Administering Medication to Parkinson Patients on Time

Lately, *Wendy is plagued with the fear of losing her mother.  Granted her mother *Marian had lived a long and happy life but Wendy was not ready to lose her.  Marian was in her seventies.  She celebrated her 75th birthday a couple of months ago.  Wendy and her sister *Lauren had taken her out for lunch to celebrate.  In the past, Marian celebrated birthdays, Christmases and every Mother’s Day at her home or at one of her daughter’s home.  However, everything changed when she was diagnosed with Parkinson’s.  She couldn’t remain in her home after she fell.  She was a widow and had been living on her own.  She had to sell her home and move into a nursing home.  It took time for her to adjust to living in a room and having to depend on nurses to change and bathe her and do the things she used to do for herself.  It was hard to give up her independence.

She was still able to go and spend time with her children and grandchildren but lately, it was becoming increasingly difficult for her to move around without the wheelchair.  She had gone from using a cane to a walker and now to a wheelchair.  She had fallen several times.  Once Wendy went to visit her and was horrified to see the ugly bruises on her arms.  Marian fell because she tried to do things on her own when she should have called for help.  The nurse would go into her room and find her on the floor.  Thankfully, she hadn’t had any serious falls but Wendy worried about her.  She had heard stories of elderly women breaking their hips and suffering other serious injuries from falls.

Just recently, Wendy received distressing news.  Her sister Lauren informed her that their mother was not responding well because she hadn’t been given her medication that morning.  The last dosage was the night before so she was supposed to get the next one around 7 in the morning but the nurse hadn’t given her.  When Marian’s regular nurse found out two hours later, she decided to wait until 11 to give her her medication.  Lauren was livid.  She demanded to know why the nurse waited instead of giving her mother the medication right away.  As Wendy listened to her sister, she felt sick in the stomach.  Their mother had been without her medication for 15 hours.  She was lying in her bed, with her eyes closed.  She was aware that her nurse was in the room and was responsive but she couldn’t do anything except lie there.  Her nurse kept checking on her to make sure she was okay.  She was relieved when Marian woke up.  Marian’s doctor told the nurse to try to get the medication into Marian which she kept trying to do until she succeeded. The doctor said that it could take 24 hours for Marian to recover as a result of not getting her first dosage that morning.

The Administration at the nursing home acknowledged that two gross mistakes had been made.  The first nurse should have given Marian her 7:00 a.m. meds and her regular nurse should have immediately given her the meds at 9:00 when she realized that she hadn’t been given her first set of meds instead of simply waiting for the next set.  The director assured Lauren that they were taking measures to make sure that this never happened again.  They plan to follow up with the first nurse who neglected to give Marian her morning medication.

Wendy was thankful to God for watching over her mother who is okay.  Tears came to her eyes as she imagined her mother lying there with her eyes closed, unable to do much else and how it could have been much worse…

How many other Parkinson’s patients like Marian do not receive their medication on time?  According to an article written on the National Parkinson Foundation website, hospitals can be danger zones for people with Parkinson’s.

Hospitals are usually a safe haven for people with serious illnesses, but for people with Parkinson’s disease (PD) going to the emergency room or being hospitalized can be a nightmare, because their condition is more likely to deteriorate due to inappropriate care and the anxiety of being in an unfamiliar environment.

Parkinson’s patients are often afraid to challenge a hospital’s medical staff, because they assume that they know what they are doing, but many may have little or no knowledge about how to care for someone with Parkinson’s, said Dr. John Morgan, assistant professor at Georgia Health Sciences University.

Three out of four people with Parkinson’s do not get their medication on time when they go to the hospital, which can cause serious complications even death, said NPF’s National Medical Director Dr. Michael Okun. Even more alarming is that research shows that the majority of hospital staff do not know which drugs are unsafe for Parkinson’s patients, and they do not understand Parkinson’s disease.

People with Parkinson’s must take their medication on time, especially those with moderate and advanced Parkinson’s who are taking frequent doses of levodopa, a common Parkinson’s medication, Dr. Morgan said. “If medication is not taken on time, they can become stiff, rigid, tremulous and unable to move and prone to falls, etc. Even one hour off of a scheduled time can make a big difference,” Dr. Morgan explained.

There is no cure for Parkinson’s, but medication helps control symptoms by increasing the levels of dopamine in the brain. Dr. Morgan emphasized that medications should be taken 30 minutes to an hour before meals or an hour or more after meals, because the protein in food can inhibit the absorption of the medication into the body. If a person eats too close to their scheduled medication time, Dr. Morgan said it is better to eat a low-protein meal rather than delay taking medication.

The article mentions that one hour off of a scheduled time can make a big difference.  Wendy’s mother had been 15 hours off her scheduled time.  Another article states, “Medications must be administered on time to promote consistent therapeutic blood levels and prevent disabling symptoms. A delay of even 5 minutes can cause the patient to suddenly lose the ability to move, walk, and speak.”  If Wendy and Lauren wanted to, they could sue the nursing home for gross negligence and failing to administer the proper help.  Marian should not have gone through what she did.  She was in a facility that was supposed to take care of her.  Their negligence could have cost Marian her life.  For now, Wendy and Lauren are hoping that this doesn’t happen again.

Want to get involved in raising awareness for Parkinson’s?  Here’s how.

*These are not their real names.

Source:  http://www.parkinson.org/About-Us/Press-Room/NPF-In-The-News/2012/November/Hospitals-can-be-a-danger-zone-for-people-with-Par; http://journals.lww.com/nursing/Fulltext/2011/03000/Administering_medications_for_Parkinson_disease_on.24.aspx

Stress

What is stress?  For some it is trying to prioritise the many projects they have undertaken and making decisions.  For others it is moving to another apartment; raising a family; going for a job interview; meeting their future in-laws.  Stress is knowing that the deadline for an article is fast approaching and you just can’t seem to find the time to sit down and write it.  Stress is having to wait another 15 minutes for a bus because the first driver did not stop even though he saw you dashing across the street, your arms flailing.

Then there is good stress like having a child; getting married or getting that promotion you always wanted.  These are stressful because they are big chances.  For each there are greater responsibilities and a lot of adjustments to make.

Stress can result from an overactive imagination.  Take Susan for example.  She invited her boyfriend for lunch for the first time.   She worried that she wouldn’t get home from church in time to prepare the meal.  She worried that he wouldn’t get a parking space.  She worried that he wouldn’t be able to eat chicken or turkey because she wasn’t sure if he was a vegetarian.  She worried that she would be so nervous that she would spill or break something.  Well, her boyfriend got a parking space as soon as he arrived.  Not only did he eat the chicken and the turkey but he had seconds.  Lunch went very well.  The only setback was that it was not long enough.  Susan had allowed herself to get stressed out because she imagined the worst.  Stress robs us of a peace of mind and rest.

Many of us have spent sleepless nights because of stress.  We lie awake worrying about that presentation we have to make to very important clients; a job interview or final exams.  A lot of times stress is self-induced.  We worry and fret unnecessarily and only succeed in giving ourselves high blood pressure. 

How do we cope with stress?  Taking time out is always a good idea and doing something else such as going for walks in the neighbourhood or in the park.  Around this time of year it is especially nice because of the changing colours of the leaves and the air is fresh.  Fresh air helps to clear the mind.  Exercise is another option.  Walk off the stress on the treadmill or pump it out of your system as you lift weights.  Read a book or flip through a magazine.  Pick up the phone and call a friend.  It helps to talk to someone.