Friday, November 4, 2016

Medication Management: Caring and Medicine

If you are caring for a Loved One (LO) either part time or full time it is very likely that you will be involved in managing their medications.  The level of care you provide and the reasons your LO needs care will determine how involved you are with medications. The lists below will help you work out what level of support you are providing in this area and then read the tips for each level. 

Minimal Support

On the most part your LO is managing their medications independently while you support them with other daily tasks such as housework, transport, meal preparation etc.  You might be:
  • getting prescriptions filled at the pharmacy.
  • aware of which medications your LO is taking.
  • aware of the medical conditions that your LO has that are being managed with medication.
  • aware of major changes to medications (new medications or ceased medications).
  • gently reminding your LO to take their medication on some occasions.

Tips for this level of care

  • Get to know the pharmacist and ensure they understand your relationship to LO- this will be helpful if and when the level of support you are providing increases.
  • Encourage LO to have an easily accessible list of their medications, what each medication is used for and the daily dose of each.  Keep a copy of this for your own reference.
  • Make sure you are aware of the potential side effects of new medications and how you should respond if these side effects arise. 
  • Look out for signs that LO is struggling to manage their own medications as you might need to increase your level of assistance. Signs may include: skipping doses, losing track of prescriptions needing to be filled, mixing up different medications, you find medications in unlabelled containers or not contained at all. 

Assisting Support

You are assisting your LO with medications while trying to promote their independence in their daily life.  You are probably:
  • using a weekly sorting system that lays out dosage by time each day (or a Webster pack) so LO can independently retrieve each dose at appropriate times.
  • maintaining a list of the medications your LO is using, what the medications are used to treat and recommended doses.
  • assisting your LO with storing medications appropriately.
  • ensuring ceased medications are disposed of correctly.
  • checking that doses are not missed.
  • helping your LO manage the use of "as needed" medications.
  • knowledgeable about side effects of medications and changes made by doctors. 
Webster Packs (available through most pharmacies)
allow you to receive your prescribed medications
already set out showing when to take them. 

Tips for this level of care

  • I know I'm repeating myself, I'm doing it on purpose!  Get to know your pharmacist.  Make sure they know you and your relationship to LO as well as your role in caring.
  • If you don't already, get to know your LO's GP and other professionals who are involved in treatments for medical conditions. This will certainly come in handy in the future. 
  • Be gentle! Your LO needs as much independence as possible and letting go of any independence will be difficult for them. 
    This pill sorter allows you to organise medications yourself,
    like a Webster pack, but you have more control.

Care and Management

You have taken control of all medications for your LO.  You administer all medications and keep track of maximum doses.  Medical professionals consider you the advocate for LO and while LO is included in conversations about medication (and health treatments) you are the decision maker.  You are probably:
  • Administering any and all medications at all hours of the day.
  • Organising medications into regular doses- such as a Webster Pack.
  • Recording what medications LO is taking and when they are taking them.
  • Knowledgeable about medical conditions and which of these each medication is treating. 
  • Speaking regularly with LO's GP, pharmacist and other members of the medical team. 

Tips for this level of care

  • Use Webster Packs or a sorting system.
  • Keep a record of medications being taken and the time taken everyday.  This helps you keep track of 'as needed' medications and stick to daily limits. Record side effects, pain levels, vital signs and other observations you make.  This is especially helpful if/ when you are discussing LO's wellness with medical professionals.  Having this system also makes it easier to leave LO with a different carer, as you know all relevant information will be recorded in your absence and substitute carer can refer back to previous days for guidance. 
  • Tell LO what they are taking when you administer medications.
  • Remind LO what each medication is used for... this is helpful when LO questions why they are taking so many tablets! 
  • Be gentle and patient.  If LO refuses a medication, assess their mood before trying to explain why it is important to take the tablet.  If they are agitated, worried or anxious, no amount of reasoning will help. Let LO miss the one dose.  Ensure it is included in the next round of medications.    Discuss it calmly with LO when they are in a better mood.  If refusal continues, record this and discuss it with a health professional at your next appointment. 

At all levels...

Remember that managing one's own medication is, for some, equal to brushing your teeth or combing your hair.  It is a personal aspect of health care and often it is the only thing that any patient is able to control themselves.  Sharing this responsibility and eventually handing it over to someone else is a huge step for anyone to take, so be mindful of this.  You have a huge responsibility now, but you can do this.