Can an Assisted Living facility force my Mom to take part in 'medication management'?

R

RandomName

Member
My Mom is in an assisted living place.

Currently she takes her own pills. Actually it is only one pill, Synthroid, every morning, and she checks it off on a list.

But she will be returning from the skilled nursing place at the same outfit, and they are talking about giving her one more med, which is ferrous sulfate, at a different time of day, and they want to be the ones to administer it, and maybe the synthroid too.

They charge a fortune for it. If they come to her apartment once per day to give her a med, the charge is $301 per month. If they come 2 times, it is $602 per month.

They are giving her pain meds in skilled nursing, which I think may be fuzzing up her memory. While she is in skilled nursing, they are going to 'assess' whether she will be able to take her own meds when she returns to assisted living.

Can she insist on managing her own meds ? Can they force her to accept med management?

Her short term memory is not good sometimes, but she has been handling the daily pill-taking OK so far and I don't think adding one more pill, even at a different time would be too much for her.

I have medical power of attorney for her. Maybe I can refuse the med mgmt.

She is in New Jersey.

I'm sure they will try to do it because it is free money for them, and it would be good to know if Mom or I can just say no.


Thanks
 

The other pill is basically an iron pill. You can buy that at any Walmart. Ferrous Sulfate: Uses, Dosage & Side Effects - Drugs.com

It is going to cause constipation. Did they tell you both of that? Did they advise she take a laxative while on it? Did they say if she is anemic and that's why she needs it?

Pain meds can make people LOOPY - no doubt about that. Try calling the NJ gov't. offices and see what resources they have on advising you what is and it not legal for nursing homes in NJ. Department of Human Services | Aging Services

There's this place too: NJAAW – New Jersey Advocates for Aging Well – njaaw.org
Oh I love the East Coast. So many of the best law schools are out there and the best lawyers know how to write public policy to protect the vulnerable. Here is this site also - looks like a non-profit: Home - ADRC NJ
 
The doctor said I can take her off the ferrous sulfate if I want to. I am OK with her taking the ferrous sulfate, which I think she can do herself.

I just don't want them to be charging her $10 per pill to come to her room and give it to her, when she can take it herself for free.
 
Vintage Better,

Yes, she is anemic. She is bleeding from her bladder, off and on. Tumors in her bladder. Yes, they are giving her a laxative also, since the ferrous is constipating. Thanks for mentioning that it is OTC. I did not know that.

The medical people there are pretty on the ball and competent and decent.

It's the administrative profit seekers I have a problem with. I and my sister have had to confront them a few times to stop them from ripping off my Mom. It's exhausting.

What they can try is to bump her up one level of care, to a more expensive level. And/or put her on this expensive 'medication management' scam.

I have spoken to them already about it (social worker, physical therapist, occupational therapist, and nurse on a conference call) that I don't think she needs medication management, but a few days after that call, the social worker said she thought 'they' still wanted to put her on medication management.

I suppose I could just refuse the ferrous sulfate, then no need for the laxative either, and just have the synthroid left, which she was managing just fine before.

Thanks for the referrals to those places. I and my sister almost had to contact one of them already, when overcharges showed up on the monthly bill, from out of nowhere that they couldn't or wouldn't explain. That finally is resolved, but they were very unprofessional about it. It took a lot of time and effort that we should not have had to expend.
 
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John cycling said:
What they're doing is elder abuse. Yes, refuse all their meds.
Personally I would call them to make that clear, and then follow that up with a certified letter...
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I dont think refusing the medication is in her best interests. Thyroid replacement medication isnt something you should just stop and sounds good reason for the iron supplement (and laxative if neccesary with it)

The problem doesnt seem the medications but the insistence on managing them for her if she can do it perfectly well herself
 
RandomName said:
Vintage Better,

Yes, she is anemic. She is bleeding from her bladder, off and on. Tumors in her bladder. Yes, they are giving her a laxative also, since the ferrous is constipating. Thanks for mentioning that it is OTC. I did not know that.

The medical people there are pretty on the ball and competent and decent.

It's the administrative profit seekers I have a problem with. I and my sister have had to confront them a few times to stop them from ripping off my Mom. It's exhausting.

