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No Pain Medication: Philosophy/Way of Life
I have a question and I'd like some honest feedback from the group (a little background first, then I'll pose the question):
My Grandfather-in-Law (my wife's Grandfather) refuses to take any Rx pain medication and will take nothing stronger than an extra strength Tylenol, and even that's a chore to get him to take. He's in a considerable amount of pain for one reason or another, is in his late 80's, and as a way-of-life (philosophy), refuses to take narcotic pain-killers because he doesn't like they way they make him feel (Apparently he had an experience with them at a VA hospital shortly after WW2 that put his back up). My Grandmother-in-Law puts bandages on his legs because he's got some small sores that refuse to heal, so she changes his dressings on a daily basis.
My question is, would it be wrong to trick him into taking pain medication?
The bandages are the key, in our mind (My wife, Mother-in-Law, Sister-in-Law). Simply put, we could approach his doctor and make sure he'd be opiate tolerant. Get his doctor (Oncologist) to prescribe a LOW dose Fentanyl patch, slip the patch into the package of dressings/bandages that are used on a daily basis, and voila... pain starts to go away with very little 'narcoticky' effect. We could ever so slowly increase the dose until it's high enough to where he doesn't constantly complain about it (which he does now but refuses to take anything for it).
So... he's against taking pain meds, as his way of life dictates. Is it wrong to get him on pain meds to improve his quality of life?
*We haven't done this yet, mind you. I'm just tossing this out there to see what you guys in the PM-Community think.
My Grandfather-in-Law (my wife's Grandfather) refuses to take any Rx pain medication and will take nothing stronger than an extra strength Tylenol, and even that's a chore to get him to take. He's in a considerable amount of pain for one reason or another, is in his late 80's, and as a way-of-life (philosophy), refuses to take narcotic pain-killers because he doesn't like they way they make him feel (Apparently he had an experience with them at a VA hospital shortly after WW2 that put his back up). My Grandmother-in-Law puts bandages on his legs because he's got some small sores that refuse to heal, so she changes his dressings on a daily basis.
My question is, would it be wrong to trick him into taking pain medication?
The bandages are the key, in our mind (My wife, Mother-in-Law, Sister-in-Law). Simply put, we could approach his doctor and make sure he'd be opiate tolerant. Get his doctor (Oncologist) to prescribe a LOW dose Fentanyl patch, slip the patch into the package of dressings/bandages that are used on a daily basis, and voila... pain starts to go away with very little 'narcoticky' effect. We could ever so slowly increase the dose until it's high enough to where he doesn't constantly complain about it (which he does now but refuses to take anything for it).
So... he's against taking pain meds, as his way of life dictates. Is it wrong to get him on pain meds to improve his quality of life?
*We haven't done this yet, mind you. I'm just tossing this out there to see what you guys in the PM-Community think.
As sorry as you feel for him...as much as you want to see his suffering ending....it truly is not your place or anyone's to go against his wishes. If he were truly unable to make a decision, he has already told you what he wishes. He doesn't want narcs. Please respect him. My heart goes out to you and his family watching him in pain but you have to respect the man. He doesn't want the stuff.
Thanks everyone for your candid & honest feedback. It is VERY MUCH appreciated.
All of you now know the situation and I'm sure you can well imagine how very difficult it's been on the family watching him suffer (not to mention it not being a very pleasant walk-in-the-park for him). This, of course, being compounded by the fact that immediate relief is but a phone call & trip to the pharmacy away... yet he just won't bend (stubborn old coot!).
Thank you all, once again, for the thoughtful insight and the frankness with which you all communicated each of your perspectives.
Cheers guys and have a good weekend;-)
LMNO
All of you now know the situation and I'm sure you can well imagine how very difficult it's been on the family watching him suffer (not to mention it not being a very pleasant walk-in-the-park for him). This, of course, being compounded by the fact that immediate relief is but a phone call & trip to the pharmacy away... yet he just won't bend (stubborn old coot!).
