Why You Need to Understand Medication Management

Early in my mom’s tenure in assisted living, I noticed her monthly bill had a significant expense labeled as “medication management.” As someone who rarely takes any medication, I realized I needed to understand the process better.  I’ll be dedicating several posts in near future to this topic, as I believe family involvement in medication management is critical.

Medication is a Major Issue

According to a 2006 study by the three leading non-profits — ACHA, NCAL and the MEFC, medication is often a major component of an older person’s life, making it a major issue for assisted living facilities. The role of medication and medication assistance (called “medication management” by assisted living administrators) is surprising:

  • 77.5% of residents needed assistance with medications
  • Residents were taking an average of 13 medications

In an assisted living setting, residents rely heavily on staff to assist with the timely and correct delivery of medication.  But in the United States alone, nearly two million Americans experience adverse drug reactions from prescription medication each year.

What can you do to protect your loved one? A better understanding of medication management can help.

Where to Get Medications

Families have several options for filling prescriptions on behalf of loved ones.  They are:

  • Mail order. Most health insurance and Medicare plans provide options for mail order delivery of medications.  Prescriptions are usually filled in 90-day quantities. Price discounts are usually offered over that of pick-up or local pharmacies. Unfortunately, mail order makes urgent medications challenging.
  • Pick-up. You guessed it?!  You or a family member pick up prescriptions and deliver them to the facility. For a small number of medications, this may be feasible.  But it doesn’t work for multiple prescriptions on multiple delivery schedules.
  • Local pharmacy delivery. Prescriptions are filled and delivered by a local pharmacy 1-2 times daily. Since assisted living facilities usually contract with a single pharmacy, rush orders and other conveniences are widely available. I recommend this option for all but the most hands-on families.

Introducing the Med Room

So where do they store all that stuff? It’s called a “med room.”  The med room is a restricted-entry office that holds all resident medication, dosage records and prescription histories.

If you’re looking into assisted living for the first time, you should ask to see the med room.  From an audit perspective, if you already have a loved on in assisted living, you should periodically ask to see the med room.

Your goal in visiting the med room is to validate the following:

  • Medication is stored in a well-organized manner like that seen in hospitals
  • Files are well-organized and clutter is at a minimum
  • The staff can quickly share with you your loved one’s medication and prescription history
  • There is a supply of pudding or apple sauce for those residents that have trouble swallowing pills
  • Contact information for your loved one’s doctors is readily available
  • The door is kept locked (verified by staff unlocking the door when they let you in)

Who Administers Medication

Medications are provided to residents by a medical aide (called “med techs” by administrators).  Med techs are responsible for the maintenance of the med room and for administering medications correctly and in a timely manner.

Med techs typically lay out all medications on a labeled delivery tray and deliver medication to each room. Their role is to ensure residents take their medications, although they will often leave medications with caregivers, if they are present.

In the unfortunate event of hospitalization, the med tech will also provide a copy of all current medications to paramedics or the individual taking your loved one to the hospital.

Keeping Track of It All

As a family member, you should stay well informed of the medications your loved one is taking. The dosage record is the easiest way to do this.

A dosage record is kept for each patient and resembles the graph paper we all used in grade school.  Along the left side of the page is a list of medications. Across the top are days of the month. Every time a medication is given, the med tech is required to sign the box corresponding to that medication and date.

The best way to spot-check medication management is to randomly request copies of the dosage report.  Secondarily, ask the staff to notify you when medications are added or discontinued, so that you have a real-time understand of the medications being consumed.

Medication Management Works

Medication management is a valuable service provided by the facility. Your involvement and periodic oversight will go a long way to ensuring your loved one is properly cared for. Your knowledge of their medication regimen will also better prepare you in the event of an adverse reaction.

  • lou jacobelli

    Ryan,
    This is a superb addition. It applies to everyone, everywhere and is great inside information on “med control” that is valuable to all. It is also a piece that is well written and presented. Keep up the good work. It’s much appreciated.
    Lou

  • http://www.insideassistedliving.com Ryan

    Lou – Thanks for the note. I’ve found that staying on top of the medication issue can be a full-time job unto itself. It’s really important to find the right place with a good med-tech you trust!

  • Lynn Armbruster

    Ryan, My parents are now in an Assisted Living Community. I”ve been told that
    they must turn over administration of their meds to the Nurse. Problem is, that
    there is constantly problems with the meds given by the nurse, ie. meds from another patient, not given at proper time. cannot identify the pill, not all prescriptions given. They tell me that this
    is a Federally manadated law that my parents cannot self administer, is this true?
    We live in Tennessee.

    Thanks
    Lynn

  • http://www.insideassistedliving.com Ryan

    Lynn:
    Thanks for the question. I do not know the answer off hand, but let me do some homework and I’ll get back to you either in this comment or as a post of its own.

  • http://www.insideassistedliving.com/2008/10/reader-qa-who-manages-medications/ Reader Q&A: Who Manages Medications? — Inside Assisted Living

    [...] of our readers, Lynn, posted a comment to our post on why you need to understand medication management. It’s a good question, and it makes sense to share the answer with the broader audience. Lynn [...]

  • http://www.insideassistedliving.com/2008/10/reader-qa-who-should-manage-medications/ Reader Q&A: Who Should Manage Medications? — Inside Assisted Living

    [...] of our readers, Lynn, posted a comment to our article on why you need to understand medication management. It’s a good question, and it makes sense to share the answer with the broader audience. Lynn [...]

  • lou jacobelli

    Ryan,
    This is a superb addition. It applies to everyone, everywhere and is great inside information on “med control” that is valuable to all. It is also a piece that is well written and presented. Keep up the good work. It's much appreciated.
    Lou