Caregiving Planning Step 4 Research: Medications
Medications are prescribed for many purposes and come in many forms. For a handy resource that explains what a medication is, the different methods through which it can be administered, what are side effects, etc. refer to:Medications
Another website that provides good information on medication safety is Knowledge is the Best Medicine. Not only is there guidance on medication safety, there is also an explanation of how to read prescription labels.
For managing medications, the following activities are recommended.
1. Centralize all the prescriptions to one pharmacy. Call each pharmacy and request that they send the prescription to your preferred pharmacy. Have the preferred pharmacy’s name, address and phone number handy when calling the other pharmacies.
2. Meet with the Pharmacist. Speak to the pharmacist about the medications and supplements the care recipient is using. Ask:
a. what the medications are for and what they are trying to achieve,
b. what the side effects are and whether the medications interact with other foods or supplements.
c. what are the storage requirements. For example, does a medication need to be kept refrigerated.
d. what formats the medications come in. For example, instead of a pill format, it might come as a lozenge, or in a liquid form.
e. ask what services the pharmacist can provide:
f. will they cut pills in half?
g. what medication packaging options are there eg: bottles, blister packs, weekly medication pill box options, etc.
h. can medications be delivered? Is there a set delivery schedule and what would that be? Is there a delivery charge?
i. if delivery is available and the pharmacy also carries food and other items, can other items be included in the delivery order.
j. ask for a business card and staple it to a blank Medication Ordering Worksheet in the 4ward Tracker Binder.
k. ask if a credit card can be kept on file for easier payment of medications ordered over the phone.
3. Transcribe the information you have learned on to the Medication and Supplements Worksheet in the Medication Section of the 4ward Care Tracker. Enter the details of what to order, (medication name, dosage, frequency) including the details of what form the medication should come in (liquid, pills, etc.) what packaging format to request and any other special instructions in the Notes Section.
4. Use a medication dispensing box (pill box or pill organizer) This is a box that allows the medications to be sorted into times of day, usually for a 7 day period. The benefit of using this type of medication dispensing tool is that it is easy to see if the care recipient forgot to take their medication and which time of day it was forgotten. The second benefit of this approach is that it gives you up to a week’s notice that medications are running out, which in turn gives you time to re-order the medications or, if that is no longer an option, make an appointment with the doctor to get a new prescription. Some pharmacies may also provide a service to fill the box each week. This requires two medication boxes. One the care recipient is using for the week, and the other is with the pharmacy being filled.
5. Track the ordering of medications. Use the Medication Order Tracking Sheet in the 4ward Care Tracker to track when, what and how much of the medications were ordered. Not only does this help if more than one person is ordering medications, this information can then be crossed-referenced against the receipts when it is time to submit insurance claims or prepare the care recipients income tax.
6. Dispose of unused medications. When a medication or supplement has been discontinued by the medication practitioner, write the reason for its discontinuation on the Medications and Supplements Worksheet in the 4ward Care Trackers and put a diagonal line through the medication in both the Health and Care Trackers. The reason for tracking discontinued medication is so that you can inform the other medical practitioners, such as emergency room doctors, and if you visit a hospital with the care recipient, you can tell the emergency doctor’s why a certain medication cannot be prescribed. Remove all medication from the house and return them to the pharmacy. Most pharmacies have a program that will ensure the medications are disposed of in an environmentally safe manner. Do NOT rely on the care recipient to remove the products from their house.
7. Review medications with the pharmacist at least once per year. Call the pharmacist in advance and request a time where you can come in and review the medications, particularly if there has been a change in health status and/or a significant change in medications. In Ontario, the provincial government has the MedsCheck Program, which pays for a pharmacist to visit the eligible person in their home to review their medications. Eligible persons are those individuals who take at least three medications for a chronic illness, has been diagnosed with Type 1 or 2 diabetes or is a resident of a long-term care facility. For more information refer to: Take Your Medication Safely