Thank you all, once again, for the thoughtful insight and the frankness with which you all communicated each of your perspectives.
Cheers guys and have a good weekend;-)
LMNO
My mom was the same way. She wanted pain relief, but couldn't handle the side effects of any of them. Even darvocet was too strong for her. You also have to understand that opiates do weird things to older folks. Demerol in particular is contraindicated for seniors as it tends to make them hallucinate among other things.
I swear, some of this attitude is simply due to the age our parents and grandparents lived in. While my mom wanted pain relief, she took it as a badge of honor to downplay pain. Being a complainer was worse than being in pain. She dragged herself around on a broken hip for almost two weeks before she collapsed at home, and absolutely refused to see a doctor about her increased pain and inability to walk. Stubbon old beotch anyway. She always had to do things her way, even if her way was demonstrably causing herself harm. Legally, she had the right to do that.
All you can do is try to get in with him at a doctor appointment and bring up the subject. The doc can't do anything with you privately due to HIPPA laws, so you or your wife would have to physically attend the appointment to be included in any treatment plan.
I swear, some of this attitude is simply due to the age our parents and grandparents lived in. While my mom wanted pain relief, she took it as a badge of honor to downplay pain. Being a complainer was worse than being in pain. She dragged herself around on a broken hip for almost two weeks before she collapsed at home, and absolutely refused to see a doctor about her increased pain and inability to walk. Stubbon old beotch anyway. She always had to do things her way, even if her way was demonstrably causing herself harm. Legally, she had the right to do that.
All you can do is try to get in with him at a doctor appointment and bring up the subject. The doc can't do anything with you privately due to HIPPA laws, so you or your wife would have to physically attend the appointment to be included in any treatment plan.
It is legally wrong and also I second everyone who says it's morally wrong. Stubborn or not, and hard on others though it is, every person has a right to make his own decisions unless he is flat-out delusional or otherwise incompetent. Even then, he would deserve that you inform him you are giving him something.
I have had similar issues with getting my Grandfather to take just about anything. He won't even take advil unless he's having terrible pain and only then if he also has inflammation that the ibuprofen would help. He won't even allow a dentist to give him a shot of novicane when drilling in his mouth. I was somewhat taking care of him for about a year and living in his house. He also had a bad experience with Morphine in the hospital years ago and was in the military. I don't know if it was a VA hospital or not but he said the Morphine just intesified his pain and lists it as his only allergy.
When my grandfather had to be hospitalized for issues relating to COPD he was given Ativan because he normally drinks a lot of wine daily and they were worried he would have withdrawls. They were not quite honest with him about it and I think in that case it made it worse. The Ativan made him very paranoid and caused some slight halucinations. He didn't know why he was so loopy and blamed it on the hospital staff and other things like the other medications he was being given. He didn't understand that the blood suger and BP meds were not the culprit and it made it hard to convince him they were okay to take when he got home.
He has had a hard time trusting doctors and nurses about medication since that incident. There were a lot of other factors and I could go on and on but I'm mentioning all of this because you don't want to do anything to violate that trust you have with your Grandfather regarding his medical care.
I know with the fentanyl patch some people feel loopy upon starting it. You don't want him to feel loopy and not know why. Then he may not trust that you are all telling him the truth about his meds, which would be a completely rational reaction.
Maybe he (knowingly) could or would try something like low-dose tramadol and work his way up, although I know some people feel that tramadol makes them loopy. Perhaps starting with Darvoset and working up to stronger meds may be beneficial in his case as he could slowly build a tolerance. Maybe you could get his most trusted doctor to talk to him about the benefits of pain medications versus the risk of untreated pain causing BP issues and trouble healing.
I wish you all the best and I really do feel for your situation. I hope you are able to convince him that just trying a med would be okay. Let us know how it goes, if you wouldn't mind. I know a lot of us here have taken care of our elder loved ones and it's always good to talk about these things that come up. It can feel very lonely and frustrating sometimes but you have all of us to talk to about it.
