A significant problem in health care is poor understanding about medicines and how they affect older people differently from everyone else. Many health professional haven't been given enough education on how medicines work, or how they interact with each other, even though they have the job of administering them to older people. They seem not to be educated on the difference between medicines in a younger, well nourished patient and the effect in an older, dehydrated, frail person. If you are looking after an older person as a family caregiver, is vital to know about these things.
A few years ago while doing a hospital investigation I was dismayed to see that nurses at times signed to say that patients had taken their pills, even though the tablets were still in the pots, beside the bed. They now understand better the importance of witnessing the ingestion of the medicine. As a family member you may need to keep an eye on this in order to be sure. I know of one patient who was hiding her pills, rather than swallowing them, because they were a different colour from the ones she usually had at home and she thought they had been given to her in error. She did not want the nurse to get into trouble for making a mistake. The danger of this is obvious.
I have seen drug administration policies that run to about 100 pages, so I doubt if any nurse read it. I almost lost the will to live just picking it up. Health systems need to have a clear understanding of how to create an easy to read and implement guide on how to administer medicines.
It is vital to observe the effect of a medicine. Again this is a job of the nurse. In many cases no one ever asks, “Nurse you have given your patient medicine x to have effect y. Has it worked?” It's a question of knowledge and behaviour. When giving out medicines at one time there would be two nurses, and the senior nurse would routinely ask the junior what the medicine was for before administering it. Without such knowledge and observation and sense of responsibility a great risk is being taken.
At this time of year with colds and coughs affecting many people there is also a risk from people misunderstanding their medication at home, and self medicating with too much of a common over the counter medicine, such as paracetamol, which might be in capsules and also in the lemon powders that we take with hot water. Add alcohol to the mix and the person can become very ill.
Your local pharmacy can give advice on how to manage medicines with a variety of "dosing" boxes and medicine reminders. And when your older relatives and friends are in hospital don't hesitate to get involved in the administration of their medicines so that you are learning together how to manage those when you get home. Nurses have said to me in the past that it was hard to take enough time to support people to take their medicines in hospital. You can help with that.
Find out more in Dementia the One Stop Guide