Some Notes about Medication
There can be a variety of issues/problems with medication and the nursing home including: Is the resident being under/over medicated? What form of a drug (e.g., liquid, pill, crushed) is best for the resident? Is the resident being given an incorrect drug? Are there hurtful side effects from a drug? Is the drug duplicating another drug? Are there non-drug approaches that could be used aside from medication?
To resolve medication issues, it’s important to know:
- The attending physician is key to initiating or terminating a drug, or altering a prescription.
- The attending physician’s nurse practitioner may be more accessible, and may be able to intervene and make some drug changes.
- The unit manager or any unit nurse should be able to contact the doctor or nurse practitioner to answer your questions about a drug. Also, contact the nursing home’s pharmacist or other pharmacists for input into understanding a drug’s side effects and alternative drug options.
- If you disagree with attending physician decisions, contact the nursing home’s medical director.
By Massachusetts law, informed written consent (IWC) must be obtained before administering a psychotropic drug to a long-term care resident (i.e., nursing home or rest home resident). Psychotropic drugs include antipsychotics, antidepressants, anti-anxiety medications, and sedatives. These drugs affect brain function and work to change perception, mood, or consciousness to treat psychiatric conditions. Please note IWC also includes any drug used in treatment of a psychiatric diagnosis or symptom. See the Informed Written Consent section in Managing the Nursing Home Experience.
Federal regulations cover many rights to protect residents from inappropriate or unwanted medications, including: the right to refuse treatment (except in certain emergency situations); the right to seek services inside and outside facility (specialists, 2nd opinions); freedom from unnecessary drugs; administration of psychotropic drugs only when necessary to treat a specific condition as diagnosed and documented; and protection from any significant medication errors, etc.
For specific language on these and additional rights in the Federal regulations, see Code of Federal Regulations: Part 483—Requirements For States And Long Term Care Facilities:
- §483.10 Resident rights (c)Planning and Implementing Care, and
- §483.45 Pharmacy services: (d)Unnecessary Drugs, (e)Psychotropic Drugs, and (f)Medication Errors.