I say this again: Don't start hospice on a weekend. Hospice is all about the drugs, and you can't get the drugs. At least not at the CVS at the corner of 528 and Southern in Rio Rancho (/an ABQ suburb).
So, hospice meds are divided between maintenance meds, comfort meds and end-of-life meds.
- Maintenance meds: Daves meds for his bi-polar, his asthma, etc. Hospice doesn't pay for this, understandably, but they order it for you.
- Comfort meds: Meds to make the patient comfortable. These are things like the meds that would have reduced the amount of ammonia in Dave's brain and made him more rational. Oxycodone is one of these meds, and I think it is a pain reliever I've used, and I don't remember any great pain relief.
- End-of-life meds: You don't get these until the end-of-life is imminent. This is your morphine (which makes Dave hallucinate) and your Dilaudid. They also give Haldol, an anti-psychotic, for people who are having terminal agitation.
Usually the meds are supplied by the hospice from its warehouse, but that isn't open on the weekends. On Saturdays and Sundays the prescriptions go to the CVS pharmacy on the corner of 538 and Southern.
CVS told the doctor and the admitting nurse that the meds would be ready that afternoon, Saturday. Dave was sane enough at that time to be on his own, so I gave them extra time and showed up at 2 in the morning. None of it was done. None of it. "Short-staffed," the woman said. I pleaded at least for the pain medicine, and she filled that - one prescription out of 11. I went back to Dave's, annoyed, but not furious.
The next morning I told the nurse about the situation, who passed that on to the doctor. I could hear the doctor shouting "Lies! Why do they lie?" through the phone.
That Sunday afternoon I went to the CVS for the rest of the meds. A smirky manager told me I had a lot of prescriptions to fill, and that some of them were for controlled substances, and that the pharmacists were the only ones who could fill those and they were all busy giving covid vaccines. I was civil enough to say good for you, giving vaccines, but if you are so short-staffed I couldn't see why you would take on orders you can't fill, and then he said I was no more important than the other people waiting, and if I didn't mind waiting at the CVS few hours he might be able to fill the prescription. I couldn't leave Dave alone because Dave wasn't sane enough that day. (Perhaps he was not sane because he hadn't been given the medication that would have reduced the ammonia in his brain, because it was, say it with me, tied up at the CVS.)
I told the manager that I couldn't imagine why the hospice was doing business with them at all, and left without the one piddly prescription they offered -- it was a maintenance med Dave already had a bottle of -- and went back to Dave's house and cried. I also formally cursed the family of the smirky manager with a protracted hospice in which they couldn't get any medicine, and he would have to watch.
On Monday the doctor was able to supply one the end-of life meds from their warehouse, and she made another plea to the CVS to fill the prescriptions they had, and when I arrived they had almost everything. As I was waiting, the man in the line next to me had just evidently told a different manager that his pharmacy was "a piece of shit," and that manager chastised him, saying that his staff worked very hard and it wasn't their fault that the computers were down. So, Saturday/Sunday the lie du jour was "short-staffed," then on Monday it was "the computers are down."
Then on Tuesday we got the last bottle, and of course it was some useless thing that he needed for his bi-polar, or for sleeping, but by then the agitation had started and there couldn't have been any sleep even if he'd been drugged.
But good God. Four days. To fill a prescription. And God knows why.
FOUR DAYS? For *HOSPICE* medications??? And since some were controlled substances, you couldn't just pull them to a different pharmacy, I guess?
Posted by: KC | November 09, 2022 at 09:23 AM
Aside from the doctors and hospice people trying to do right by Dave, every single other part sounds like the world's biggest cluster. I am so sorry the universe was so intent getting in the way of you who was there for a kind and important reason. Damn universe.
Posted by: kathy potvin | November 09, 2022 at 11:19 AM
KC - I would have, but every day they were imminent. Had I known they were four days down the road I would have gone elsewhere - but, the hospice recommended CVS because the ither alrernative, Walgreens, was slow.
Kathy Potvin - It was just a bad sitarion. I wish I could have picked my hospice, or brought my own drugs.
Posted by: theQueen | November 09, 2022 at 11:03 PM
hahaha. I so often think bringing my drugs could make things better.
Posted by: kathy potvin | November 10, 2022 at 07:55 AM
Kathy Potvin - My drug of choice is food. I have been eating at a rate not seen since mom died.
Posted by: theQueen | November 10, 2022 at 07:32 PM