Discussion
Does anyone work in or have a relative in a Care Home?
After a discussion with my Mum about the possibility of my Grandad going into one, she is under the impression that all care homes require a form to be signed saying that their own doctors can administer medicines as and when required. She believes this will result in my Grandad being prescribed a 'zombie pill' to make their job easier.
Is this the case, or is consultation/agreement with the family required?
After a discussion with my Mum about the possibility of my Grandad going into one, she is under the impression that all care homes require a form to be signed saying that their own doctors can administer medicines as and when required. She believes this will result in my Grandad being prescribed a 'zombie pill' to make their job easier.
Is this the case, or is consultation/agreement with the family required?
anonymous said:
[redacted]
Sorry, when I said 'carehome doctor', I meant whichever GP they use - as opposed to say my Grandad's regular GP.I suppose this story is along the lines of my mum's fears - http://www.telegraph.co.uk/health/healthnews/62649...
The Alzheimer's society also has some concerns on the over-prescription of antipsychotics - http://alzheimers.org.uk/site/scripts/documents_in...
Ah I get you.
I guess it's not something anyone can guarantee would never happen. All doctors are responsible for their own prescribing and I've never known a form being needed to enable them to prescribe any medications to people in their care.
That said, doctors are accountable and they can be struck off if they are found to be abusing their power or prescribing irresponsibly/dangerously.
If your Grandad needs the support of a care home, it probably is the best place for him but I understand the family's worries. The care home will have a record of any medicine given and the family have a right to access that through the data protection act.
The media loved to publicise scare stories, but most people in care homes are treated with dignity and respect and given appropriate medications so don't tarnish all homes. Do be aware though that people do often change a little bit on admission to a care home while they adjust to the new environment and routine.
I guess it's not something anyone can guarantee would never happen. All doctors are responsible for their own prescribing and I've never known a form being needed to enable them to prescribe any medications to people in their care.
That said, doctors are accountable and they can be struck off if they are found to be abusing their power or prescribing irresponsibly/dangerously.
If your Grandad needs the support of a care home, it probably is the best place for him but I understand the family's worries. The care home will have a record of any medicine given and the family have a right to access that through the data protection act.
The media loved to publicise scare stories, but most people in care homes are treated with dignity and respect and given appropriate medications so don't tarnish all homes. Do be aware though that people do often change a little bit on admission to a care home while they adjust to the new environment and routine.
I've been on placements with GPs over several counties, and I've probably been into 10 different care homes over that time. Doctors do what their patients need, they certainly do NOT prescribe them medications to make other peoples' lives easier (unless for example a psychiatric patient is causing danger to themselves or other people).
I worked in a care home and where possible we contacted the resident's GP unless their GP for their previous location was now too far away to be practical. Meds were administered in accordance with each resident's MAR chart and there was always a reluctance to dish out meds unless they were genuinely needed - it's not uncommon for care staff, who genuinely care, to be proud that the residents are on so little medication and the GP's on the whole take the same view.
Your best bet is to visit the care home in question - sit down and talk to some of the residents whilst you're there. Let's face it, they have plenty of free time and love to talk to anyone who will listen. You'll find out how things work and have a fairly good idea whether it's the sort of place that will be suitable. Obviously, take anecdotal evidence with a pinch of salt as with everything.
The district nurses are also really good and contribute a lot to the resident's well being, if they disagree with any condition a person is in, they will say so and this extends to medication.
Care homes get a bad rep and abuses do occur as the media loves to shout about, however from what I've seen they tend to be very very good, although it's worth taking a good look and making an educated choice.
Your best bet is to visit the care home in question - sit down and talk to some of the residents whilst you're there. Let's face it, they have plenty of free time and love to talk to anyone who will listen. You'll find out how things work and have a fairly good idea whether it's the sort of place that will be suitable. Obviously, take anecdotal evidence with a pinch of salt as with everything.
The district nurses are also really good and contribute a lot to the resident's well being, if they disagree with any condition a person is in, they will say so and this extends to medication.
Care homes get a bad rep and abuses do occur as the media loves to shout about, however from what I've seen they tend to be very very good, although it's worth taking a good look and making an educated choice.
