Medication management: The perspectives of people with dementia and family carers

Abstract

The safe self management of medicines will be affected by the presence of dementia. A qualitative study using grounded theory was undertaken by a community nursing organisation in Melbourne, Australia, in order to develop a strength-based and person-centred approach to the assessment of medication ability. The perspectives of the person with dementia and their carers were explored to see if there were any significant differences in their medication management experiences when compared to those of older adults without dementia and their carers. People with dementia are able to sustain self management of their medicines using established routines and strategies. As cognitive changes affect short-term memory, external strategies and task allocation to family members are introduced by the individual to support their continuing independence. The family member assumed the carer role as their concern for medication safety increased, but this role engendered stress and a burden that was unacknowledged by the health professional.

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

“…This has also been reported in other research (Kaasalainen et al 2011, While et al 2012. Our evidence suggests that there are two sources of conflict.…”

“…The small non probability sample limits the generalizability of the study results although it is characteristic of similar qualitative studies of family caregivers of people with dementia (Kaasalainen et al 2011;While et al 2012). Despite the small sample size however, there was a consistency of findings across focus groups and individual semi-structured interviews with significant key findings relevant to the research question identified.…”

“…While general studies of medication management by family caregivers of older adults are available (Travis, Bethea & Winn 2000;Smith et al 2003;Travis et al 2003;Francis, Smith, Gray & Denham 2006), few studies have focused exclusively on family caregivers of people living with dementia (Cotrell et al 2006, Kaasalainen et al 2011, While et al 2012. In particular, studies of the medication management experience of ethnic minority family …”

“…Medication management is a broad concept that involves many key players, including the care recipient, the caregiver (when appropriate) and often times multiple health care providers (While, Duane, Beanland & Koch 2012). From a family caregiver's perspective, medication management includes maintaining continuous supplies of medications, assisting with administration, making clinical judgements and communicating with health care providers and care recipients (Smith, Francis, Gray, Denham & Graffy 2003).…”

Safety Strategies for Care in the Home

“…If a family member makes an error they have all the burden of responsibility that a professional bears combined with the terrible experience of harming someone close to them. Interviews with carers suggest that the responsibility for giving powerful medications can become burdensome both because of the time commitment and anxiety about making mistakes; many carers do not receive clear guidance about medication, leading to omissions, incorrect doses, anxiety and confusion which are often not recognised by health professionals (While et al 2013 ). Relatives of people near the end of their lives face the additional worry about hastening death through improper use of medication (Payne et al 2014 ).…”