Senior Medication Management, with Kelley Smith
Kelley Smith at CarePartners Living talks about medication management. It’s a big deal because as we age we can get forgetful. There are a hundred reasons why we’re on certain medications. If you take too much or too little, the medication could either cause damage or be ineffective. Certain medications for seizures, blood pressure, diabetes or pain have to be taken regularly or they don’t work.
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*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.
The following podcast is provided by care partners living and answers for elders radio. So welcome back everyone. We are back here with Kelly Smith from tear partners living and we’ve had an amazing discussion about the whole assisted living concept and transitioning into assist a living. But I wanted to spend Kelly a little time on medication management because I don’t talk. I don’t think most of us. No, specifically, number one. What does that mean and why is this such a big deal? So what let’s talk about? First of all, why it’s a big deal. It’s a big deal because as we get a little bit older sometimes we can be a little forgetful and what that can mean is your doctors prescribed medications for a reason. Right we maybe have a little high cholesterol or blood pressure issues. Maybe we take something because we have a bad back and we take pain medication. There’s a hundred different reasons why people take medication. If you have the early onset of dementia, your doctor May Have you on different medications to kind of help with that transition. If you take too much, if you take too little, the medication can either cause damage or it can be ineffective or an anidepressant. That’s a whole other piece. Your antidepressants and certain medications for seizures, certain medications for pain, certain things that doctors give you. If you don’t take them on a regular basis, they become ineffective. Right, right, right. You can’t just take them when you feel like it. You right, take the right in earlier. They don’t work. Also, would like certain medications, blood pressure medications, for example. Any doctor will tell you this. You can’t take them three times a day if you’re supposed to take them once a day. Right. So then you wind up with somebody in the hospital because they fallen on the floor because their blood pressure went nuts. You you know diabetics, for example. You can’t mess with that kind of medication. It can throw you for a loop. It could actually cause your death. So with medications you have to know what you’re doing. I’ve seen kids come over and go, I just filled up MOM’s med set for the week. She’s fine, okay, good. Are you making sure that she’s actually taking them every day? There’s there’s consequences for medication not being taken on time. Now, if mom remembers to take them every day, then good. But if you’re calling her four times a day and she’s still not taking your medications. So we still have a problem when people move into assisted living and one of the nurse’s assessment questions is is definitely about medication. We’ve had people move in that have absolutely no assisted living needs, but one of the things they’re doing is met occasion. Well, and I think, Kelly, one of the things that when we talk about it is everybody thinks that they can do their own medication. I remember my mother had a Steno pad and she put it a hash mark every time she took her medication right. Well, then all of a sudden one day I got a call and it was her the hospital, local hospital. Well, your mom over overdosed on her medication, and I was going like I well, I just forgot to take the Hash but put the hash mark in. Well, that’s the whole reason why, mom, you’re forgetful. What makes you think you’re not going to forget that too? Write and those are the kind of things that when we look at you, know, I’m I bet I take a medication before I go to bed every night. I know for me, I like sometimes I’ll go to bed and I’ll think to myself, did I take my medication and it? Yes, I finally you know, no, I did. But you know, there’s certain amount of feeling that you know those things if you’re on if mom or dad are on several different medications, which they definitely could be. Yep, those are some things. Obviously that can get mixed up. You can forget which pill is which. Not The whole thing. We’ve gone and done assessments and people’s homes where they’ve had twenty five medication. MMM, can tainers on it on a desk and you walk up to him to go, okay, what’s this one for? I don’t know, and then you look at the dates on them. Well, Gee, that’s neat. This expired in two thousand and sixteen. Why is it still sitting here? Because people don’t throw things away, they don’t go through the medications, the kids don’t touch them and we’ve got a problem. Why do we have expired medications setting out? See, it’s things like that. Yeah, why, if we got grandchildren around, do we have narcotics sitting out exactly, see, which doesn’t make any sense to me. No medication should be in reach of a child. Now, what about hospice? Patients. I actually had a hospice nurse come and tell me one time that she just about freaked out because family thought they could cut a fenton all patch. Well, congratulations, you almost wiped out the entire family. So because they didn’t read the instructions? No, you can’t. You got to fold it and you got to know how to handle it. I don’t think they even use them anymore. But what I’m saying is people, people don’t always pay attention to medications. So if you’re not trained, you’re not going to take the time to read them. But it comes to your parents or even yourself, you got to slow down and pay attention. When you go to your mom and dad’s if they’ve got medications sitting out, take a minute and read them. Are they expired? Right? What’s going on? Why do mom and dad have expired medications? Okay, do we know how to expose, how to get rid of those medications? You know how to take care of them? And again, or mom and dad taking medications that the doctors are no longer asking them to take? Right? That’s a big concern. Well, and I want to go one step further with this because, Kelly, when I was taking care of my mom. They were giving her every medication, every pills, she wore a vent and all patch she was taking Thailand on top of it. I’m flipping out because I’m thinking she’s on way too many drugs. Right, somebody needed to set me down and say, Suzanne, she is on a Palliative Care Program now, that is a