On December 3, 2013, a year after Mom had moved into a long-term care facility (LTCF), I sent an email to the person in legal control of my mother’s care, and the Director of Nursing of the LTCF. It read in part:
I am deeply distressed by Mom’s present condition.
I have reviewed in detail the nurses’ notes from November 2012 to September 2013. Based on the notes and my own observations of Mom’s health and behaviour, I’m convinced the well-intentioned strategy of medicating Mom more and more is not the best way forward. These are some of the deleterious effects I see:
- Her balance and ability to walk are being affected, thus increasing the likelihood of falls and injury
- Her quality of life is diminished
- Her capacity to enjoy life is diminished
- Her dignity is being compromised rather than preserved
- She is gaining a great deal of weight
- Her decline is being accelerated
Two simple actions will immediately alleviate the problem:
- provide one-on-one care to Mom from 09:00 – 21:00 seven days per week
- reduce the Seroquel and Risperdal she is being given
Moving her to the second floor to a room of her own will also help.
I would like to work together to determine what combination of medication, dosages, activities, and one-on-one care levels best meet Mom’s needs and allows her to enjoy life in whatever way she can in her remaining time, while also respecting the rights of other residents and staff.
The Director of Nursing, the on-call facility doctor to whom Mom had been assigned (and who had likely seen her for less than an hour in total over the previous year), the person in legal control of Mom’s care (plus spouse), and I met the following week.
During that meeting, I was told I didn’t understand my mother’s disease or her behaviour, that she could not have additional one-on-one care for several arbitrary reasons, that she had to be medicated for the safety of others, and that if I didn’t stop asking questions about her care we would need to find her another home.