Managing medication in care services is obviously very important. Medicines can be a life-saving part of care and support, and mistakes can have very serious implications. This week and next I hope to cover the principles and best practice in supporting people with their medications.
Dignity, choice, privacy
The basic principles of support and care should apply to medication support. These principles, the basis for the National Care Standards in Scotland, are dignity, privacy, choice, safety, realising potential, and equality and diversity. Participation and good outcomes are other objectives which services are required to aim for.
When I began to work in care homes for older people, some years ago (!!), medication was often taken out of the control of the older person on admission. Medicine was given individually to people, often in public in the dining room after meals, from a large obtrusive trolley. Medicines were seldom reviewed, and often people had multiple medicines recorded across several pages.
Giving people independence
In retrospect, this was the perfect denial of each of the principles which I outlined above. We began working to give people as much independence in taking their own medicine as possible, using dosettes and taking the pharmacist’s advice.
We included medicine support plans in admission assessments, and regular medicine reviews. The outcomes of these measures were often reduced medication, raised self-esteem, and improvements in physical and cognitive wellbeing for several people. Dignity, privacy and choice were restored, and some of the older people expressed their gratitude for the changes.
For me the importance of independence in medication has remained as a guide in my support and management practice ever since.
