AIBU to sort my mum’s medication and appointments at the GP?

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DM is 79. Needs a lot of support due to health issues. Recently dsis demanded I do more (which is difficult as I work full time, have dc and difficult circumstances).

I said I’d pop in more to see DM and I’d take her to a few appts. Dsis said that I needed to take her to the GP for her blood pressure check, a blood test and a medication review.
Ive seen how many unused tablets etc she has so I thought it would be helpful to go through them beforehand and check what is current and what’s not.

At the appt we went through it all and some things were changed/ removed. Also DM had paracetamol and glucose on there so I said it’s ok to remove them as she has quite a stock building up and going forwards I’ll just purchase them.

Dsis has gone mad about this ??? Thinks I shouldn’t have ‘meddled’ and wants me to arrange getting them reinstated? I’m happy to purchase them once the current ones run out . The amount it would cost for one month is about £6!!!

Now dsis is saying she will get DM to retract the GP consent for me to be involved in her care and that she will find me other things to do not involving medical support .

The only reason that it’s reasonable to have paracetamol on prescription is if large quantities are taken regularly. Because you can only buy 32 at a time ( and sometimes 16) if you need 8 per day then you’d be forever having to buy more.

The rest is weird. Does your sister want to be in charge and for you to simply do her bidding? This needs a proper conversation and delegation of responsibilities and then regular communication with updates. Your DM may last for years needing support.

You really shouldn't have removed the paracetamol and glucose as it now means if she is hospitalised she won't be given them as they are not on her prescription. I was told off by my doctor for doing it with paracetamol and hayfever tablets.

If this was me, I would be very irritated, mostly because it’s so much easier if a GP will prescribe paracetamol, nothing whatsoever to do with the cost. My mum’s GP prescribed paracetamol for her and she needed to take two tablets four times a day for a long term and incurable back problem; the pills just used to arrive with everything else in her dosette box and were always available. In contrast, when I slipped a disc in my back, and was in constant agony for two years until I had surgery, I was taking the maximum dose of paracetamol, amongst other painkillers, on my doctor’s advice, but I had to buy them myself. Pharmacies are only legally allowed to sell you a maximum of 100 tablets at a time, which isn’t even a week’s supply, and I found that most would only sell 64 tablets at a time. Supermarkets will only sell two packs of 16 pills in one transaction - two days supply. It was really inconvenient to buy enough paracetamol for what I needed each month. Ive no idea how easily you can buy glucose, but you have potentially caused huge inconvenience with this and I would have been really annoyed if anyone had meddled with my mum’s medications like you have done without thinking about the ramifications.

And as another poster has said, there will also be implications for your mum if she is in hospital and they aren’t on her prescription.

She doesn’t take a huge amount

I’ve been in hospital a lot myself and regularly given paracetamol and other painkillers and I don’t have then on a repeat prescription?

I would have been delighted if Boots or Amazon would had delivered a month’s supply of paracetamol at a time but they are not allowed to sell that many. NNo pharmacy is allowed to sell more than 100 tablets at a time, and may won’t sell tjst many anyway.

That’s because you will have needed it for the condition that you are hospitalised for. Drugs that you need to take regularly you are expected to take in with you and have documented.

She would be able to take purchased paracetamol and glucose then !

Her paracetamol dose is 2-4 tablets every 1-2 days. It’s not a regular daily medication. I don’t even know why it was added to repeats. Glucose yes she needs more often but that’s still not a huge amount as she has x2 tablets per hypo

most Hospitals would not allow any drugs from outside to be taken by an in patient unless they could see that they had been prescribed and were in their original boxes with the pharmacist’s label attached.

Not quite the same scenario though.

I also manage the meds schedule for someone in their 70s, thirteen different items, one of which is daily Aspirin. I could likely get that very cheaply but I would not remove it from the prescribing schedule as it forms part of the bigger picture for any GP/health care provider in future or a time where I might not be available.

