This is the Whole Care Network. Music Helping you tell your story, one podcast at a time. Content presented in the following podcast is for information purposes only. Views and opinions expressed in this podcast are solely those of the host and guest and may not represent the views and opinions of the Whole Care Network. Always consult with your physician for any medical advice and always consult with your attorney for any legal advice. And thank you for listening to the Whole Care Network. Music I wish I had started monitoring my husband's medication sooner than I did. You'll hear more about that in tip three. In today's episode, we're talking about supporting your care receiver with medication management. We have four tips. Sue, you ready to get started? I sure am. Welcome. We are Sue Ryan and Nancy Treister. This podcast brings our years of experience in a variety of family caregiving roles to prepare you to navigate your caregiving journey. We're sharing our personal experiences, not medical advice. And because it's our passion to support you on your journey, we believe no topic is on limits. Let's get started. Music Before we begin, it's important that we share this disclaimer. Neither Sue nor I are our doctor. We are not. We're not giving medical advice. Nope. We're not lawyers. Nope. We're not giving legal advice. We are definitely not. We are, however, caregivers and we are giving caregiving advice. Yes, we are. All right. On to medication management. Medication management is something you're going to be focused on throughout your caregiving journey. From as soon as your care receiver is diagnosed onward, you are going to be the eyes and the ears of what's going on on the ground every day. The doctor is going to be relying on you to observe and to raise up any adjustments that might be needed to medication. So let's start with tip one. Sue, you want to start? Yes, ma'am. Tip one is to begin medication audits. When our care receiver has received their formal diagnosis, one of the first things that we're going to be asked is what medications are they taking? And we want to be able to provide a very thorough listing of all of their prescribed medications, all of their supplements, and any alternative medications they're taking so that the medical team has a complete picture of everything our loved one is currently taking. Second thing that's really helpful is as much as possible. Yes, there are going to be multiple doctors. Let's have one pharmacy where all of the medications are coming from if at all possible, because that's part of what pharmacies do. They know about interactions. They can raise the flag right away if there's a potential interaction. And then the next part of it is when we're doing these audits, we're proactively sharing every single time we go in to see the doctor, we are taking the current audit information, whatever doctor it is. Now we're asking them, you know, where do we stand with this medication? Another thing that we're doing is we're making sure each of them is specifically connected so that they know who our entire medical team is from all of the different types of doctors. So they're able to share about medications, they know dosages, they have all the information that is valuable. We're proactively taking that list in to whatever doctor it is every single time, so they're able to stay right on top of what that is. I prioritized this because I didn't always do this, and it almost caused us a pretty significant issue. And here's what it was. Even before my husband was diagnosed, we had talked about the medications he was taking, we had talked about the supplements he was taking, and that was fine, we had the information. When he was diagnosed, we did the full audit. When we reviewed it with our doctor, he began asking questions about the different medications and the different supplements, and he came to two different supplements, and he asked my husband why he was taking them. And he said, well, one of my buddies was taking them, and he said they sounded like they were good, so I just started taking them. Well, they interacted with a medication he was currently taking, and that was a huge red flag for me, and I vowed that from that point in time on, I would make sure that every doctor knew any medication or supplement or anything else, and we're able to be proactive in making sure that none of them interfered with each other. You know, part of the reason this is so important is we're really their advocate. I mean, we're advocating for them with this because they don't know, and that actually, Nancy, leads us into tip two. Yes, and tip two is to be their advocate. Now, by default, you're already naturally doing that, probably, but let's first talk about being their legal advocate, which means taking ownership legally of their medical decisions. If you're in the United States, you do this through a medical power of attorney. Now, the medical power of attorneys are different state by state, so you need to understand which, you need to get a medical power of attorney that's correct for your state, and if you're not living in the United States, understand in your country what's required to get legal responsibility for their medical decisions. You want to get legal responsibility while they're still capable of signing and making these decisions. This is the time to get out there and have these conversations with your loved ones so that they can actually sign over legal responsibility to you. That's huge. That's absolutely huge is do it early while they can still sign. I promise you, from stories I've heard in support meetings, from people who haven't done it, you just really don't want that to be your experience. Here's the time that medical power of attorney is not the same as financial power of attorney. I found that out the hard way. I took the financial power of attorney to a doctor's appointment with my father-in-law, and they're like, you don't have the right to sit here and have this conversation and make this decision for him. Now, thank goodness they gave me the correct form, and I did go get a medical power of attorney, but you need both, so that's something to know. Then there's in the U.S. you need to have HIPAA rights. HIPAA is healthcare privacy, and your care receiver needs to sign off at each individual doctor the