Benefits of Homecare and Medication Safety
You have just been discharged from a hospital, rehab, or feel as though you are spending your "golden years" at the doctor's office and come home with additional prescriptions. You ask yourself, "What is this medication for? How am I going to take all these pills in one day?" You have just become part of the largest concern that may contribute to medication errors called poly-pharmacy. Poly-pharmacy is defined as the use of 5 or more medications for one patient. The more medications, the more risk for medication errors. Other reasons for errors are:
- Multiple physicians - decreased communication amongst each other
- Poor discharge instructions
- Confusion with generic and brand names
- Transcription errors
- Look a like, sound a like medications
- Cognitive and visual problems
Home care services can be of great help. Many times on the initial visit, home care nurses spend a great deal of time organizing patients' medications, checking expiration dates, providing education to the caregiver/patient, and making phone calls to one or several physicians to help decrease the confusion of multiple medications. Additional visits can be made by the nurse to:
- Monitor vital signs – especially with blood pressure and heart medications.
- Ongoing education to pt/caregiver of medications.
- Monitor for side effects such as dizziness, lightheadedness to help prevent falls.
- Assess reasons for not taking or skipping doses.
- Continue to communicate with physicians if problems arise.
- Assess for other disciplines such as:
- Physical/Occupational/Speech Therapy - Assist patients to regain or improve their level of physical function and communication skills. Prevent falls that may be caused by medication.
- Medical Social Worker - Assist in community resources, long term planning and medication cost.
- Home Health Aide - Assist with personal care.
Homecare nurses are an excellent resource for creative ideas that can be used to keep patients independent and safe in their homes. Studies have shown that between 40-75% of the older population don't take their medications at the right time or in the right amount. Examples of strategies to take medication easier are:
- Charts, calendars and weekly pill boxes. A homecare nurse can teach the patient and/or caregiver to fill their med box weekly. Check with your pharmacy to see if they provide this service if no one is available to assist you.
- Ask the pharmacist for over-sized, easy open bottles - great for arthritis.
- Ask the pharmacist for large type labels, use a magnify glass and good lighting for vision impairment.
- Use meal time or bedtime as a cue for medication.
- For serious impairment- assistance from family members or professionals, adult day care or supervised living facilities.
Tips to avoid drug interactions
- Take a list of medications to each doctor you visit. Make sure each doctor knows what the other one is prescribing. This list should also include any over the counter drugs and vitamins. You need to be assertive and knowledgeable about your medications.
- Have your doctor review your medications. Take your prescription bottles to your appointment.
- Get all prescriptions filled at one pharmacy. A pharmacist can screen for drug interactions and keep an updated list of all medications. Keep them informed of allergies to medications.
- Read inserts that comes with the prescription. Don't be afraid to ask your doctor or pharmacist questions about your medication.
- Follow directions on label. Check if medication should be taken with or without food.
- Contact your doctor or pharmacist immediately if you have any side effects.
- Don't forget to take medication.
Physical signs that may attribute to drug reaction:
- Fatigue
- Constipation or diarrhea
- Confusion
- Incontinence
- Frequent falls
- Weakness or tremors
- Excess drowsiness or dizziness
- Notify your physician if any of these reactions occur
Mixing food and drugs
Some foods inhibit the effectiveness of some medicines. Make sure to ask your doctor or pharmacist if any foods should be avoided
Grapefruit juice can increase the absorption of certain drugs.
Calcium (diary products) and antibiotics can decrease absorption causing the medication to be less effective.
Vitamin C and fruit juices can impair absorption of drug, causing the medication to be less effective.
Foods rich in vitamin K can reduce effectiveness of Coumadin (blood thinner) causing increased clotting. These foods include leafy green vegetables such as spinach and kale.
Cranberry products may increase the effectiveness of Coumadin causing increase bleeding.
Fiber can bind certain drugs, decreasing concentrations causing the medication to be less effective.
Alcohol - use extreme caution when taking medication.
Stretching your prescription dollars
- Ask physician for a sample of a new prescription in case side effects occur.
- Ask for a senior citizen discount.
- Ask for generic equivalent.
- Find out about drug discount or assistance programs from disease related organizations (e.g. American Diabetes Association).
- Mail order - 90 day supply through insurance.
- Call pharmacies for cheaper price or check out online drugstores.