My mother's in a nursing care home with dementia, and I was worried she'd be doped down - she is very difficult, always has been before the dementai and is far worse now. She's always refused mediaction of any kind - it's hard to get her to take paracetamol for her arthritis even tho she's in a bad way with that too. There's been no attempts to do so, tho, a fact I'm pleased about - she doesn't want to be there but I can't have her for various reasons with my own health, and one small consolation for me is she's not being force fed tranquilisers as I feared would happen.
bull996 said:
The care home my grandmother was in would call HER own doctor when needed, not their own.
Worked very well, as her own doctor knew his history etc.
Care homes don't have Doctors, Care home residents are under the care of a (local) GP and any hospital consultant tehy are all ready seeing ( the exception might be where it's intermediate care where there will be arrangements usuing either community CoE consultants and their teams or local to the home GPs). Worked very well, as her own doctor knew his history etc.
If the care home is within a reasonable distance of the person's old address they can stay with their previous practice and GP, if the care home is a fair distance away ( as in what happended with my gran she moved from a nottingham sururb to a village half way between Nottingham and Loughborough she changed Gps to a local one (as it happens, the same practice as my aunt + uncle who live in the next village along to the care home).
The main exception to this is if a GP or practice has financial interest in the care home where often they willencourage people to move to 'their' practice ... but there is little or nothing they can do about forcing you to change to 'their' rather than any other in the locality that is accepting new patients.
Inappropriate prescribing or sedatives, anti psychotics and the like as well as over use of PRNs is the kind of thing that is picked up at internal and external audit / Inspections and may also be picked up by Community Pharmacies supplying the home.
Having worked in 50+ care homes, we have only come accross one which was 'zombie-ing' the patients and to be fair, its that obvious what's going on anyone with half a brain cell would notice on a visit. You can tell be the attitude of the staff straight away before you see the residents, the miserable, offish way they are. Most staff are friendly, polite and are happy to talk to you about your relative. With the crap wages they get, they need to love the job to do it. Any home worth its salt will be quite happy for you and prospective resident to visit, look around and chat to staff and residents and discuss things like med charts etc with you. You can soon tell if they are trying to hide anything and, sad but true, a home that doesn't smell is a good one!
mrsxllifts said:
<snip>, sad but true, a home that doesn't smell is a good one!
i did wonder when the sniff test would raise it's head ... another suggestion on those lines - is if you know anyone who works for he ambulance service in the area ask them which homes they rate - as i've seen some right shockers when doing NHS ambulance shifts with SJA ... (even more fun if the NH staff are theat dense they don't notice mt grey slides and 'Nurse' badges )
mrsxllifts said:
sad but true, a home that doesn't smell is a good one!
Incredibly true... And don't go in under the misapprehension that expensive means better. Of the dozens and dozens of residential and nursing homes I've picked patients up from, some of the best (in terms of staff and general cleanliness) have been the Council run homes. Conversely, the absolute worst around my area are BUPA...parapaul said:
mrsxllifts said:
sad but true, a home that doesn't smell is a good one!
Incredibly true... And don't go in under the misapprehension that expensive means better. Of the dozens and dozens of residential and nursing homes I've picked patients up from, some of the best (in terms of staff and general cleanliness) have been the Council run homes. Conversely, the absolute worst around my area are BUPA...It was an absolute s
thole. Neglect and low-level abuse were normal. They lied to prospective families about facilities, activities, staffing levels, quality of supervison. I will kill myself if I'm ever facing residential care again. The staff were a heady mix of cruel, incompetent, lazy and bullies, the management were worse than useless. During the 9 months I was in their tender care I racked up a total of amost 8 weeks in hospital, followed up by another 6 weeks shortly after I got out, because of the inadequate care they provided. My last hospital admission was almost exactly 2 years ago (I've had the odd trip to A&E since but never needed to stay). I'm now cared for in an adapted bungalow by personal assistants funded by the council and the now doomed Independent Living Fund, backed up by the local District Nursing team. My condition has continued to progress, but I'm happy, and as healthy as I'm likely to get. I'm safe, and I have a life again.
The only thing I'm really scared of now is ending up in institutional care once I'm too far gone to do anything about it.
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