Preventing Medication Mistakes in Assisted Living, At Home

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By Michelle Seitzer | SeniorsforLiving.com

When I asked our Twitter community about topics of interest and importance that they’d like to see on our blog, our friends at @NAWDPharmAssist (Nationwide PharmAssist Corporation, a retail pharmacy with mail order services headquartered in Boca Raton, FL) suggested a piece around medication (mis)management.

Anyone who is a caregiver, from the professionals in an assisted living community or hospital to the family members providing care at home, will likely have to deal with medications in some way, at some point. Filling prescriptions, administering medications, easing the discomfort of side effects, masking tablets in applesauce or pudding to ensure consumption — you name it, caregivers will almost certainly have to do it at least once. In my experience, I worried about toxic interactions.

A few years ago, my mother-in-law had a knee operation. She lives alone, so I took time off to stay with her for the critical first 24 hours after major surgery. Thankfully, she has an extensive support network: hour after hour, friends stopped by with food, cards, and flowers, or just to say hello and wish her well. Also fortuitous, one of her closest friends is a registered nurse, and I ended up calling her in a panic when my mother-in-law had a bad reaction to the pain medications the doctor had prescribed. I also had to make a trip to the local pharmacy to refill her prescription for migraines, as she experienced one in concert with her other post-surgery symptoms.

My primary concern in all of this: mixing medications. I don’t have a medical background, but I knew my mother-in-law was on a number of different medications already (she has terrible arthritis and fibromyalgia in addition to her frequent migraines), and I had heard my share of stories about medications mixing with fatal consequences. I was a nervous wreck as I matched up her symptoms with the side effects and warning signs on the labels.

Thankfully, she did just fine once she stopped taking the pain pill the doctor had prescribed, which just didn’t seem to agree with her no matter what else she was (or wasn’t) taking.

In short, medication management is no simple thing.

This article from Caring.com, 5 Medication Mistakes Caregivers Can Make, speaks to some of the common errors that occur even among the most conscientious caregivers. Consider these striking numbers from The National Center for Health Statistics as cited in the article: medication errors cause harm to more than 1.5 million people a year (more than 76 percent of those over age 60 take at least 2 prescription drugs; 37 percent use more than five). Read the full article for helpful insights on better storing, filling, modifying and organizing prescriptions safely and effectively.

Writer Jane E. Brody shared her horrific personal experience with overmedication (her 92-year-old aunt nearly died on account of the episode) in a recent article on The New York Times’ “Well” blog. The article, Too Many Pills for Aging Patients, points to what she believes is a “crisis among the elderly” and offers tips for family caregivers and patients (those taking the medications) to be more responsible about their prescriptions. This sometimes means taking the doctors to task about a new prescription, asking lots of questions, keeping detailed records, and notifying the appropriate chain of command when an adverse reaction occurs.

Medication adherence is also an issue among seniors. In the case of Brody’s aunt, too many medications, and not the right ones, landed her in the ER. But for older adults with high blood pressure or high cholesterol, for example, not taking a prescribed medication could mean a visit to the ER too, per this article from FierceHealthcare.com.

More often than not, medication mismanagement occurs — at home, at hospitals, at assisted living communities, in ERs — whether intentionally or accidentally. Sometimes as a result of over-prescribing, incorrectly or inappropriately prescribing, sometimes due to harmful interactions caused by certain cocktails, sometimes based on a physiological reaction that even the most astute professional could not predict. Body chemistry is complicated; medications can be helpful and harmful all at once. That is why vigilance on the part of caregivers and healthcare professionals charged with medication administration is necessary always. The best we can do as caregivers, or as people who take a number of prescriptions? Be ever aware of what we are taking or giving, what the risks may be, and how it will affect our bodies.