Carers giving medication

[TheLazyPanda]

6 weeks ago, after years of refusing point blank to have any outside help, my parents (89 & 96) started having visiting care twice a day from a private company. One of the main needs/concerns was their medication because they had become very confused with it. The breakfast time carer gives them their morning tablets. We asked for the lunchtime carer to put their night time tablets in little pots that we provided (like hospitals use) and leave for them to take at bed time. This has been working fine until the company rang me yesterday and said they can't do this, it's against their medication policy because they can't leave tablets out for later. They said it's called "secondary dispensing" and I googled it and it is a Thing. They presented me with 2 solutions: 1) the family does it - not practical as my sister and I don't live locally; 2) they have an evening visit. This is mad, paying for another minimum half hour visit just to hand out some tablets. It increases the weekly cost by 50% (they are fully self funding). My parents can't be left to do it themselves because my mum's arthritic fingers can't handle the boxes and my dad tends to mess them up. Has anyone encountered anything like this and found another solution? Thanks

I assume you've tried using the weekly boxes already? This sort of thing?

Find a box or a small bag your mum can handle?

1. See if their local pharmacy can dispense in weekly dosette boxes. This will save you having to do it.
2. Speak to GP and see if the medication has to be taken at night. I managed to get my FIL and dad's boxes changed this way so it coincided with visits.

Talk to their pharmacist about options. Some drugs aren’t suitable for dosette boxes but also check with the care agency whether it would interfere with the meds they give in the morning. I am not sure they are allowed to give out of dosette boxes unless prepared by a pharmacist as they will have no idea what the drugs are and it could ne potentially dangerous. It also depends on whether your parents can safely self administer drugs, i.e. no eyesight problems or confusion etc.

Does the care comapny offer 15 mins visits?

Agree the pharmacist should be able to sort this for you.

I know that some pharmacies can supply medication in blister packs so it is fairly simple for the patient to know what to take. They are a bit like the dossette boxes Chewbecca posted about but sealed so less chance of getting it wrong.

They are right. There's no way of checking if the tablets have been taken if they are left out in pots so the carer cannot sign for them, same as in a hospital. Also there's the risk of missed doses and overdoses. Ask the gp or pharmacist if the tablets can be given with the others at the earlier time or arrange an evening visit. The care company run a very high risk of malpractice if they leave tablets out knowing the client has trouble taking them independently

What is the reason for the lunchtime visit ? Any possibility of moving that second visit back to late afternoon / early evening so that the second carer could give the medication then ?

I agree that if the cares have responsibility for giving medication they have to take it directly from the original packets and ensure that it is taken while they are there.

Lots of patients in the community have morning and evening visits, do they lunchtime meds as well? If not could the morning carer make a sandwich or similar for lunchtime and leave it in the fridge?

There are electronic devices such as a pivotell that may be useful if your mum and Dad could work together?

Yes, that's what I mean by nomad boxes/ pill boxes. They are delivered by the pharmacy every week with the tablets in.

The lunchtime visit is to make their lunch.

This is what they have, but they can't manage them themselves

You could buy an electronic tablet dispenser or you could swap the lunch call to the evening call. The carer at breakfast could prepare lunch and leave in the fridge

They have their main meal at lunchtime which the carers cook, hence that visit. The carer prepares a sandwich for tea time and leaves it in the fridge in a sandwich bag. Mum's evening tablets can't be taken earlier as they make her drowsy

https://pilltime.co.uk/

Free online pharmacy service that provides medication in sorted date and time stamped pouches

Pivotell pill dispenser with the tipper so it's easy to get the pills out

Could you swap the main meal.to the evening and have a sandwich at lunchtime. Mum has zero pivotell but someone needs to load it and with twice daily medication that's a fortnightly commitment.

Buy a pivotell, it dispenses the medication and will sound an alarm whilst doing so. You can also buy a stand for it, to tip the tablets into a cup.

In what way can't manage?

I load pills fortnightly for my Dad. It is a box with 7 individual circular boxes one for each day, 3 marked compartments, so dad can take out one daily and move it from A to B. Quite large so less fidly.

No, as I say, it's minimum 30 mins visits.

If your parents can't manage their evening medication then they need an evening visit too.

Pivotell could work, but if not, it's another visit.

What are the night time meds?

A pivotell will only work if someone is able/willing to fill it. Not all care agencies will and if the carers won't and the family live too far away to commit to visiting at least every 2 weeks then it won't work and it will need an evening care visit. That might mean swapping the lunchtime visit or an extra visit depending on the overall situation.

Many elderly people have visits just for giving medication as they cannot reliably take it themselves. You’ve said they were getting confused with it previously so the carers have no way of knowing who took what when if they’re not actually there when it’s taken. I had a man who was taking his wife’s medication by mistake and ended up in hospital!

If your parents need help with medication then they need help at the appropriate times of day to give the meds. If they have their main meal at lunchtime then it sounds like they need another evening visit for meds only if that’s the timing of their medication schedule