just before admission to the psych. unit my mother’s cardiologist changed her meds, for no reason that I can discern other than him misunderstanding the AL request for occasional extra Lasix.
She went into the psych. unit on the 11th and they did not discover that she was having acute kidney failure (pretty bad) until the 18th (despite the fact that tests were done on the 16th and 17th, so they didn’t check-?) Her blood pressure was 68/4? due to dehydration.
At that point her discharge was rescinded and the psych, unit wanted to keep her. She needed to be hydrated via IV, medically, but they don’t have IV’s in the psych. unit so they opted to do it orally with water by the bed. Needless to say she was asleep most of the time (due to a med mainly) and whenever I visited the water cup was full. So I had to spend a few hours pushing fluids on her- no one else had the time.
I was upset that day and the unit was defensive. I told them I was upset at seeing my mother like that and left, to think about what to do. I didn’t want to have some sort of uncontrolled outburst that would invalidate my concerns!
The next morning I called the unit and firmly said “I want her discharged to a medical facility, or even home.” I got my brother and AL involved. She was transferred to the hospital next door to her AL, thank heavens and they seem to know what they are doing.
They are also willing to say that the cardiologist erred in changing the meds, which caused extreme dehydration, very low blood pressure and kidney failure. Geez.
I talked with the cardiologist and he, like the NP on the psych. unit, basically told me she is 91, DNR and has kidney failure and I need to accept what is happening to her.
Well, I took her out of that place and despite the cardiologist’s dire warnings, her kidney values are improving with IV and she will go home tomorrow.
I feel my job is often to protect her FROM the medical system as you all well know. (My brother “trusts the professionals” but is slowly learning to trust me- ha!)
Sorry @compmom, goals of care are really hard and we typically don’t discuss them in any detail until it’s too late. You are a good daughter and must be an advocate for your mom. Be patient with the health care providers as other families often make different decisions. I think maybe your cardiologist only erred because his goals may have been comfort care (extra fluid pill if needed for something like shortness of breath or swelling due to heart failure) while yours are comfort but also to maintain life with the best quality possible.
Personally, I have chosen comfort care only for my parents. I filled out a form for my dad not to be put in the hospital for any reason besides pain management. I know, from our previous discussions, he doesn’t want to live with severe dementia and I don’t think he has a quality of life now.
@GTalum - I think ds would like them to be there, but he understands the challenges of it all. I, on the other hand, would not prefer them to be there. Mil is lovely and able-bodied. Fil is a curmudgeon-like PITA (has always been - it’s not because of his health) and currently not able-bodied (though maybe the timing will work well, and his mobility will be better by then). He is the one who has been adamant about attending commencement. He is extremely proud of ds (as he should be, as we are as well), but I do NOT enjoy his company at all. Of course, I do NOT harbor ill will toward him and certainly hope he gets better. But, selfishly the weekend will be MUCH easier logistically and much less stressful if they do not attend.
GTalum I was after just one or two diuretic pills, but the MD changed three meds entirely. This was unnecessary and not what we wanted but I didn’t know enough and though the new regimen was gentler. I think it was a misunderstanding because I was carrying a message from assisted living nurses and he just thought the regimen wasn’t working if extra Lasix was needed. But it was only for a couple of weeks due to her weeping wound.
Anyway, we have a MOLST form and don’t want extraordinary interventions but she is not at the hospice point yet (I am calling them though).
The real problem is that the Assisted Living required her to go to the hospital for getting off alcohol (and she really didn’t need it afterall) which set in motion a chain of events, just as it always does.
She has been hydrated by IV and is better and is going back to AL tomorrow to vacillate between compliance and sneaky behavior with gin!!!
Ah, @hoggirl, it sounds horrid, but I spent the lead up to DD’s wedding fearful that FIL would triumph over his physical condition and get them both to our town and thereby ruin the day for us. Because he was a PITA by choice.
@compmom, FIL had several Rx for assorted options to deal with constipation. The AL kept him on one daily and only used the others as needed. Flash forward to an admission to the hospital and overnight stay. He was a problem patient and insisted on getting out. After working that through the system, DH was getting him dressed when it became apparent that the hospital had administered ALL the constipation meds, the ones that were just as needed. It was as if the dairy queen soft serve machine was stuck open. Oh my goodness, it was years ago and we still laugh and cringe at that day. Poor DH! Poor FIL.
Changing medical providers means the new ones do not know what the usual routine is and it is a time that is ripe for errors.
On the credit freeze -
I haven’t done that for MIL yet, but I did remove the checkbooks and credit cards from her home (with H’s blessing), redirected her mail to our house and put all of her bills online. Now that my SIL no longer has access to MIL’s finances, I have been able to get MIL back on track. Her taxes are up to date and her other bills are not accruing late charges and there are no more shut off notices coming. SIL was running up a tab with Home Shopping Network. I had H call (he has POA, we are changing it to add me and to allow us to act independently of each other) and tell them to cancel the card and that we would not be making any more payments. SIL freaked out and started ordering stuff COD, which was then sent to my house. At my son the mailman’s advice, we told the PO that we would not accept COD’s and they have stopped coming. THen, SIL had MIL call and beg for her checkbook back so she could pay the aides (the aides are paid by Medicaid!). After that, SIL made her call and beg for the checkbook to pay the “pain doctor.” All of MIL’s legitimate medical expenses are covered by Medicare and/or Medicaid, due to her (lack of) income, she has no copays or deductibles. It is so frustrating. I didn’t do a credit freeze because all of the mail comes here and we wanted to know if SIL was trying anything. She did try to get a debit card for MIL’s account but I changed the phone number to my house and when the bank called, H told them one wasn’t necessary and to mark the account that no debit or credit should be sent. EVERY day, it’s some other way that SIL is trying to rip her mom off.
@techmom99 – Is there a reason you don’t want to place the credit freeze? I realize that your SIL can still try to access your MIL’s existing accounts, and a credit freeze can’t prevent that.
My mother still pays her own bills, but I just thought it was prudent to place the freeze, since she wasn’t going to be applying for new credit.
@CT1417 -
H didn’t want to place the credit freeze and she’s his mom. I plan to bring it up again when I next do her finances. I have most of her bills on autopay and monitor it every month on the 3rd when she gets her SS deposit into savings and I move money into checking to cover those payments. If she was my mom, I would have placed the credit freeze but I think H is hoping to catch his sister doing something so he has grounds to evict her. She is an alcoholic and a pill abuser, hence trying to get MIL to the “pain doctor.” Honestly, MIL could still pay her own bills IF her D didn’t live with her.
somemom, the medical error for my mother was by her longtime regular provider…I watch transitions like a hawk and go over med lists with the before and after providers, and always catch errors…
Back to AL today, no alcohol, we’ll see. Local taxi company may get some business from her to local liquor store.
Take care all with your situations and thanks to everyone.