right for you to have access to their medical records. So those are HIPAA rights. HIPAA rights and medical power of attorney are not the same thing. They're two different things. So you need to have HIPAA rights at every doctor, a medical power of attorney that's appropriate for your state or for your country that you live in. While you're getting the medical power of attorney, this is a great chance to have the difficult conversation around other things. Financial power of attorney, it's a great chance to talk about getting your name put on their bank accounts, possibly becoming their Social Security representative. There are other things that now that they have the chance to sign and you have the time to have those conversations and you're having the hard conversations, this is your chance to sort of go through the laundry list of things to discuss. Nancy, this is also a really good time to discuss the advance healthcare directive. Some people may still call it a do not resuscitate order. When you're doing the rest of these, this is a really, really valuable component to add. We talked about being your care receiver's legal medical advocate, but you're also there just on the ground day to day medical advocate with their doctor. The doctor is counting on you to observe what's happening every day and make recommendations or have discussions around any potential medication adjustments that need to happen. A couple of examples, very common with people living with dementia or sleep challenges or even behavior challenges. Yes, they are. And there's lots of medication options that go with those two things. It's not always easy to decide what to do. So the lens I look through when I think about how to make medication choices for my care receivers is, if the roles were reversed, what would I want them to decide? And that's been a real guidepost for me. How would I want them to, what would I want them to do if they were making this decision for me? And that's given me a lot of peace of mind when I've had to make difficult decisions around medication. Ready to go on to tip three? Yes, ma'am. All right. Tip three is taking over medication distribution. Back where we started, which is don't wait as long as I did to start monitoring medication distribution. As soon as your care receiver has a diagnosis, start inserting yourself into what's happening with the medication. Here's how I learned that lesson the hard way. All of a sudden, a few months after my husband's diagnosis, he started acting more confused, a lot more confused than normal. And or that he had been and I thought, what has happened? He has really taken a turn for the worst. I called the neurologist, we got an appointment for like the next day and I walked by his office and he's got his pill box in front of him. And he says, hey, come in here for just a second. You see this pill, this medication right here. I said, yeah, he said, I haven't, that's, I've been out of that for a couple of weeks. So I haven't been taking that. Well, it was his dementia medication. Well, okay. No wonder he's confused, right? I just thank goodness that it was a medication that showed symptoms. What if it was his heart medication or something that was critical to his survival? So fortunately for me, it was something that was symptomatic and I could see that there was a medication challenge. But don't let it, this was only a few months after his diagnosis. So don't even wait that long. Just insert yourself in. You can do it very lovingly and very casually. Check when the medications are becoming, when they're getting low on their medication. Check how they're putting their medication together. Is it going in the right pill containers? If they don't use a pill box or some sort of pill distribution method, now's the time to do it. They got some good pill distribution methods now. It's got it today. We use just the old pill boxes back then, but today you can get pill dispensers that have alarms. They can send alerts to your phone, not just the phone of the person who needs to take the pill, but to a caregiver as well. They can send an alert when the container's been opened. So there's lots of great ways. There's pill packs that your pharmacy can put together. Lots of great ways to help maintain that independence. But stand over them and watch and make sure that it's actually happening correctly. And that includes actually the taking of the medication because there was a time, a day, both for my father and for my husband, where my husband took two days of medication at once. And my father did the exact same thing. So it's, and this wasn't long into our diagnosis. So start monitoring the medication pretty early in the process. And that's just really all the way through to taking the medication. True. And when you talk about independence, when we're talking about the medication on maintaining independence, let's see what independence means for them in that. Let's have conversations with them. Let's try to help. Can we support you with that? Can we organize it? It gets kind of cumbersome. What can we do to help? And part of the reason is that we may think that they're going to have more of an issue than they did. Because share the story about your husband when you decided after all of this that maybe you should do a little bit more with it. I did. I just said, well, you know, would you like for me to put the picture of medication in the pillbox for you? He's like, that'd be awesome. So, I mean, he was struggling. He was happy to have me take it over. Might not be as big a deal as you think it is. So there is that pocket-gilling. There is. And it's worth injecting, inserting yourself into the process and figuring out what the right, you know, combination of you taking it over is at what point. Also, if your loved one is living independently, you're going to leverage a lot of these pill dispensers and pill packs and things to try to help support their independence as long as possible. Because if they can't take their medication, they can't live independently. So this is a good example of supporting someone who lives independently as long as possible. But medication management has got to be working in order for that to happen. However, there is more than just the medication management when they're living alone. Because part of what we need to