Medication Management is key to preventing falls and hospitalizations
Medication management for in home care is a critical part of ensuring the ongoing quality of life of the homecare client. Elderly Americans take 40% of the prescription drugs in the United States and 35% of the over the counter medications, sometimes leading to confusion, missed or double doses and resulting adverse reactions. That’s why finding quality medication management is critical for long term successful aging.
When families call home health and home care agencies to learn about services provided, they often ask for “medication management”, without truly understanding what that means.
A registered nurse or care manager is the proper clinician to provide medication management, not an in home caregiver. Per California statue and the scope of practice for caregivers, non-medical staff may provide “medication reminders” or “assistance with mediation normally self administered.”
However, that is now how Medication Management is defined. With medication management, the nurse audits all of the mediations being taken, creates a list that can be updated regularly, checks for interactions, looks for medications that are duplicates or that cause serious side effects, then works with the doctor and pharmacist to limit medications to only those that are helpful and effective.
Most quality in home care agencies, such as At Home Nursing Care, have a medication database built into software that can run a report and look for dangerous drug interactions. The nurse can then educate the client about signs and symptoms of a bad drug reaction, if one were to occur. The nurse will also look for any recalls or signs that the medication is not appropriate for the age or condition of the client. The Cleveland clinic puts out a list of potentially dangerous medications here.
When a person is discharged from the hospital is an ideal time to consider medication management. That’s because, according to the National Institutes of Health, preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings. About 30% of hospitalized patients have at least one discrepancy on discharge medication reconciliation. Read more here.
Some of the warning signs that a parent may need help with medication management include confusion about the medications they are taking, not knowing why they are taking the medications, skipping medications, not controlling insulin levels or blood pressure, falls or hallucinations, dizziness or being disoriented, nausea or sleepiness.
Quality medication management also addresses other areas of concern, such as nutrition for older adults, or removing trip hazards, or the need for physical therapy or occupational therapy services. Medication management works best when it’s part of a comprehensive, client-centered plan of care that is based on a client’s needs, goals, strengths and wants.
The RN case manager will also coordinate refills, look for discounts for medications and work with the client’s insurance to make sure they are getting the most economical version of the drug or medicine.
Medication management may also be a benefit for Medicare beneficiaries. When a person gets a new prescription, Medicare may pay for an RN to educate the person about that medication, then do a follow up a few days later to monitor the effects and the person’s retention of the training.
As part of our medication management services, each time At Home Nursing Care brings a new homecare client under our care, our RN Case Manager conducts a full evaluation of their medical history, paying particular attention to the medications being taken in the home. Our nurse then makes a legible list of all medications. She/he will coordinate with the patient’s doctor and pharmacist to make sure none of these medications are outdated or conflicting.
Our nurse will fill the pill box or medication dispenser, and then make weekly or bi-monthly visits to monitor reactions and ensure there are no adverse effects. Every two months we contact our patient’s physician to stay on top of how the patient’s needs may be changing.
Eighty one percent of older Americans don’t know why they’re taking the pills they’re taking, so there’s a lot of confusion. Our nurses help clarify that. This oversight help with fall prevention, improve activities of daily living, assist caregivers with daily care and limit injuries often associated with wrong dosages or conflicting medications.
Better medication management for in home care leads to a better quality of life at home.