Tuesday, June 4, 2013

Tuesdays with Elders - Roger's Guardian Going to Law and Med School

I thought with my folks in the nursing home, things for me would be easier and smoother. Far from the fact.

The nursing home had sent Ma to the geriatric psych hospital because they claimed Ma was a danger to herself and to others. I had suspected an incident that happened had been blown out of proportion. My suspicions were corroborated when Ma, without prompting, related what had happened.

The nursing home claimed Ma needed anti-psychotic medication. Ma has dementia, sees people, animals, vermin that are not there. They insisted she needed the drug Risperdal.

Use of anti-psychotic medications for an incapacitated person requires a Roger's Guardian to be appointed by the Court. The Roger's Guardian monitors the care plan and use of drugs and reports back to the Court.

I found myself going to law school and medical school. As my mother's temporary guardian and her daughter, I not only felt a filial obligation, but a moral obligation as well to fight on her behalf. Because of the dementia, Ma couldn't make decisions regarding her health and welfare.

The use of anti-psychotic medications in Massachusetts state institutions was challenged in 1975 when Rubie Rogers and others sued a Massachusetts state mental institution for using drugs as chemical restraints without the patient's consent.

Most of the residents on my mother's floor at the nursing home spent their days parked in wheelchairs in front of the nurses' station. For these poor souls, the lights were on, but no one was home. Ma didn't fall into this category. She was outspoken and demanding. I think at 92 years old, she felt she had earned the right.

I then read up on Risperdal, the drug the nursing home wanted to use. I found the drug is used to treat schizophrenia, mania or bipolar disorder. In all the literature I read, it plainly stated the drug was not to be used to treat behavior problems in elderly adults with dementia. Other literature suggested that in elderly patients there was an increased risk of stroke. Ma had a stroke in 2003, and I'm sure she has had several mini-strokes since.

At the geriatric psych hospital Ma showed none of the behaviors the nursing home claimed. She didn't post a threat to herself or others. Ma's age and the possible side-effects didn't warrant the use of Risperdal in my opinion. The doctors at the geriatric psych hospital agreed. The nursing home refused to take Ma back without a Roger's Guardian in place. That's how in the middle of a blizzard I found myself touring nursing homes that would be able to care for my mother without the use of powerful drugs that would cause more problems than give her benefits.

My parents were transferred to a nursing home that specializes in dementia (Alzheimer's is the most well-known dementia). They got good care at the first nursing home, but now they get excellent, individualized care.

I still keep a watchful eye out. I attend all care plan meetings and question all medications and treatment. I make unannounced visits and observe staff and other patients. I'm The Guardian.


  1. You're a good daughter, CJ. Your parents are blessed to have you watching out for them.

    Do you have a cape? I think one with your guardian emblem would be awesome.

  2. I'm glad to hear you found a safe and happy place for them. Whew! (I think you deserve a cape too!)