What they can try is to bump her up one level of care, to a more expensive level. And/or put her on this expensive 'medication management' scam.

I have spoken to them already about it (social worker, physical therapist, occupational therapist, and nurse on a conference call) that I don't think she needs medication management, but a few days after that call, the social worker said she thought 'they' still wanted to put her on medication management.

I suppose I could just refuse the ferrous sulfate, then no need for the laxative either, and just have the synthroid left, which she was managing just fine before.

Thanks for the referrals to those places. I and my sister almost had to contact one of them already, when overcharges showed up on the monthly bill, from out of nowhere that they couldn't or wouldn't explain. That finally is resolved, but they were very unprofessional about it. It took a lot of time and effort that we should not have had to expend.
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I'm so sorry. This is why it's important to have access to OUTSIDE help in these situations - and I mean outside help that will really help and is not silent partners with the team you are complaining about.

I'm a big fan of audits, for this reason. Convalescent care homes should be audited every two years, or something like that. They should have to send their accounting to Medicare once a year, IMO.
 
I think you can. I too would think twice about the iron. Constipation and possible stomach upset.

Even in an actual long term care facility people have the right to self administration of meds. They hate it of course because it's a hassle. Papers have to be signed and the patient/resident needs a locked place for the medication.

If she can manage in assisted living with the plan she's been using or get her a daily pill box, if you can fill it once a week, keep doing that.
 
If you are anemic - as shown by blood test results - the n I would take the iron supplements and if neccesary, a laxative with it.

You may not need the laxative but have it on standby and be aware of possible side effect of constipation.

When I was on iron tablets years ago, I didnt find any such issue though - it wont be a problem for everyone but is a possibility.
 
OP here. I want to remind folks I want her to be on Ferrous Sulfate for her anemia.

I just don't want to pay the assisted living place $450 per month minimum, to give them to her.

It's boiling down to greed from the upper management levels here. Huge profits.

Tomorrow is Monday and I will go up against the top brass here. The Director of Nursing and the Director of Health Care. I don't have much hope, but I have to try.

A nurse here said she thinks Mom can self-medicate, but the Director of Nursing did an 'assessment' and thinks she needs med management.

Tomorrow I expect to be stonewalled, but maybe they will have some good news, like only having her on med mgmt for 2 weeks, then reassessing her ability to self-medicate.

In her 'residents rights' pamphlet, it says she has the right to refuse medication. I'm sure they will resist that somehow.

She is only taking synthroid, ferrous sulfate, colace, and omepazole, How hard can it be?

Mom is doing well at this point in time. At least that is good news.
 
RandomName said:
OP here. I want to remind folks I want her to be on Ferrous Sulfate for her anemia.

I just don't want to pay the assisted living place $450 per month minimum, to give them to her.

It's boiling down to greed from the upper management levels here. Huge profits.

Tomorrow is Monday and I will go up against the top brass here. The Director of Nursing and the Director of Health Care. I don't have much hope, but I have to try.

A nurse here said she thinks Mom can self-medicate, but the Director of Nursing did an 'assessment' and thinks she needs med management.

Tomorrow I expect to be stonewalled, but maybe they will have some good news, like only having her on med mgmt for 2 weeks, then reassessing her ability to self-medicate.

In her 'residents rights' pamphlet, it says she has the right to refuse medication. I'm sure they will resist that somehow.

She is only taking synthroid, ferrous sulfate, colace, and omepazole, How hard can it be?

Mom is doing well at this point in time. At least that is good news.
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You have a right to complain. Paying $450 to make sure mom is taking her meds is outrageous. It’s $15 a day or a minute. How long does it take to make sure someone is taking their pills.
 
PeppermintPatty said:
You have a right to complain. Paying $450 to make sure mom is taking her meds is outrageous. It’s $15 a day or a minute. How long does it take to make sure someone is taking their pills.
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Yes, it is outrageous. They don't even let you have the pills in your possession. They bring them in a plastic cup and watch you take them. Mom is not mentally incompetent. They based her need for med mgmt on the fact that she did not know what pill she was taking, in skilled nursing. They never told her, so why would she know?
 
RandomName said:
OP here. I want to remind folks I want her to be on Ferrous Sulfate for her anemia.