So it depends, was she prescribed it as simply an occasional pain relief? Or is it part of a daily medication regime she’s on? If the former then likely it doesn’t matter, if the latter then best to have her full regime registered with the GP.

Have you considered asking the pharmacist/GP for a dosette box instead of individual boxes of pills? IF meds are changed, the dosette box gets updated too.

Out of interest, why does she take glucose tablets?

How odd. I'm not in the UK and recently spent a week in hospital and they provided me with my regular medication daily.

For occasional pain relief

Type 1 diabetes

If you have been written up for them you will get them but you have to wait for that and in some cases that can take hours.

So presumably the glucose is just if she is having a hypo and not a daily thing? If not, then she needs a diabetic review ASAP.

Family!

Ignore her.
You work full time and £6 ..get a life.
Call mum reguarly
some people can never be pleased..repeat that to the sister.

If your mum is at risk of muddling up tablets then not having paracetamol on repeat is a good thing - removes the risk of accidental overdose. I'd just rise above sis (no idea why she's annoyed, you've done exactly the right thing). Clear out stocks of meds and take anything out of date or not needed back to chemist, make sure all her repeats are on repeat and if possible getting delivered in a blister pack or dosette box.

Just tell sis this was the GP's decision not yours. They won't reinstate meds just because she demands them - they need to be clinically required.

The OP states the glucose tablets had been building up at home - so clearly unused, thus she is not having regular hypos.

That’s a very good point.

Maybe your sister is addicted to paracetamol and was using them?

I can't see what you've done wrong OP.
Its shocking the wastage that happens with medication for elderly people. I've had people come into the pharmacy with several black bin bags stuffed with medication from a relatives cupboards. Not because the patient has died, but because someone decided to have a sort out and discovered stock piles that had been dispensed months, sometimes years before, out of dates, old dosage, no longer using etc....
No one should ever need more than a month worth of medication, especially the elderly who can easily get confused. Its a danger to the patient, young children visiting the patients property, and a huge drain on the NHS.
We also have relatives who come in to drop bags off, and they tell us they've kept certain things for themselves they'd normally buy over the counter.... such as paracetamol and glucose. Is it possible your sister was taking from your mums free stock pile which you've now cut off?

The issue is the amount you can get on prescription is different to what you can get over the counter. It also allows the dr's to monitor the need for pain relief and whether other options are needed

My mum has chronic pain caused by a back injury. She takes a combination of paracetamol and codeine when it bad and cocodamol when it is less bad and just paracetamol when it's mostly ok. Whilst she can get the cocodamol and paracetamol from the pharmacy relatively easily. Taking the recommended amounts means going to the pharmacy every 3 days. Her prescription for paracetamol and cocodamol gives her nearly two weeks worth. Meaning 1 trip to the pharmacy instead of 4!!!

The GP monitors the frequency she is needing codeine Vs cocodamol Vs paracetamol so they can see if her pain is being managed. When her pain levels were increasing and she was needing more pain relief they then referred her back to the physiotherapist for more exercises. She periodically has physio support as her needs evolve and the exercises get adjusted.

The other thing is the communication between you and your sil. I imagine you would have had a different response from her if you said. Let me do more, how about I sort out the prescriptions. I can set up the proxy and get them ordered. I can pick up paracetamol as required too - what do you think?Rather than, this is what has happened this is what I'm doing.

effective communication is so important between joint carers. My mum and her sister cared for my grandparents and it took time to find the right rhythm once they were both doing the medical side. My mum had done the bulk of the medical side and they shared the social stuff. It was only when it resulted in the wrong medications being given because my aunt hadn't realised it had been changed that they introduced a note book in the medication cupboard. It listed all conversation with the drs around medication. When it was prescribed, why it was prescribed and why it was changed.

Hrft but its about control.
Whilst your Dsis can moan at you about not doing stuff, doesn't mean she wants to lose control.
Like most unreasonable disputes she feels like things are out of her control and she's not comfortable with that.

What you did was absolutely reasonable, how you fix with Dsis is more tricky.