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Pain Patches: A Cautionary Tale The following information was given to us by a concerned family to alert healthcare providers and the public about the potential for misuse of pain patches and to encourage families to be diligent advocates for residents in senior's facilities. March 2005- A father was prescribed a pain patch for severe osteoarthritis by his family doctor when he was living at home. He continued to have pain and over time the patch was increased. Eventually he moved to a nearby nursing home. Shortly after arriving there, the family was told that he had pulled the patch off his back and was uncooperative. He told them that someone was "fiddling" with the patches. The family raised questions about this but received no explanation. It was implied that their father was confused. His condition continued to deteriorate and his patch and other pain medication were increased. He did not want to participate in activities, became withdrawn and anxious, and was always in pain or in a somnolescent state. He was becoming weaker every day. Then the family was informed that the nursing home suspected a staff member had been tampering with his medication by taking patches from him. The family took their father home to monitor his pain. His patch was reduced and he was kept at home for a week to ensure he was safe. A worker at the facility was charged. The Judge hearing the case was a wise and sympathetic man who encouraged the family to continue to seek explanations and to increase public awareness. The family has contacted seniors advocacy groups, the Advocacy Centre for the Elderly, the Canadian Pharmaceutical Association, private medical pharmacies, and drug companies that supply the patch. Nursing associations and colleagues are making their members aware. These organizations have all been supportive of making the public and providers aware of the risks involved, through their own connections and membership. The lesson this family has learned is to expect the unexpected and if something is not corrected, press the issue even if it may seem awkward or difficult. They have made small steps in attempting to prevent this happening to residents in other facilities. Public education of the process and senior's rights still require monitoring and champions. Physicians prescribing patches and healthcare workers dispensing and applying them should be diligent in the use and disposal of the patch. Drug companies should offer alerts and advise disposal of patches in the sharp container as noted on the patch inserts. Ongoing education and updates for facility staff about new medications, policies and communication within and outside the organization are very important. Facilities need to ensure a safe environment and have safe practices. No one wants a family member in a place that is not safe. The older person, like anyone else, wants to be treated, loving and respectfully, in a safe place. |