Medication Management in the Home

One daily challenge that many caregivers face is managing their loved one’s medications.

Medication Management falls to the caregiver for a variety of reasons:

  • The patient cannot physically open the containers that hold the meds.  In these circumstances, the caregiver needs to set out the meds for the patient to take at the appointed time;
  • There are more meds than the patient is capable of tracking, or the administering of them requires some help;
  • The most common issue is confusion or cognitive impairment, and this usually occurs when the patient is suffering from dementia or a variety of conditions, each of which requires seperate medication.

Medication Management Tools For Caregivers

Here are some choices available to caregivers.  Check with your local pharmacy to find them.  They may also be available through your local senior center or senior resource office:

  • Pill boxes labeled by the day of the week.  They do need to be filled accurately at the beginning of the week, but after that, the pills are easy to find and take.
  • Blister Packs (also known as Bubble Pack) are a fairly new way of packaging medications for consumers, although elder care communities and hospitals have been using this method for some time.  The Packs are prepared by the pharmacy and each pack contains one day worth of pills, or pills to be taken at a certain time, such as breakfast or dinner.
  • Some Pill boxes come with alarms for people who need prompting and reminding to take their medications.  Some also come with a monitoring service that can alert the caregiver when medications have not been removed from the box.

In addition, there are visiting medication management services which can provide an aide or nurse to visit the patient’s home to assist with medications.  Some In-Home Care agencies will offer medication management as part of their services.  Check with your local Area Agency on Aging to find out what’s available in your area.

Blessings, Joanne

Tips for Medication Safety

One of the most pressing issues for part-time or long distance caregivers,  is medication safety.  How can you be certain that your loved one is taking her or his medications properly?

Your first step is a brown bag autopsy.  This isn’t as grim as it sounds.  You put  everything your loved one is taking (prescriptions, over-the-counter drugs, all vitamins and supplements) into a brown bag and take it to her or his primary physician or a licensed pharmacist for analysis.  You want to be sure that there will be no adverse reactions among the various items.

Once you’re confident that what she or he is taking is all going to work together beneficially, then you want to be sure that the pills are being taken at the right time and in the right amount.

One way to do this is to personally observe how your loved one takes her or his meds during the day and at night time.  Is she or he able to sort through the complexities without mishap?  If so, then you can relax about medication safety, for now.

However, if there’s any level of confusion about what’s to be taken when, then you may want to consider creating a chart to assist them.  On it you’ll need one more column than the number of medications and supplements.  That first column should be a time schedule that lists the time when each medication is to be taken.  Each successive column should have the name of the medication or supplement and its purpose.  Opposite the time in the first column that the med is to be taken, make a note about how it’s to be taken—with food, an hour before eating, etc.  Also list any warnings about causing drowsiness, nausea, etc.

If the chart is too confusing for your loved one, then you’ll need to implement a daily pill dispenser.  Each container in the dispenser is labeled with the time and instructions.  “Take the pill in this box at lunch time, etc.”  Pill dispensers can also be found that have automatic reminders and specific pill dispensing abilities.  In addition, these high-tech dispensers can also alert you if your love one has not taken their medication.

If a pill dispenser proves to be too confusing, then you’ll need to consider in-home care or professional medication management for your loved one so that someone is on hand when medications are taken to ensure that the right pill gets taken in the right amount at the right time.

One of the most common reasons that elderly people are hospitalized is adverse drug reactions from taking medications and supplements improperly.  Protect your loved ones from this emergency by assuring they are provided with the tools to take their medications safely.

Blessings, Joanne

What Is In-Home Care?

In Home Care is designed to support those who do not desire or need to leave their homes, but do require assistance with one or more of their daily activities. Care in the home can take on a variety of shapes and sizes and can incorporate family, friends, and professional assistance. I think most people, given a choice, would prefer to receive assistance from someone they know, family or friends.

There are certainly situations, however, that family or friends providing care is not appropriate, or does not appeal to everyone, including the family and friends. If professional support needs to be hired, here are a few considerations and questions to ask the agencies you are interviewing.

  1. Most In-Home Care agencies have hourly minimums, usually 2-4 hrs. If a shift does not meet these minimums, the client may still have to pay for the full shift.
  2. Make sure the agency you are considering is licensed, and caregivers are bonded and insured.
  3. What kind of training and orientation do the staff participate in?
  4. Is there a nurse to oversee caregivers and provide training?
  5. What is the process if a caregiver is sick or does not show up for a shift?
  6. What are the fees? Do you pay less for longer shifts? Does the agency bill monthly or weekly? Do they provide transportation to doctor appointments, grocery store, etc…?
  7. Does the agency have access to other resources in the community should you need them?
  8. Check inspection results at medicare.gov.
  9. Ask to see references and customer testimonials. You can review online eldercare ratings and reviews right here on The Senior List.com.

What is the advantage of hiring my own private caregiver?

  • generally less expensive than working with an agency
  • caregiver is your employee, they work for you.
  • may be able to exchange care services for room and board, this works well for students

What is the advantage of hiring an agency?

  • agency pays taxes, insurance, etc… No liability on your part, less risk
  • shift will always be covered
  • agencies are regulated and must pass inspections to operate

What type of Assistance can a caregiver provide?

  • Bathing/ Grooming
  • Light Cleaning
  • Shopping
  • Laundry
  • Meal Preparation
  • Toileting
  • Dressing
  • Mobility
  • Night care

How Much Does In-Home Care Cost? I have seen quite a range for costs, anywhere from $12-$22 per hour, depending on geography and duties of the caregiver. If the caregiver is a CNA, the cost will typically increase due to training that the individual has received.  Who Pays for In-Home Care?

  • Private Pay (you)
  • Long Term Care Insurance- check your policy for restrictions and make sure agency is able to accept payment from Insurance provider
  • Some Health Insurances- check your policy
  • Medicaid- offers limited in-home care programs for those who qualify