classification in life that it’s not hospice. They’re not eminently dying different yeah, but palliative care is about comfort, right. It means that you’re not going to get any better, you know, but this is about doing what you can just stay comfortable. And there’s these are different classifications that your care care team understands, you bet. Specifically, we’ve had the privilege of working with like Evergreen Providence. They’re palliative care staff that right, that do a lot of education around this. So we’re able to educate families in and get them in front of the right able second, teach them what’s really going on here. Yeah, and really to understand the whole palliative care process. Means that they’re going to be on more medications. Likely there is it’s about comfort. Yeah, yes, of course. And and to not flip out because I was like thinking, how do I get her off the all this stuff? This is what was in my mind, right, of course, because I was thinking this is not good for her. Of course, if I had at the back in the day, if I had had somebody sit me down and say, Suzanne, this is the classification of treatment that your mother is in, if I had that knowledge, I would have had many less sleepless nights than I did, because, you know, but I think we as families forget our you know, providers. Now that I’m on sits on this side, we forget how little families understand about this process. But you also have to remember to what also is happening Susanne. They’re also going through a morning process. Yes, mom’s just been diagnosed with cancer, but it’s not it’s not hospice yet. Now they’re talking palliative care, right, so a longer period of time and here’s what they’re going to do for you. And all you heard was cancer. Yeah, all you heard is I’m probably going to lose my mom and you’re not thinking straight anyway, right. So you got to keep that in mind when we’re working with families. You have to remember too. We got it. We got to provide some love and care for them too, because they’re suffering right, they’re not going to hear a lot of what’s going on, so we have to retain some of that so that we can help them get through this well, because emotions can get us off track with medications. Amen. And if you think that we’re not paying attention, what do you think’s happening for mom who just found out she’s sick? Yeah, so again it’s about paying attention, and that’s why we’ve carved out just to medication management, because sometimes people don’t need a whole list of things for an assisted living level. All they need is just medication management, right. And the one of the mistakes sometimes families make is mom moves into assisted living, she’s got some socialization, she’s getting three square meals a day, somebody’s coming in and cleaning her. She doesn’t need the medication. Yeah, Oh, the medications management’s doing really well, she’s getting better. I’m going to take her home. No, honey, there’s a reason she’s doing better. Leave her alone. It took her home and their medication gets mixed up, and you do have medication mix that mix up. So I got to tell you right now that’s that’s another one of the number one reasons people of a certain age wind up back in the hospital is because in medications get mixed up or doctor prescribe something in the pharmacist misses it somehow. I always tell families when the doctor gives your mom a new medication, when you go pick it up at the pharmacy, take a minute and talk to that pharmacist. Very based on all of the other medications she takes. One of the possible side effects well, and I think the other piece of it, and this is something again, where your care staff is so skilled that mom may have a doctor in providence and another doctor that’s attached to Swedish and another doctor that’s attached to Evergreen and they’re not talking to each other. I can’t tell you how many times my nurse has gotten a medication list and set ah exam, made a phone call yeah, and said what are you guys doing now? It doesn’t happen all the time, I don’t know. To scare the stink out of your listeners and think, oh good Lord, what’s happening out there, but when you got you eight hundred residents you take care of and it’s happened twice in a year. So that’s twice too many times. But I’m grateful that our folks pay attention to that. Yes, absolutely, but they do. You know, they’re like, wait a minute, why did why are they giving them this and this? So my nursialmcphone call because they at the end of the day, we want to work with those families to make sure that those residents are getting proper doses, proper medications right. And you know, before we finish this segment, I’m just kind of throw out a little piece of advice to our listeners. If your parent is in assisted living, you should always have a list, current list, of their medication amen and I always kept that in an envelope with my power of attorney and I kept it in the flap of the back seat, our front seat, of my driver’s seat, right there, so that if I had to go to the hospital, if I had to go take my mother to a doctor appointment, anything, that listing was right there with that document. And you can get them from the assisted living community, the nursing to pay she lives. Had it set up that whenever there was a medication change, they automatically had it, gave it to me. Another thing, just one thing I would add. They also have something called a face sheet at the assisted living community. Also, get a copy of that perfect and have that in that that because that you’ll forget when they ask you, who’s our primary doctor? What’s her insurance company? If she’s in a stressful situation, you’re going to forget all that. Add it with you as well. Absolutely that’s a great idea. So the point is everyone have those little you know, keep up to date with your loved one of what is it that they’re on and what is the dosage, which is really important to because you never know. So and in that case, just know that when you’re an assistant living it’s about improving quality of life. And so the next segment we’re going to talk about specifically health care for dementia and Alzheimer’s, which you guys are the experts on seven locations cottages and soon to be nine of yeah, my Gosh, that’s amazing. So, anyway, Kelly will be right back right after this. The preceding podcast was provided by care partners living and answers for elders radio. To contact care partners living, go to care partners livingcom
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Originally published February 23, 2020