When my grandfather had to be hospitalized for issues relating to COPD he was given Ativan because he normally drinks a lot of wine daily and they were worried he would have withdrawls. They were not quite honest with him about it and I think in that case it made it worse. The Ativan made him very paranoid and caused some slight halucinations. He didn't know why he was so loopy and blamed it on the hospital staff and other things like the other medications he was being given. He didn't understand that the blood suger and BP meds were not the culprit and it made it hard to convince him they were okay to take when he got home.
He has had a hard time trusting doctors and nurses about medication since that incident. There were a lot of other factors and I could go on and on but I'm mentioning all of this because you don't want to do anything to violate that trust you have with your Grandfather regarding his medical care.
I know with the fentanyl patch some people feel loopy upon starting it. You don't want him to feel loopy and not know why. Then he may not trust that you are all telling him the truth about his meds, which would be a completely rational reaction.
Maybe he (knowingly) could or would try something like low-dose tramadol and work his way up, although I know some people feel that tramadol makes them loopy. Perhaps starting with Darvoset and working up to stronger meds may be beneficial in his case as he could slowly build a tolerance. Maybe you could get his most trusted doctor to talk to him about the benefits of pain medications versus the risk of untreated pain causing BP issues and trouble healing.
I wish you all the best and I really do feel for your situation. I hope you are able to convince him that just trying a med would be okay. Let us know how it goes, if you wouldn't mind. I know a lot of us here have taken care of our elder loved ones and it's always good to talk about these things that come up. It can feel very lonely and frustrating sometimes but you have all of us to talk to about it.
I also do not think that this would either be wise or "correct". Fentanyl patches are pretty potent, and even at the lowest dose, can cause side effects, even though many patients do not get that "narcoticy" feeling as you say. The effects of the patches can be greatly increased, possibly to a deadly level, if they were to be placed on an area of the body that has an open wound (or even a scrape). To try and get him to an opiate tolerant level without his knowledge would be difficult at best. As someone else mentioned, if he were medicated without his knowledge and then ended up falling because of the side effects of the narcotic, there could definitely be more problems.
If he were to be deemed as incompetent to make decisions for himself, then the situation may be different, but it doesn't sound like that's the case - it sounds like he just doesn't want to take meds because of the way they make him feel - and while the longer acting meds such as fentanyl often do not give that same euphoric feeling that some patients get from shorter acting meds, they all still do have some side effects.
My suggestion, rather than trying to medicate him with the patches without his knowledge, would be to attempt to sit down with him and his doctor and explain that you understand he is in pain and that he doesn't want to take narcotic pain medications and also explain that if his pain levels were under better control, then his quality of life could be much better. Then start off by trying to get him to try the extra strength tylenol (or other over the counter med) to see if that helps at all. It may or may not, but at least if you start off with that, and it doesnt help, then you may have better luck in trying to get him to AGREE to give a low dose narcotic a try.
Of course, all of this is just my opinion, but if it were one of my family member, while I would feel bad about them being in pain and not wanting to take anything for that pain, I would feel worse if I medicated them wihtout their knowledge and then something worse happened. THAT would make me feel absolutely horrible - and guilty.
I wish you the best of luck - you're in a tough situation.
If he were to be deemed as incompetent to make decisions for himself, then the situation may be different, but it doesn't sound like that's the case - it sounds like he just doesn't want to take meds because of the way they make him feel - and while the longer acting meds such as fentanyl often do not give that same euphoric feeling that some patients get from shorter acting meds, they all still do have some side effects.
My suggestion, rather than trying to medicate him with the patches without his knowledge, would be to attempt to sit down with him and his doctor and explain that you understand he is in pain and that he doesn't want to take narcotic pain medications and also explain that if his pain levels were under better control, then his quality of life could be much better. Then start off by trying to get him to try the extra strength tylenol (or other over the counter med) to see if that helps at all. It may or may not, but at least if you start off with that, and it doesnt help, then you may have better luck in trying to get him to AGREE to give a low dose narcotic a try.
