Medication Management at Home for Elderly Patients
The Scale of the Challenge
Medication errors among elderly people living at home are a major and largely preventable cause of hospital admissions in the UK. Older adults are frequently prescribed multiple medications — a situation known as polypharmacy — and managing complex regimens without support is challenging even for those without cognitive difficulties.
Common Medication Management Problems
- Forgetting doses: Particularly common in people with early or moderate dementia, but also affects cognitively intact older adults managing five or more medications.
- Taking the wrong dose: Poor eyesight, arthritic hands that struggle with child-resistant caps, and confusing packaging all contribute.
- Stockpiling medication: Unused medication accumulates, posing both a safety risk and an obstacle to effective monitoring by the GP.
- Drug interactions: Many older people see multiple specialists who may not have a full picture of all the medications being prescribed.
- Difficulty with certain forms: Swallowing tablets, operating inhalers, and using eye drops all require fine motor skills that may be compromised by age or disability.
The Role of the Domiciliary Carer in Medication Support
Professional domiciliary carers can provide two levels of medication support:
- Medication prompting: The carer reminds the client it is time to take their medication and observes that they do so. The carer does not handle the medication.
- Medication administration: Trained carers can physically administer medication, including topical creams, eye drops, and controlled medications, following a Medication Administration Record (MAR) sheet.
The level of support required should be identified through a care needs assessment and documented in the client's care plan. Carers who administer medication must have completed accredited medication training.
Dosette Boxes and Blister Packs
Many GP practices and community pharmacies offer blister pack or dosette box services, whereby a pharmacist pre-fills a weekly tray of medication sorted by day and time. This significantly reduces the risk of errors and makes it much easier for both the client and carer to monitor compliance. SMIG Services carers are trained to work with MAR charts and blister pack systems.
Reviewing Medications Regularly
NICE guidelines recommend regular medication reviews for older adults, particularly those on five or more medications. If you are concerned that your relative's medication regimen is not being reviewed, speak to their GP or ask for a referral to a clinical pharmacist.
Our team at SMIG Services is fully trained in medication management. Learn more about our elderly care services.