Morning Meds

Marp

I talked with my sister's care facility this morning to see how she was doing with a med change her neurologist made recently.

The med tech said she was doing good. She didn't have her morning meds because she didn't get up until almost 10:00.

When I asked why they didn't give her the meds when she got up, the tech said, "We're not allowed to give morning meds past 9:00 a.m".

Anyone else here of something like that?

She did check with the nurse who said that, with my permission, they could give her the meds late. Her meds in the morning are pretty important so I gave permission to give the meds late.

SusanB-dil

Gracious! That's good to know for us for future reference…

MIL often sleeps in, and of course, we let her. We have checked the meds with the pharmacist due to this same situation, and they said that a few hours 'off' would be ok. I would think it would depend on just what meds they are. Also might depend on the timing of when she gets the evening meds.

There was one her doc wanted to try, and it was imperative of being 11.5-12 hours apart. We couldn't guarantee that, so her doc worked around it and we opted out of that one, especially since we found that it probably wouldn't make much difference. …so, then why?… right.

Iris L.

Sometimes I don't wake up and get out of bed until 11 am or noon or sometimes even later. I take my morning meds when I get out of bed. I know it's not ideal but this is how it is for me.

Iris

towhee

You know how if you read the prescription inserts they tell you if you have missed a dose to take it ASAP and if you cannot then wait till the next regular dose? Like that. Usually they are given a two hour window to give meds. So if a med is at 9 then they can give it from 8 to 10. Also they are dealing with a lot of patients, and it is hard for them to go back later. Often their computer screen is set up to where they can only see one set of hourly meds at the time. If your LO is consistently waking up late than talk to the facility nurse/doctor about changing the time of the meds.

H1235

At my moms AL they wake her up. She has a thyroid pill that needs to be taken before breakfast. So they wake her up then she get around for breakfast and then takes her other medicine with breakfast.

ButterflyWings

DH would not be able to miss his morning Seroquel even by an hour (definitely not 2) without the whole day going South. I think of M1's partner who has strong pain meds, and can't imagine that it is good to be so flexible with many of the medications PWDs simply must have, and on a regular schedule.

There are some (maybe antidepressant, for example) that if missed one day (or most of the day) should not be double-dosed. You don't take it later to make up for it, you skip it so as not to have too much in the bloodstream I believe is the reason. But there are consequences to having too little. Behavior, etc.

Even the antibiotics or other meds DH has taken for a temporary situation, if not given on a regular schedule they don't do what they are supposed to do and can allow an infection to not be addressed completely, or to re-occur. And what if something needs to be taken with food, or without it - the meal intervals get thrown off too.

@Marp I hope they get your LOs situation sorted out with more urgency, even if she is not having negative effects yet. It seems like given how expensive MC is, the med schedule is one thing they could prioritize for excellence.

M1

BW is right, we have ongoing issues with meds being given in a timely manner. The nursing and aide staffs continue to be short handed, and some of the temporary nurses hired from staffing agencies are particularly problematic. When i got there at ten yesterday she had not received any of her morning meds, and that clearly contributed to her bad day yesterday. Not only the narcotics matter; most people with rheumatoid arthritis have more difficulty in the mornings, and the sooner you get the meds going the easier it is to get going. But these subtleties get lost in a group setting. We have a bath aide scheduled to come from hospice tomorrow, and I need to call today to specify that it be after lunch.

Marp

https://alzconnected.org/discussion/comment/213792#Comment_213792

Thanks. I didn't know asking for the time to be changed was an option.

I really hate the computer system this facility uses; anytime a doctor changes something, I have to follow up with 2-3 people to make sure the changes get entered correctly. The doctor's orders have to pass through multiple people before they're finalized, and the more people who touch something, the more opportunity for a mistake. I'm not the only family that has complained about that.

I don't know how a med management system that is that difficult to update can be helpful. I wonder what long distance caregivers do, those whose can't be there several times a week to check that the computer is correct.

Marp

I was stunned when the med tech told me that my sister didn't always get her meds if she sleeps in. The tech said it only happens once every couple of weeks. She has had a terrible time sleeping (and we're working with the doctors to figure that out) so they're, understandably, reluctant to wake her up if she's sleeping well.

It's just that some of those meds do affect how she feels during the day and they have a short half life so skipping a dose is risky, unless it's almost time for the next dose.

Part of the problem is that it takes time to analyze whether or not it's appropriate to skip a dose or whether the dose should be given late. Most of her morning meds are given once a day so, if she wakes up two hours late , giving her the medication late shouldn't be a big deal. Two of the meds are twice a day, but she doesn't get her second dose until around 7-8 pm so, again, taking those an hour or two late shouldn't hurt her; they just aren't allowed to do that.

For awhile, she took one of her meds 3 times a day; that one is one she should probably skip if she sleeps a couple of hours late.

At home, I would think that all through and make the determination which meds to give late and which to skip. I just don't think most facility staff would know how to do that. Even if they do, there is probably a state law that prohibits them from using their brains.

Marp

One of the med techs told me she's been waking my sister up long enough to take her meds. If she goes back to sleep after that, it's ok. Fortunately, her breakfast time meds can be taken with or without food,