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Family Living Focus: Drug dispensing and the caregiver

Family Living Focus

One of the common issues that caregivers have to deal with on a daily basis is the need to dispense their care recipientís medication in a safe and timely fashion. Navigating the dangerous waters of different pill sizes, colors and dosages can be an intimidating experience as most family members and home care workers possess neither an in-depth knowledge of these medications nor the ability to discern when a problem with the pills may be developing. Elderly and infirm clients often seem to be on a never ending slew of pills that need to be doled out on a regular basis. The home care worker, family member or employee must then be responsible for administering the medications.

In past years, medications were often dispensed three or four times per day or more. Thankfully, in our modern day, each medication only has to be taken once or twice every twenty-four hour period. The downside is that there are a lot more diseases that can be treated and consequently a lot more pills people can consume.

In an effort to decrease the angst this process can cause and keep the care recipient on a safe and effective regime, there are several simple rules one can follow.

First of all, itís a good idea to keep all medications in a safe and secure place. Playful grandchildren, nosey visitors and even confused patients will get into the pill bottles if theyíre left unattended. Some medications have to be refrigerated, but most can be safely stored in a secure cupboard. Pharmacies have developed blister packs that link the pills with specific days of the week. In the middle of a busy day, if the caregiver suddenly wonders ìDid I give him his morning pills?î all it takes is a quick look at the package to confirm that, yes, it was given. In the same vein, all medications should be administered at the same time every day. Modern pills have been designed for specific durations and maintaining a regular dosing schedule will decrease the risk of adverse reactions.

Dosages of drugs should not be changed without first consulting the clientís physician. The old adage ìIf one is good, two is betterî does not apply in these situations. Playing with the dosages of blood thinners, heart pills and pain killers can easily have unforeseen and unfortunate side effects.

Despite what the infomercials say, donít start using over-the-counter products, herbs, vitamins and supplements without first discussing it with a physician. Not only is quality control for these products somewhat lacking (as compared to prescription medications), but they may interact with the clientís normal medications by increasing or decreasing the medicinal concentration in the body.

Check the expiration date on the prescription bottle. Medications that are only used on an as-needed basis may become ineffective if left too long on the shelf. A good example would be nitroglycerin pills for chest pain or an inhaler for asthma. The one time you need it could be the time you discover itís out of date. Likewise, itís prudent to double check the prescriptions that are picked up from the pharmacy against a home list of medications being given.

There are also options to consider if the condition of the person you are caring for begins to deteriorate. For example, if problems†develop with his or her ability to swallow, there may be some pills that can be changed to a liquid or even given through a small butterfly needle in the skin. Some newer medications are actually a combination of two or three different drugs and using them could decrease the total number of pills consumed daily.

Another aspect to consider, especially if his or her condition is worsening, is whether they really require all those medications. If grandmother, who is well into her ninth decade, is truly failing, does she really need that cholesterol pill or that Alzheimerís drug? Maybe itís time to have a family discussion with the physician and ask the question, ìHave we reached the point where we are treating the disease instead of the patient?î One of the benefits of modern medicine is that there are many wonderful drugs to combat the detrimental aspects of aging and disease. However, just because these drugs now exist doesnít always mean itís in the best interest of the client to use them.

The use of medicines is one aspect of caregiving that will not disappear in the foreseeable future. It is a complicated and precise job that requires concentration and adherence to a rigorous schedule. The aforementioned tips are meant to simplify this task and make life that much easier for the caregiver in your family.

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Information adapted from article by M. Simon in the Caregiver Newsletter, Thursday August 1, 2013 – Issue #649.

If you would like more information on ìDrug Dispensing and the Caregiverî feel free to contact Gail Gilman, Family Life Consultant, M.Ed., C.F.C.S. and Professor Emeritus ñ University of Minnesota at waldn001@umn.edu. Be sure to watch for more Family Living Focusô information in next weekís paper.

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