As an assisted living caregiver, you see the effects of aging on your residents’ health. Because of these age-related health changes and challenges, doctors frequently prescribe medications to seniors to help manage their health. In fact, the following statistics on medication use among older Americans are quite surprising:
- 75% of older adults take one or more prescription medications.
- 25% of older adults take five or more medications.
- older adults make up 13% of our population, but use 25-30% of prescription medicine.
Because the number of chronic illness diagnoses is higher among older adults than younger adults, it is imperative that assisted living staff follow regulated and safe medication management processes when caring for their residents.
Your Role In Medication Assistance
The first step in medication assistance is determining your boundaries as a caregiver. Licensed healthcare professionals can dispense, hand out, insert, or apply medication that a resident cannot do themselves. Although regulations vary by state, a caregiver’s role follows this general rule: you are restricted to assisting a resident with medication they could normally administer themselves but cannot because of their physical or mental condition
For example, a resident who takes an oral medication would typically be able to complete that task on their own. However, he may be unable to open the medication packet due to joint pain. In this scenario, a caregiver may assist the resident with his medication by opening the bottle for him.
Types of medication that caregivers may assist with include:
- oral medication
- eye drops or ointment
- ear drops or ointment
- nasal sprays and drops
- topical medication
- limited injections (insulin, B12)
However, it is necessary to note that as a caregiver, you may not assist with intramuscular injections.
From there you need to perform your role as caregiver following the key principals of assisted living along with the six rights of senior medication management.
Key Principals for Assisted Living
In all the tasks you perform throughout your day, you need to keep the principals of privacy, dignity, and individuality in the forefront of your mind, and medication assistance is no different.
As a caregiver it is your responsibility to help maintain a resident’s medical privacy. This includes not sharing the names of any medication the resident is taking or the conditions for which she is taking medication. To ensure a resident’s privacy, you should offer her medication in a private area, away from other residents, such as her room. You should also refrain from discussing a resident’s medication information, either with the resident or with co-workers, in front of others.
To maintain a resident’s dignity when assisting with medication management, it is necessary to offer choices. This lets the resident know she is in control of the process. Each resident has the right to decide if she is able to self-administer her medication or if she would like your assistance. Don’t assume she needs help. Other choices that should be offered during medication assistance can include the kind of beverage to accompany oral medication, the types of small snacks for medication that must be taken with food, or the order in which the medications are taken.
Practicing person-centered care gives each resident the opportunity for individualized care. This type of care extends to assisting a resident with medication. When it does not pose a risk to her health, a resident should be offered the choice of when she would like to take her medications rather than being held to a medication pass schedule.
Additionally, any caregiver who plays a role in senior medication management should always listen to residents when they have misgivings or are reluctant to take their medication. This could help to avoid a potentially dangerous situation where a patient is given the wrong medication.
Six Rights of Senior Medication Management
In addition to the resident rights that are the foundation of assisted living, as a caregiver that provides medication assistance for residents, it is necessary to learn and strongly adhere to the rights of medication management in senior care. These rights and your responsibilities for ensuring that each right is met are outlined below.
The Right Resident
- ask the resident for his/her name before helping the resident with medication
- check if the Medication Administration Record (MAR) includes a photograph of the resident and compare it to the resident you are assisting
The Right Drug
- compare the drug listed on the MAR with the pharmacy label or the physician’s order in the resident’s chart
- do not administer the medication if there are discrepancies in the information
The Right Dosage
- verify the dosage includes the strength of the drug and the amount given
- compare the dosage listed on the MAR with the pharmacy label or the physician’s order in the resident’s chart
- do not administer if there are differences with the information provided
The Right Time
- compare the frequency (once per day, three times per day, etc.) listed on the MAR with the pharmacy label or the physician’s order in the resident’s chart
- do not administer if there are differences
- follow the medication time schedules (once per day, three times a day, at bedtime) that are set by your community while keeping in mind that “with meals” and “as needed” may require a break from the community’s daily medication pass schedule
The Right Route
- this describes how the medication is taken (oral, topical, nasal, injection, etc.)
- compare the route listed on the MAR with the pharmacy label or the physician’s order in the resident’s chart
- do not administer if there are differences with the information listed
The Right Record
- update the resident’s MAR each time medication is administered
- include the patient’s vital signs
- include your initial, name, and title where appropriate
- make note of any special circumstances, including if the resident refused medication
Your residents’ safety depends on your careful attention to detail when assisting with medications. Therefore, it’s recommended that you check the six rights of medication at three different points during the process:
- when removing medication from storage
- immediately before assisting the resident with her medication
- immediately after assisting the resident with her medication
It may seem like a lot of checking, and double checking, but your residents’ safety depends on your careful assistance.