Self-Medication: Empowering Persons with Disabilities

 Proverb - “Nothing will be attempted if all possible objections must first be overcome.”  Proverb - “Difficult things take a long time, impossible things a little longer.”  The Bible - “All things are possible to him that believeth.”

 Kathleen Ward, BSW, MPP  Saundra Brown-Asante, BA, RN, DN/CM  The Department of Human Resources Project Home Program, a residential program for mentally ill and disabled adults, is giving their residents a greater sense of independence and autonomy while ensuring safety in a program designed to teach residents to self-medicate.  What are your expectations?

Administer medications safely and as prescribed by the health care professional. Provide support/personal assistance to meet the needs of the individual who needs assistance to medicate in a way that promotes optimum dignity and independence. Let’s talk about ways to administer medicines to your loved-ones or patients.

Self-medication is having the ability to take medication at the correct time, using the correct route, in the correct dose with the support of a caregiver or a caregiver’s back up who can offer physical assistance and/or reminders. Self-medication means that at a minimum the patient or loved-one identify a pill by size and/or color, know when they are to take pill and why they are taking it.

 Independently – without assistance  Implies that the individual has the physical and cognitive ability to take medications without any support or assistance from others.

 With Assistance or Supervision - When an individual can safely take medication with physical assistance, reminders or supervision only.  Implies that the individual has some minor physical or cognitive limitation, but only to the point of requiring some cueing and coaching or minimal supervision.

 Given by Caregiver –  Implies the individual does not have the physical and/or cognitive ability to safely administer medications even with physical assistance, reminders or supervision.

 Frees up your time  Provides an extra layer of safety  Increases safety when substitute caregivers are present  Empowers by increasing independence  Builds feelings of self-worth

Persons with developmental disabilities Persons with mental illness Persons with physical disabilities (visual, hearing, ambulating) Persons with chronic illness Persons who are frail or elderly Persons with dementia

 And children

 Pill boxes  Totes  Bubble packs  Unit dose  Alarms  Pictures

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 Electronic Pill Dispensers  Braille bottles  Pre-filled syringes  Creative use of markers, pictures of medications,  Charts

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 Medications must be kept in a safe manner at all times.  This protects the individual and other household members.

COACHINGCUEING  Sit beside individual and show how to count the correct pill(s) for Pill Box.  Help place a small amount of ointment on individual’s finger and assist hand to wound.  Wash individual’s hands before touching medicin.e  Remind individual to fill pill box.  “Is it time to take you fluid pill?”  “Lunch is ready. Do you have your medicine”

 How old is the person?  Are they capable of taking their medication independently? With assistance?  Is eyesight impaired?  Do they understand why they take each medication?  Will others understand the method?  Is the method flexible?

 Associate the medication with a meal or event rather than a time of day. You can “re-label”.  Use a pill organizer. Electronic?  Organizes medicines on shelf in order of use.  Written reminders in places the individual will see it.  Use personal markers or colors on top of the bottle.

 Braille wording on bottle top.  Change pill bottle shapes or sizes for each medicine.  Rubber bands on bottle to indicate how many doses or pills need to be taken each day.

 There is help out there  Get to know your pharmacist  Ask your doctor questions such as:  Why is the individual taking this medication?  What side effects should I look for?  How will I know when it is working?  How will I know when it is not working?  When will I see the effects of this medication?  Does the individual need blood tests while on this medication?  Will this medication interfere with other meds. the individual is taking?  Are there any OTCs he/she can’t take?  Are there any vitamins or herbal supplements that he/she can’t take?

 There is no wrong way to develop a system as long as it meets physician orders’ and provides the necessary medications when they are needed.  Involve your family members or other staff in the planning process.  It can take weeks, months or longer for an individual to learn to self-medicate and that’s OK!