Towards the end of life, the matter of pain control becomes paramount. In order to make sure the patient can have surcease from pain, strong drugs are needed. Sometimes these drugs can kill. The tricky part is to give the patient as much relief as possible while avoiding overdosing and possibly killing the patient.
While I’ve read about this happening in several (nonfiction) books, I’ve only seen a case where someone was purposely giving more pain medications than what was ordered once. A caregiver (name and agency withheld) is strongly suspected of overdosing our elder. It could very easily have killed her. All of us are lucky it didn’t.
Why is this a problem? Leaving aside the death of the patient, purposely overdosing anyone can be considered a crime. If the patient dies as a result, it can be considered murder. In our case, add to the mix that the patient has severe dementia and you can see that everyone could have suffered from this incident.
Who to talk to: This depends on the situation. Our elder was on hospice at the time and the appropriate person to tell was the hospice nurse. As our elder is now off hospice, I would contact the agency and the doctor. In a hospital, it would be the doctor or a nurse. In the latter two cases, the medical professionals could explain why the medication is so strong. They won’t mind the question.
What to ask: It’s perfectly acceptable to ask what any medication is and what it does if you are not in an emergency situation. This includes questions about strong pain killers. Doctors, and pharmacists for that matter, would prefer you to ask them over doing an internet search. The reason for this is that not all internet searches are going to have the correct answer to your particular case.
As an example, our elder is allergic to a certain class of pain medications. Were I to look this medication up on-line, I would find that it does work as a pain reliever. If I were to ask why she wasn’t being given that medication, the doctor would have to provide a long explanation of why it isn’t a good idea.
How to ask: There is always a right and wrong way to ask questions. I have heard people asking them the wrong way and it’s not good for anyone. Never demand an answer. Try not to ask questions if you are angry. Doctors and nurses are human and while they will strive to respond in a professional capacity, they might not be as forthcoming with information if you back them into a corner. They get sued too much.
Instead, ask quietly and patiently. Something like, “I’m curious about…” or “I don’t understand…” These aren’t threatening. In fact, when I asked a doctor a question about surgery our elder had several years ago, I got a drawing to go with my answer. If I’d demanded the information, I doubt he’d have taken the time to draw it out for me.
As our population gets older, these situations are going to become more common. The more we all know now can make it easier to prevent patient doping and help our elders have a good quality of life.