Can I as my Mother's POA refuse a medication she is taking at the nursing home she is in? She was admitted to the nursing home in September of 2020. She weighed 196 lbs. Around January she started exhibiting more aggressive behaviors (she has a diagnosis of frontotemporal dementia). Throwing things, grabbing/hitting at people, inappropriate sexual comments, etc. She's not in good physical health. There's only so hard she can grab/hit and only so much force that she can put behind a throw. Those behaviors need to be addressed. It's not ok for her to touch anyone else in anger. I completely see that. The psychiatrist at the nursing home put her on an anti-psychotic medication to try and manage the behaviors. By March she had started to gain weight. I questioned the weight gain in April and was told that she was just forgetting that she had ate and was eating twice. In June at her planning meeting I question the weight gain again and am told that dementia patients sometimes forget they've eaten and are constantly looking for food. I questioned if it could be the ani-psychotic medication that was added in January (weight gain is a top side effect from what I've read). I was told it was the dementia. Since then I've went back and forth with them about the topic. The psychiatrist has admitted at this point the food obsession and constant hungriness is more than likely due to the medication but she feels like her weight gain is worth her not exhibiting the aggressive behaviors. I feel like they should try something new since this is the first medication like this she has ever taken. When she went in the nursing home in September she weighed 196 lbs. When they weighed her mid-July she weighed 244. That's 48lbs in less than a year with the overwhelming majority of it happening since January. She can't keep gaining weight at that rate of for no other reason making her already limited mobility worse.
Can I refuse this medication for her and demand them to try something new? They act as though I can't make that decision without them kicking her out. Can that happen? I know those aggressive behaviors need to be managed. I'm ok with that. I just don't think this is a side effect that can be tolerated.
Have you considered having your mom admitted to a geriatric psychiatric facility to help figure out her meds?
A nursing home is no place to do the sort or trial and error administration of psych meds to see what will suit mom best. She needs to be in a place where she can't do harm to herself or others.
The other thing I need to say is that when it come to end of life issues, there are always trade-offs and very few "good" choices. Only the least bad ones.
There are all sorts of regs in states these days about patients needing to be on the lowest possible dosage of any psych drug. We had JUST gotten my mom's "cocktail" of anti- depressants and anti- anxiety meds titrated when some new Behavioral Health NP came along and cut her dosages in half. And no one told us.
24 hours later, my SIL (not a medical professional, she's a cpa/MBA) called me after a visit and said " something is wrong". Mom had reverted to weeping, wringing her hands and mumbling about Hell and the IRS. I called the DON and they discovered the change in orders.
Your job, as POA and adult child, is to advocate for your mom NOT being in distress. Yes, send her back to the psych unit and make d@mn sure the NH obeys the doctor's written orders.
If you demand the med be stopped, mom could very well be kicked out. The facility is responsible for the care and safety of other residents too. My mom was kicked out of a facility because of her behaviors.
I agree with Barb, finding the right med is something that needs to be done in a geriatric psych facility.
I completely understand that the safety of all the residents has to come first. I'm not asking that she's not medicated I just wish they could find one without the side effects she's having. I like what Barb said about a geriatric facility.
I just want to make sure I do what is right/best for her. It's so hard.