Medication Management in the Nursing Home
It is our intention to periodically provide opinions, information and resources to our clients and any visitors to our website. Welcome to our very first blog post!
So many pills!
Perhaps it goes without saying that most residents of nursing homes are prescribed a myriad of medications to treat a myriad of co-morbidities. However, they don’t often understand or even ask questions about their medications. Although most nursing homes are required to have systems in place to routinely audit and discontinue unnecessary drugs, particularly psychotropic medications, it is not uncommon for a nursing home resident to find herself taking upwards of 20-30 pills per day. Given that she is relying on their nurse to accurately dispense these medications, it can be difficult to ensure that the nurse hasn’t made any errors with that volume of pills. Despite the volume of medications, it is important that we are fully aware of each medication we are taking, including what it should look like and what time it is scheduled for.
If you are a nursing home resident, you can ask the nursing staff or your primary care physician to provide you with a written list and description of all of your medications. This way, you can be assured that you are getting the correct medications every time.
Regarding psychotropic medication…
By regulation, nursing homes are required to periodically review resident medications and discontinue use of unnecessary drugs, particularly psychotropics. Historically, psychotropic drugs and sedatives had been widely used to control undesirable behaviors and to sedate unruly patients who may have been experiencing physical or mental anguish. This misuse of medications is now considered to be a chemical restraint by Federal nursing home regulations. They are still widely used, and can be highly effective for geriatric patients who are experiencing agitation, insomnia, and depression. But, did you know that in order for the nurse to administer a psychotropic medication, the individual or their guardian/POA MUST provide consent? And when you give consent, the facility should provide you with an informational page regarding the specific medication(s) and dosage(s). While there are certainly excellent psychotropic medications out there, many of which prove to be extremely helpful, harmless and effective for most patients, there are also many that pose a greater risk and can cause significant harm to the patient. It is always wise to ask questions about any medications before taking them. You should ask your physician or psychiatrist about side effects as well as any possible contraindications with your other medications. If two weeks after starting a new medication, you are still experiencing a difficult adjustment to the medication or are not feeling any relief, you should discuss your concerns with your doctor.
Feeling more independent?
Did you know that nursing home regulations require the facility to allow residents who are capable to self-administer their own medications. Typically ointments and eye drops are a given, but you may be able to have the nurse pre-package your pill form medications as well, and you can then further exercise your autonomy. Just know that the facility will have an assessment process to ensure that you are able to exhibit the ability and safety awareness with regards to your medication. If you have a history of substance abuse, suicidality or cognitive impairment, you are not likely to be eligible.