Of course, all of this is just my opinion, but if it were one of my family member, while I would feel bad about them being in pain and not wanting to take anything for that pain, I would feel worse if I medicated them wihtout their knowledge and then something worse happened. THAT would make me feel absolutely horrible - and guilty.
I wish you the best of luck - you're in a tough situation.
This must be so difficult to go through as it is never nice seeing someone suffer, especially when they are blindly refusing something that can ease their pain based upon an experience that happened so long ago! (it must be something to do with getting old when they refuse to accept that just because something happened once it doesn't mean it will happen again, especially in medicine, where so much has changed since his experience!!)
Have you thought to maybe ask your grandfather-in-law to consider these patches, as they are not tablets which is what he seems to be against. If he questions the type of medicine they are, just tell him they will help the pain but means he doesn't have to take any narcotic pain-killers. Would he not agree to that?
Otherwise you could discuss the situation with his doctor and see what they suggest, and possibly, if your wife and his family are in agreement with you, seek to take Power of Attorney due to his age and situation? I am not sure on the laws and so on so you must try to do everything right, as you don't want to be breaking the law for trying to do what you think is best!! Good luck, I hope you find a solution! x
Have you thought to maybe ask your grandfather-in-law to consider these patches, as they are not tablets which is what he seems to be against. If he questions the type of medicine they are, just tell him they will help the pain but means he doesn't have to take any narcotic pain-killers. Would he not agree to that?
Otherwise you could discuss the situation with his doctor and see what they suggest, and possibly, if your wife and his family are in agreement with you, seek to take Power of Attorney due to his age and situation? I am not sure on the laws and so on so you must try to do everything right, as you don't want to be breaking the law for trying to do what you think is best!! Good luck, I hope you find a solution! x
El,
Peek is right - you really do need to let him know unless he is truly incompetent.
My thoughts on the Tramadol was that he MIGHT accept that since it's NOT Narcotic. Just an idea.
Best of luck to you guys.....Sherry
Peek is right - you really do need to let him know unless he is truly incompetent.
My thoughts on the Tramadol was that he MIGHT accept that since it's NOT Narcotic. Just an idea.
Best of luck to you guys.....Sherry
He'd still have to be told what he is ingesting with Tramadol. He might feel better about it, but he'd still have to know.
Having a POA still doesn't mean you can medicate someone against their will, or give them medication without their knowledge.
For that, he'd have to be declared legally incompetent to make his own decisions. If that's the truth, that's fine.
It's a tough situation, and I feel for you and know you only want him to feel better. But it's his decision to make, even if you or I would make a different one.
Having a POA still doesn't mean you can medicate someone against their will, or give them medication without their knowledge.
For that, he'd have to be declared legally incompetent to make his own decisions. If that's the truth, that's fine.
It's a tough situation, and I feel for you and know you only want him to feel better. But it's his decision to make, even if you or I would make a different one.
El,
Peek made a LOT of good points. Have you ever considered getting something such as Tramadol. I believe that LEGALLY speaking it is NOT considered to be a Narcotic. Would he take that?
That way you wouldn't be going against his wishes.
Just want you to know - thought I had thrown it in - my Mom ALSO had moderate Alzheimer's and I had Power of Attorney over her. Do you have that for your parents? Does your Dad have any problems with Dementia or Alzheimer's? That DOES make a difference.
Hope som of this helps......Sherry
Peek made a LOT of good points. Have you ever considered getting something such as Tramadol. I believe that LEGALLY speaking it is NOT considered to be a Narcotic. Would he take that?
That way you wouldn't be going against his wishes.
Just want you to know - thought I had thrown it in - my Mom ALSO had moderate Alzheimer's and I had Power of Attorney over her. Do you have that for your parents? Does your Dad have any problems with Dementia or Alzheimer's? That DOES make a difference.
Hope som of this helps......Sherry
My honest answer is no, I wouldn't do it.
Medicating someone against their will or knowledge is illegal and unethical. No doctor would be, or should be on board with this plan. Pain medications can predispose someone to falling...it would be awful if he didn't know this was on, and got dizzy one time and fell, fracturing a hip or something. The consequences could be severe.