make sure of is that all of those fancy dispensers or pill packs or whatever are actually being used in the correct way. And the medications are being taken. And I have a variety of stories. This didn't happen to me. I have a variety of stories of other people who've shared that the importance of cameras for their loved ones who are living alone to help them maintain their independence is especially important when it comes to medication. And the cameras need to be positioned so that where you can see that your loved one is actually taking the medication. And here are a couple of examples of why that's important. One of the young ladies in a support meeting said that she went over to help her mom clean up and she was getting ready to throw some things in the trash and she saw something shiny and she looked down and here were all these pills in the trash. She's like, Mom, what did you throw your pills out for? She said, I didn't. I was just cleaning up the kitchen. I was getting all these crumbs off the counter. Part of the diagnosis is changes in depth perception, changes in vision. The mom had apparently gotten the medication out and put it all on the counter and then did something else, got distracted. And then when she came back to it, she couldn't see them clearly and she thought they were crumbs. And so she threw them out. So they said, yeah, so they wouldn't have known it. And so it's really helpful to make sure that our care receiver is actually taking the medications that these wonderful resources can be providing. That's so true. Okay. Ready for tip four? Let's go to tip four. As our loved one is transitioning, we may need to change how they actually receive their medication. Many of the medications that are prescribed are pills and some care receivers forget how to actually swallow the pills so that could become a challenge. I know with my grandmother, one of the medications they prescribed, she was quite petite and we used to say, well, this medication is about as big as she is. It was a huge pill. And like she can't even swallow that. And so we were looking for alternative ways. At any rate, with my dad, he was struggling to be able to swallow them. He really did have some challenges swallowing. So we got a pill crusher and they're really great. So by the way, also a side thing with that, if you're having a frustrating day, it's really great to crush the pills. But you crush the pills and then you serve them in something that they like. My dad, his whole journey loved applesauce. He loved applesauce his whole life, so that was not an issue. However, my husband, who loved chocolate anything, I used to put his in chocolate pudding. And then one day he's like, no, no more chocolate pudding. He would not eat the chocolate pudding. So what I learned is that when I was going to give my loved one the medication in whatever it was, yogurt, pudding, both my dad and my husband liked ice cream. So periodically it went in the ice cream. But when I was giving them their medication, I would give them a bite without the medication first to make sure this was a day they liked that. Then I would give them the medication and put a little bit of it in and put it in a bite and then give them another bite without it. And Nancy, you have a great tip on the way that you put the medication in whatever they're going to be getting it. Yes, because I also have made this mistake. I crushed the medication and we give my husband his medication, which we call dessert, by the way. We don't call it medication. We call it dessert. And that's a great tip. We give it to him after dinner and in a little small yogurt and we would mix it all in there. And after about two bites, he was done having this yogurt. And yet I'd be freaked out because the whole medication, it was all in the yogurt, the medication was. So we've learned to crush the pills on top of the yogurt, give him a spoonful with the medication in it. And then if he wants to eat the rest of the yogurt, that's great for dessert, which often he does. But really bad problem when I put it all in there, mixed it up, and I was committed to him finishing the entire cup of yogurt. And that was a problem, more than once. That's a problem. So there are a variety of different options for that. And then another option is that when we are having these medication audits with our doctors, let's talk about alternative ways for the medication to be distributed. So at the time they're being prescribed a medicine, ask what different ways can this medication be received? Because if they're already taking five or six pills, there's a way to not have another pill being added and there's something that if there's a cream or there's a liquid or something else that can kind of change it up, let's do that. So from the very beginning, let's look at it. If they start having challenges with swallowing the pill or they can't remember, my dad would put the pill in his mouth, drink water, and you think this is great, and then he would take the pill out. And so there are alternative ways. So this is where, again, when we go back to being their advocate, were there advocate for the ways to receive the medication throughout their journey, as well as how to make sure that it's all getting in there? That is so true. All right, we ready to summarize? Yes, ma'am. All right, today we talked about how to support your loved one with medication management. The first tip was to begin performing medication audits. The second tip was to be your care receiver's advocate, both legally and just day-to-day. The third tip was to begin taking over medication distribution. And the fourth tip was around understanding all the different ways you can deliver the medication. Now, if you have tips around medication management that you think would help people, please go to our Facebook page or our Instagram page and share those tips. The links are in the show notes. If you like this podcast, please follow or subscribe, as well as rate and review this podcast. And please share it with your friends or other people that you think would get some advantage out of this podcast. Today we talked about medication management and the fact that it will be a continuous part of your caregiving journey. It sure will. With these tips, you can handle it. We're all on this journey together. Yes, we are.
