New York Times: Nursing Home Patients in Pain

The D.E.A. is enforcing a law designed to prevent drug abuse by requiring that skilled nursing facilities (SNF) wait for a physician’s signed prescription before providing patients with pain control medicines such as Vicodin, Percocet or morphine.

This leaves our vulnerable elderly population in a difficult situation that is also uncomfortable for the SNF nursing staff.

Here are three suggestions for families:

1.  Anticipate

Determine what the doctor has prescribed and make sure the prescription is sent to the SNF ahead of need.  If the patient receives prescriptions on Monday that will cover the week, see if the physician can write two.  Provide the second to the director of nurses.

2.  Hand carry

Anyone with a relative or friend in a nursing home or convalescent hospital knows that the best possible care is obtained by showing up.  Being present for daily or several times weekly visits at random increases the amount of attention staff pays to your patient.

Ask the physician if you can hand carry the prescription to the SNF.  Make it part of your visit routine.

3.  Standing orders

Ask the physician if the prescription plus amended standing orders to provide more discretion to the attending nurses will help the patient receive pain medication faster while complying with the rules.  Keep in mind that doctors see patients in a SNF far less frequently than if the same patient were in a hospital.

Above all, ask questions and find a solution that will work for the patient.  Read the New York Times piece on the enforcement of DEA rules.

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