Drug Dispensing and the Caregiver

By M. Simon

One of the common issues that caregivers have to deal with on a daily basis is the need to dispense their care recipient’s 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. It doesn’t matter that the clients have accumulated them honestly, usually a few at a time during each hospital admission; but the sum total is what the home care worker, family member or employee, must face every day on the job.
In past years, medications were often dispensed three or four times per day or worse. 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 we can treat and consequently a lot more pills people can consume.In an effort to decrease the angst this process can cause and keep the client on a safe and effective regime, there are several simple rules one can follow.
First of all, it’s 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 they’re left unattended. Some medications have to be refrigerated, but most can be safely stored in a secure cupboard. Pharmacies, in an effort to keep your business, have developed blister packs that link the pills with specific days of the week. So, in the middle of a busy day, if the caregiver suddenly wonders “Did I give him his morning pills?” 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.
Not to overstate the obvious, but dosages of drugs should not be changed without first consulting the client’s physician. The old adage “If one is good, two is better” 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, don’t 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 client’s normal medications by increasing or decreasing the medicinal concentration in the body.Check the expiry 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 a ventolin inhaler for an asthma exacerbation. The one time you need it could be the time you discover it’s out of date. Likewise, it’s prudent to double check the prescriptions that are picked up from the pharmacy against a home list of medications being given. The employees filling the prescription are human too (and often pharmacy assistants) and can make mistakes.
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 Alzheimer’s drug? Maybe it’s time to have a family discussion with the physician and ask the question, “Have we reached the point where we are treating the disease instead of the patient?” One of the benefits of modern medicine is that we have so many wonderful drugs to combat the detrimental aspects of aging and disease. However, just because these drugs now exist doesn’t always mean it’s 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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