Much as you love him, it sounds as though this is the way he wants it. If he is in his right mind and not legally declared incompetent to make his own medical decisions, it is illegal to secretly administer a narcotic (or any medication) to an adult without their knowledge or consent.
Even if its "just" a patch, and in a low dose.
I can tell you as a nurse, what you are tossing around in your mind is clearly against the law. Please don't do it.
Talk to him, try to get his doctor to talk to him...but the bottom line is that if he is a sentinent adult, he has the right to make his own decisions as to the medications he puts in his body.
Even if we love our elderly family members, they have the right to make their own decisions. I understand how hard it is to watch someone you love be in pain, and feel helpless. But you can't trick someone into taking medications.
Medicating someone against their will or knowledge is illegal and unethical. No doctor would be, or should be on board with this plan. Pain medications can predispose someone to falling...it would be awful if he didn't know this was on, and got dizzy one time and fell, fracturing a hip or something. The consequences could be severe.
Much as you love him, it sounds as though this is the way he wants it. If he is in his right mind and not legally declared incompetent to make his own medical decisions, it is illegal to secretly administer a narcotic (or any medication) to an adult without their knowledge or consent.
Even if its "just" a patch, and in a low dose.
I can tell you as a nurse, what you are tossing around in your mind is clearly against the law. Please don't do it.
Talk to him, try to get his doctor to talk to him...but the bottom line is that if he is a sentinent adult, he has the right to make his own decisions as to the medications he puts in his body.
Even if we love our elderly family members, they have the right to make their own decisions. I understand how hard it is to watch someone you love be in pain, and feel helpless. But you can't trick someone into taking medications.
Hi El,
I'm so happy to see that you are back on the board!! We missed you.
I don't want to come right out and say this so I'm going to tell you MY answer this way.
I LOST my Mom to Cancer in 16 years ago and she was in TREMENDOUS pain. Fortunately, she took what the Doctor told her was best for her and they were able to keep her out of pain. IF she had refused them - I would have had the Doctor do EXACTLY what you are considering doing. She was 85 years old and I - as well as my Dad - wouldn't have been able to see her suffer. I'm assuming that you ALL are on board here with this plan - is that correct? There is NOTHING worse than seeing someone you have loved ALL of your life suffer. We want to protect them and take care of them and keep them OUT OF PAIN the best that we can.
Do you have a plan on how to make him opiate tolerant without him knowing? Maybe his Doctor might have some ideas. Just remember - as I'm SURE you already know - those patches CANNOT be around an open wound or he will get too much medication in.
I wish you the VERY best in being able to bring comfort to your Dad. I'm SOOOO very sorry for what you and your Family are going through now. I KNOW how DIFFICULT it is for you all.
God Bless your Family and of course Your Dad. Your in my Prayers.....Sherry
I'm so happy to see that you are back on the board!! We missed you.
I don't want to come right out and say this so I'm going to tell you MY answer this way.
I LOST my Mom to Cancer in 16 years ago and she was in TREMENDOUS pain. Fortunately, she took what the Doctor told her was best for her and they were able to keep her out of pain. IF she had refused them - I would have had the Doctor do EXACTLY what you are considering doing. She was 85 years old and I - as well as my Dad - wouldn't have been able to see her suffer. I'm assuming that you ALL are on board here with this plan - is that correct? There is NOTHING worse than seeing someone you have loved ALL of your life suffer. We want to protect them and take care of them and keep them OUT OF PAIN the best that we can.
Do you have a plan on how to make him opiate tolerant without him knowing? Maybe his Doctor might have some ideas. Just remember - as I'm SURE you already know - those patches CANNOT be around an open wound or he will get too much medication in.
I wish you the VERY best in being able to bring comfort to your Dad. I'm SOOOO very sorry for what you and your Family are going through now. I KNOW how DIFFICULT it is for you all.
God Bless your Family and of course Your Dad. Your in my Prayers.....Sherry
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