One of the most frequent complaints of our elder is that she “doesn’t get medicine when she asks for it.” I don’t doubt that for a minute. The problem is in part that she’s used to having one to one patient care. The other part is that she often wants pain medication when she doesn’t need it.
The rules for her facility on medications are very clear and very firm. All medications, including over the counter items, go in the medicine cart and are given out via the med tech. Other caregivers may hand the patients the medication, but before it leaves the cart it has to be signed off by the tech.
These people are not glorified nurse’s aides. They are highly trained and some have degrees in the field of medicine. Some even have undergrad or minors in psychology. You may think that’s not needed, but when dealing with dementia patients, particularly those who have become addicted to strong painkillers, it’s almost a necessity. Their job prevents possible tragedies like those below.
“Stealing:” Our elder claims people come into her room and “steal” things. I seriously doubt this, but were it true, it makes the need for all medications to be locked into a central, guarded location important. A bottle of aspirin might be fine for one patient but dangerous for another. Some illnesses and medications don’t do well with even something that simple.
Overdose: This was one of my biggest areas of concern. It is very easy for a dementia patient to overdose on medications. They often forget they’ve just taken it. Sometimes they have faulty memories about the passage of time, and as the pain is still there they think they need another dose. I’ve watched it happen…before I could get the bottle out of our elder’s hands. *That* was a struggle. As the medication in question could be deadly if enough is taken, it’s a scary thought. Much better that all medications are in the hands of a med tech.
Wrong Medications: This, too, has happened. Before going to the memory care unit, our elder managed to get her hands on her pill planner. She took all of her evening medications…at ten in the morning. That scared us, the caregiver, the nurse and probably didn’t do the doctor much good. It’s easy to do, especially if there are no records and there is easy access to the medications.
Improper Use: This happened to our elder when one of her at-home caregivers decided not to follow instructions. She gave our elder some extremely strong medications without the go-ahead of a nurse or doctor. These medications were on the premises in case of emergency and required authorization. Believe me, when I found out, that person didn’t come back.
This highlights one of the most important aspects of the med tech. *Every* medication has to be accounted for. There has to be a record of who got what, when, where, why and how. Medications get counted to make sure there are no mistakes.
The Salon Pas Incident: While this story doesn’t seem like a big deal, it really was a serious incident that could have been closer to tragic. Our elder uses pain patches for headaches and back pain. These patches are supposed to be in the hands of the med tech and only the med tech. Unfortunately, we didn’t realize that, and gave her a box (and were appropriately reprimanded).
When she put the patch on her neck, a good bit of her hair got stuck in it. One of the caregivers found her trying to cut her hair out of the patch with a pair of scissors (another thing she’s not supposed to have). The situation was remedied, scissors and patches taken away and a very disgruntled elder was left to complain about the situation. The way her hands shake, she could have done some serious damage to herself with those scissors. The med tech makes sure her hair isn’t caught in it, thus relieving the problem.
I have a great deal of respect for all of the caregivers in our elder’s unit. They take the complaints and occasional verbal abuse without complaining themselves. They are skillful in redirection and validation therapy, and the med techs know what they are doing. It gives me peace of mind.