Medication Management

“Medication Management” is a simple phrase that refers to an often complicated family caregiver task. It may mean ordering and picking up prescriptions, setting up a pill box, reminding a family member to take their pills or even giving injections. The task variables usually are defined in terms of the complexity of the task itself – not taking into consideration if the care recipient is able and willing to cooperate. Caregivers for those with dementia know how big a difference in cooperation can make. A recent article written by a caregiver noted, “Medicine time with my dad has become one of the greatest difficulties, often taking an hour or more as we cajole, distract and sweet-talk him into swallowing pills or liquid medications. He doesn’t understand why he should do so.” When an otherwise straightforward task turns into an emotional battle of wills, it means more stress for already stressed caregivers. This is an important finding in a recent study. The study found that 61% of family caregivers caring for somebody with both cognitive or behavioral condition as well as chronic physical condition felt stressed “sometimes to always”. Nearly half reported feeling depressed within two weeks of completing the survey. This rate is significantly higher than the rate reported by family caregivers caring for someone with a chronic physical illness but no cognitive or behavioral condition. A majority of the dually challenged caregivers were women between the ages of 50 and 79 and about half lived with the person needing care. Most had provided care for several years. While it is well recognized that people with cognitive or behavioral conditions may act in ways that make them hard to care for, the report found they also are less healthy than care recipients without these conditions. Nearly 90% of such people also had higher rates of chronic medical diagnoses, such as stroke or hypertension, arthritis or osteoporosis, heart disease and diabetes. These conditions are commonly treated with many medications that require frequent monitoring and different forms of administration. Most (84%) family caregivers for people with both kinds of conditions assisted with the medication management, along with providing personal care and managing household tasks. They were two and a half times as likely as other caregivers to say it was hard because their family member did not cooperate. As a result, they found medication management time consuming. When asked what would make the task easier, almost one-third said, “more cooperation from their family member.” Strikingly, two-thirds of these caregivers reported they had little or no training, learning how to administer at least some of the medications on their own. Family caregivers need a lot of help. Family caregivers need training and support that help them understand the sources of someone’s resistance to care and provides effective ways to respond. Making sure your loved one takes their medications and cooperates should be a routine part of loving care, not a constant source of conflict.