Medication management concerns of ethnic minority family caregivers of people living with dementia

Abstract

This qualitative study explored the medication management experiences of Australian ethnic minority family caregivers of people living with dementia. From the perspective of this group of caregivers, medication management was a source of stress resulting from the progressive loss of ability of care recipients to manage their own medications; the complexity of the medication regime and the caregiver's lack of trust of the care recipient to safely and effectively manage medications. Caregivers used various strategies to manage medications and avoid conflict with care recipients including being watchful and involving other family members in medication management tasks. Family caregivers indicated that a lack of information and access to support to inform their medication management role added to their stress, which was exacerbated in some cases by limited English proficiency. Supportive factors noted by caregivers included a well-established relationship with a community pharmacist, involvement of a geriatrician, family support and caregiver support group participation. KeywordsCommunity, dementia, ethnic minority, family caregiver, medication management Supportive factors noted by caregivers included a well-established relationship with a community pharmacist, involvement of a geriatrician, family support and caregiver support group participation.

Exploring the challenges of medical/nursing tasks in home care experienced by caregivers of older adults with dementia: An integrative review

“…First, the literature showed that care recipients’ cognitive impairment required caregivers’ hypervigilance and constant involvement in medication management. One study reported that caregivers of older adults with dementia often checked‐up on their care recipients' understanding of medication instructions from doctors (Gillespie, Harrison, & Mullan, ). Results also show that as changes occurred with the progression of dementia over time, medication management expanded to include reminding care recipients to take their medications, checking pillboxes, dispensing medications and monitoring side effects (Cotrell et al, ; While, Duane, Beanland, & Koch, ).…”

Developing a framework for a novel multi-disciplinary, multi-agency intervention(s), to improve medication management in community-dwelling older people on complex medication regimens (MEMORABLE)––a realist synthesis

“…Previous experience indicates that this will generate sufficient data for an in-depth analysis from multiple perspectives [41, 42]. However, interviews will stop when theoretical saturation is reached.…”

An intervention to maximize medication management by caregivers of persons with memory loss: Intervention overview and two-month outcomes

“…14 While at least one study showed that the involvement of family caregiver is associated with better medication adherence, qualitative research on this topic indicates that assuming responsibility for medication management can be a major source of stress for dementia family caregivers. 12,15 Caregivers in two qualitative studies described frustration with working to avoid conflict and to address uncooperativeness with care recipients during medication administration, with caregivers in the study by While and colleagues poignantly emphasizing that these challenges persist despite the caregiver having adequate knowledge of the medication regimen. 12 This suggests that the problems faced by family caregivers of those with cognitive impairment are complex and unlikely to be addressed by standard nursing interventions like medication education or the use of reminder systems.…”