I just don't want to pay the assisted living place $450 per month minimum, to give them to her.

It's boiling down to greed from the upper management levels here. Huge profits.

Tomorrow is Monday and I will go up against the top brass here. The Director of Nursing and the Director of Health Care. I don't have much hope, but I have to try.

A nurse here said she thinks Mom can self-medicate, but the Director of Nursing did an 'assessment' and thinks she needs med management.

Tomorrow I expect to be stonewalled, but maybe they will have some good news, like only having her on med mgmt for 2 weeks, then reassessing her ability to self-medicate.

In her 'residents rights' pamphlet, it says she has the right to refuse medication. I'm sure they will resist that somehow.

She is only taking synthroid, ferrous sulfate, colace, and omepazole, How hard can it be?

Mom is doing well at this point in time. At least that is good news.
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Well, of course the Director of Nursing would feel that way. She wouldn't be the Director of Nursing for very long if she disagreed with her bosses very often.......

Can you set up a pill box for your mom and then call her every day to make sure she took her meds? I would think that would be "management" enough.
 
RandomName said:
Yes, it is outrageous. They don't even let you have the pills in your possession. They bring them in a plastic cup and watch you take them. Mom is not mentally incompetent. They based her need for med mgmt on the fact that she did not know what pill she was taking, in skilled nursing. They never told her, so why would she know?
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Tell them what you just wrote here. It sounds like a set up. When my mom got admitted to the hospital they put her on a cocktail of pills to sedate here. They didn’t tell her what the pills were either but it’s all covered federally so we don’t know how much she was charged. Can you ask them to take the test over fairly ? Give your mom a chance to know what they are.
 
RandomName said:
OP here. I want to remind folks I want her to be on Ferrous Sulfate for her anemia.

I just don't want to pay the assisted living place $450 per month minimum, to give them to her.

It's boiling down to greed from the upper management levels here. Huge profits.

Tomorrow is Monday and I will go up against the top brass here. The Director of Nursing and the Director of Health Care. I don't have much hope, but I have to try.

A nurse here said she thinks Mom can self-medicate, but the Director of Nursing did an 'assessment' and thinks she needs med management.

Tomorrow I expect to be stonewalled, but maybe they will have some good news, like only having her on med mgmt for 2 weeks, then reassessing her ability to self-medicate.

In her 'residents rights' pamphlet, it says she has the right to refuse medication. I'm sure they will resist that somehow.

She is only taking synthroid, ferrous sulfate, colace, and omepazole, How hard can it be?

Mom is doing well at this point in time. At least that is good news.
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This is really horrible.

May I suggest that you take a notebook with you and if things do not go the way you hoped, after the meeting, in your car, write down all that was said? Also request everyone's business cards. Then, when you get home, SCAN everything to save in the cloud or on your hard drive or both.

Alas, with every confrontation with managers, the rule is DOCUMENT, DOCUMENT AND DOCUMENT. How I wish I had learned to be that paranoid and hyper-vigliant in times past. Unfortunately, or fortunately, I was raised in an era where people were expected to keep their word and tell the truth. Things have changed drastically in society since those days.

I have learned the hard way to assume everyone is lying. Everyone. And since everyone in the room may be lying, they think I'M lying (i. e. projecting their behaviors onto another). So I have to always have my documentation too.

This IS what will destroy American society. If no one is acting in Good Faith anymore, then companies can't even do business any longer. And without businesspeople acting in Good Faith, the whole nation falls apart. We'll become just like Russia and in Russia, if you speak out too much, they will kill you. Or you will accidentally fall out of a window.

ANYWAY, on that cheery note, write it all down while it's fresh in mind then save it in two safe places.

If they insist, then you need this documentation when you call one of those outside agencies I gave you.
 
I spoke to the dir of nursing. She will allow Mom to go back to assisted living with no med management only if I get approval from her doctor to remove all the OTC meds, which would leave her with only synthroid.

I'm waiting for a call back from her doctor.
 
PeppermintPatty said:
Tell them what you just wrote here. It sounds like a set up. When my mom got admitted to the hospital they put her on a cocktail of pills to sedate here. They didn’t tell her what the pills were either but it’s all covered federally so we don’t know how much she was charged. Can you ask them to take the test over fairly ? Give your mom a chance to know what they are.
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I found out from the dir of nursing that Mom has to know the names of all the pills, and their dosages, and when to take them.

