Incompatible Medications

This week in reviewing resident charts discovered a problem with elevated INR results due to coumadin for three of the residents we were reviewing. Modern pharmaceuticals are phenomenal however they also bring risks. To keep a resident safe it is everyone’s responsibility to be vigilant to the potential untoward effects. The residents INRs were above therapeutic ranges measuring from 2.3 up to 9. In researching possible causes learned that simivastatin can increase results of an INR. Two of the three clients were taking simivastatin. When developing a care plan there should be directions for teaching the resident what signs to watch for and report to the nurse, directions should include indications for which caregivers should be alert and when the resident should be seen by the doctor or sent to the hospital.

Memory loss

Geriatric nursing can be so delightful and full of surprises. Each senior is different and has a story to tell. I had a pleasant elderly lady call me this week. If fact she has called me at least three times. She never remembers my name or that she has called me. She was concerned about the government being charged for protective undergarments when her insurance is paying for the supplies. I explained that this type of issue is handled by the Medicaid Fraud Unit and often takes an extended amount of time to complete an investigation. She continued on with her story and listed people she has talked to, she couldn't remember their names but knew they worked in the government. I continued to visit with her and asked her how I could help her. She wanted to know when she would be receiving a report about what was found out. I replied I was sorry, but that I do not work at the Medicaid Fraud Unit so do not know that information. I asked her if she was getting the supplies she needed and she said yes. I asked her if anyone was mistreating her she said oh no, of course not, she was just wondering about what had been done about the government being charged for the protective undergarments. We visited a little more. I thanked her for calling and said if I could be of assistance please call back. She thanked my for my time and for listening. I suppose I will get another call next month and my friend and I will visit again.

Vulnerable Adult?

Who is defined as a vulnerable adult?An adult who:

*is 60 years or older who cannot take care of him or herself and/or

* has a developmental disability and/or* has a legal guardian and/or

* lives in a facility (adult family home, boarding home, nursing home, or soldier's home) and/or

* receives services from a licensed health, hospice or home care agency and/or

* receives personal care or health services from an individual who is paid for providing the service.

What is abuse?Abuse is an action (that is not an accident) that injures, intimidates, punishes or unreasonably confines a vulnerable adult. Abuse can be physical, mental, sexual, or coercive. Types of abuse include abandonment, neglect, self-neglect, and financial exploitation. Some professions are automatically mandated reporters such as nurses, teachers, psychologists, and employees of any adult family home, boarding home or nursing home. I'm sure there are others that I have missed.