Medication Safety for People Living with Dementia
Pharmacists play an important role in the care of people living with symptoms of dementia. In line with March being Pharmacy Awareness Month, in this article, we would like to talk about medication safety for people living with symptoms of dementia and ways on how we can be more intentional in partnering with our pharmacists as key members in the circle of care.
Family caregivers are, in reality, “informal experts” in dementia care. Providing almost 24/7 care for their loved one, family caregivers possess a wealth of knowledge and experience about their loved ones that can allow healthcare professionals to make informed decisions on the best direction and next steps in dementia care for their patients.
What Family Caregivers Need to Watch Out for When a New Medication is Prescribed
In a Pharmacist’s Guide published by the Alzheimer Society of Canada, they emphasized that both doctors and pharmacists rely on the patient’s and their caregivers to inform them if there are noticeable improvements in the “patient’s condition and/or their quality of life.” By the same token, if there are subtle or significant deterioration or undesirable effects that are observed in a person’s condition, it is also critical that healthcare professionals are informed of these changes in a timely manner.
When a new medication is introduced it is important for family caregivers to observe and note both positive and negative changes in their loved one’s condition and report these changes to the physician who prescribed the medication AS WELL AS their pharmacist. Some of these possible changes can include:
● weight loss
● loss of appetite
● heart-related symptoms (e.g., slowing down or increase in heartbeat)
● unusual dreams or nightmares
Family caregivers should not feel “shy” or “embarrassed” to speak up. It is not an inconvenience to be proactive in keeping healthcare professionals informed as one cannot assume that healthcare professionals are able to know the full picture.
It is also important to know that healthcare professionals also have to adhere to legislations such as the FIPPA or the Freedom of Information and Protection of Privacy Act. This means that though they have access to their patient’s medical records, they need their patient’s (or the patient’s legal health care representative) to access these records and a reason to do so.
Questions Family Caregivers Should Ask from their Doctor and Pharmacist
When caring for someone living with symptoms of dementia, knowledge is not just power, it is safety and peace of mind. Staying informed and fully understanding what the plan of care is and what to expect, allows family caregivers to prepare and anticipate what to watch out for – what is “normal” and expected and when it is time to ask for medical help and/or act urgently.
The article, “Managing Medicines for Persons with Alzheimer’s” published by the National Institute on Aging provides helpful information family caregivers need to know when a new treatment regimen for their loved one is given. Below is a list of some of the questions family caregivers need to ask when a new medication has been prescribed for their loved one:
● The medications intended use or benefits to the patient
● What the positive effects would look like and watch out for in their loved one
● How soon can these positive effects be observed
● Possible side effects and adverse reactions to the medication and what to do when this happens (e.g., when to bring to the emergency room, medications to take to counteract the symptoms, or, medications the patient needs to stop taking which can be exacerbating the symptoms)
● How long this new medication will be taken and how it may affect their loved one physically, cognitively, psychologically, etc.
● How often the person needs to take the medication (e.g., does it have to be taken before or after meals, same time everyday, etc.)
● What happens if the person misses a dose (e.g., can it be taken at a different time? Double up the dose? Call their family doctor?)
Consulting with the Pharmacist
Since family caregivers are key members in the circle of care for a person diagnosed with a form of dementia, communication should always be a two-way street – that is, it is not just healthcare professionals providing information to family caregivers; but it is also family caregivers providing information back to healthcare professionals.
Older adults tend to have multiple medications prescribed which may have effects that counteract each other. It is important to be fully informed and aware of the use, effects and side effects of each medication (see checklist above and apply these questions for each medication prescribed).
BEFORE giving a new medication to their loved one with dementia, family caregivers could request a consultation with their Pharmacist. Though Pharmacists would, in practice, review these medications before they dispense new medications to a patient, it is important that family caregivers are likewise aware of how these medications affect their loved ones. This allows family caregivers to be more aware of what is “normally expected” versus what is a red flag and a medical concern.
Additional Supportive Resources for Family Caregivers
Being a family caregiver can, at times, be overwhelming, especially with everything they need to remember in caring for their loved ones – from doctor’s appointments, to taking them to adult day care programs and being on top of their medications.
It is important and comforting for family caregivers to remember that they are not alone in their experiences and challenges. There are several support groups that are available across Canada, both in-person and online. At these sessions family members can ask questions including about medication management, from other family caregivers and/or specialists who moderate these support groups. These support groups can provide a brief respite but also, acquire valuable information on what to expect and what other family caregivers have tried and worked with their loved ones.
Please remember, there are supports out there and that you don’t have to journey alone.
Karen Tyrell CPCA, CDCP is a Dementia Consultant, Educator, Author & Advocate, and Founder of Personalized Dementia Solutions Inc. (www.DementiaSolutions.ca). Karen offers her expertise on dementia care through speaking engagements, workshops, support groups and by working one-on-one with families and caregivers to provide emotional support and practical solutions. She was also on the design team for The Village Langley and provides ongoing education to the Village team, families and the community.
The contents of this blog are provided for information purposes only. They are not intended to replace clinical diagnosis or medical advice from a health professional.