I asked why she cant just have a chart on the kitchen table, and a pillbox, and be sure to take the red pill at 9 AM, and so on. Nope, not good enough.

Unless I get out of it, they want to put her on one month of med mgmt and then retest her.
I said what about 2 weeks.
Nope, one month.
 
RandomName said:
I found out from the dir of nursing that Mom has to know the names of all the pills, and their dosages, and when to take them.

I asked why she cant just have a chart on the kitchen table, and a pillbox, and be sure to take the red pill at 9 AM, and so on. Nope, not good enough.

Unless I get out of it, they want to put her on one month of med mgmt and then retest her.
I said what about 2 weeks.
Nope, one month.
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I'm still working and I don't know the dosages of my three meds. I know two of them, but I don't know the third. But I do know the names of all three. I'd better memorize that third one!!!!!!! Never know when someone will put me in a home due to lack of answers.

Is there any LAW that says this is how it has to be, or is it just their policy? You should really call a lawyer - Elder Law. Just get a consultation.

But call those agencies I posted. See what they say.

I wonder if they will remove our right to vote next? "Better know all those candidates lady, even for the Green Party, or no ballot for you!"
 
RandomName said:
I found out from the dir of nursing that Mom has to know the names of all the pills, and their dosages, and when to take them.

I asked why she cant just have a chart on the kitchen table, and a pillbox, and be sure to take the red pill at 9 AM, and so on. Nope, not good enough.

Unless I get out of it, they want to put her on one month of med mgmt and then retest her.
I said what about 2 weeks.
Nope, one month.
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It’s sounds like a money grab to me. I dont think I know the names of all my pills but I don’t forget take them only because I’ve got a reminder on my phone and have them in a Monday to Sunday pill container. Do you live in the US. The reason I ask is that Canada has a free service that will send people to make sure she takes them.
 
PeppermintPatty said:
It’s sounds like a money grab to me. I dont think I know the names of all my pills but I don’t forget take them only because I’ve got a reminder on my phone and have them in a Monday to Sunday pill container. Do you live in the US. The reason I ask is that Canada has a free service that will send people to make sure she takes them.
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That's exactly what it is. AL's quote a reasonable rate then bump it to the sky with outrageously padded "concierge" type extras.
 
Update:

I was saved by my courage to fight, some minor cleverness, and by a doctor with ethics.

I called Mom's doctor and asked her to remove all the meds form her list, except for the synthroid. (All Mom was on prior to this 3 week disaster was one synthroid per day and she was fine) The doctor agreed right away !

The director of nursing agreed to let Mom take her synthroid alone as she always has. So there will be no ripoff occurring this time. No one coming to deliver a generic over-the-counter pill for $15, etc.

By the way, the drugs removed were all OTC, and not really life-sustaining. The ferrous sulfate was the most important, for iron, but Mom can get iron from Boost and Ensure.

I actually plan to buy her a bottle of ferrous sulfate and colace, just to be sure she has it, but she will be taking it herself, for free.
 
PeppermintPatty said:
It’s sounds like a money grab to me. I dont think I know the names of all my pills but I don’t forget take them only because I’ve got a reminder on my phone and have them in a Monday to Sunday pill container. Do you live in the US. The reason I ask is that Canada has a free service that will send people to make sure she takes them.
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Yes, I am in the U.S.
 
VintageBetter said:
I'm still working and I don't know the dosages of my three meds. I know two of them, but I don't know the third. But I do know the names of all three. I'd better memorize that third one!!!!!!! Never know when someone will put me in a home due to lack of answers.

Is there any LAW that says this is how it has to be, or is it just their policy? You should really call a lawyer - Elder Law. Just get a consultation.

But call those agencies I posted. See what they say.

I wonder if they will remove our right to vote next? "Better know all those candidates lady, even for the Green Party, or no ballot for you!"
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I don't know if it is a law. Probably just a greed policy. I guess I could refuse and see what happens. Didn't have go nuclear and refuse, though. See my other post.
 

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