Medication outside dosset box

Discussion in 'ARCHIVE FORUM: Support discussions' started by Zooey, Nov 5, 2007.

  1. Zooey

    Zooey Registered User

    I'm typing this in a rush while cleaning the litter trays before work, so please excuse me for being brief.

    Does anyone have any experience of medication given to someone with AZ that isn't in a dosset box? This has happened twice to my Mum in the past 3 weeks. The first was from an out of hours doctor and the tablets were painkillers. As the pain didn't last for more than a few hours, I wasn't too concerned about my Mum needing them, but raised the problem with a District Nurse a couple of days later. She seemed to think I was being difficult, so I didn't press the matter.

    Then on Saturday night we were visiting my Mum and she was being sick all night. She blamed the "new tablets" which I found in a box by her side. They were antibiotics and were prescribed last Tuesday (30th October). She should have had 4 tablets a day and therefore should have taken 16 by then. Only 2 tablets were missing.

    I'm furious on 2 counts. That my Mum has important medication that she can't be trusted to take and the visiting DN has just handed over the packet. My Mum can't remember what the tablets are for, or that they must be taken with food, which brings me to the other point. I presume my Mum was so sick because she had taken a tablet on an empty stomach. She is literally confined to her chair, so couldn't get up to get food, even if she wanted to.

    I don't have time to go into details, but we have been far from impressed with my Mum's doctor of late. He won't visit and he won't even refer her to a psycho-geriatric consultant. When the care manager got in touch to insist that he did, the doctor phoned me at work to complain.

    The carers are good, but won't give medication outside the dosset box. Does anyone have any idea where I go from here? The out of hours doctor I spoke to yesterday said it was down to luck if someone had a friend or neighbour who could drop in to give the extra pills. Surely it isn't as bad as this? I live 25 miles from my Mum and there is no-one else we can ask.
     
  2. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,439
    #2 jenniferpa, Nov 5, 2007
    Last edited: Nov 5, 2007
    There were occasions where my mother had meds outside her prepackaged box - antibiotics and pain medications primarily, although she also had daily soluble asprin that couldn't be in the box. The first set of agency carers weren't supposed to adminster these, but they did anyway (I was 3500 miles away) and the second set of onsite domicillary carers also took a very pragmatic approach, although I'm not sure whether they got some level of "dispensation" to do it. My point being is that there are work-arounds. If it turns out that the meds can only be adminstered by a trained nurse, and not regular care personnel, then your local PCT will have to provide that trained nurse. They won't want to do it, but they don't have a choice, although you'll have to be exceptionally pushy about it because this is grey area. If a medication is prescribed that your mother needs to take, and not taking it will cause a deterioration in her condition to the point where, possibly, hospitalisation will result, it is in their best interests to ensure that that medication is taken.

    An alternative might be an antibiotic that is administered only once a day, but these are expensive compared to things like penicillan.

    Edited to add: is your mother in East Sussex as well? Because this is relevent if so (from http://www.eastsussex.gov.uk/socialcare/adults/homecare/)

    "Can a home carer give medication?
    Adult Social Care staff and staff from private agencies aim to assist service users to maintain responsibility in administering their own medication.

    Decisions concerning an individual’s capacity and ability to administer their own medication are made with that person, their carer/relative and other health professionals such as a district nurse.

    Administration of medication is only undertaken by staff who have had the appropriate training. "

    In other words, if your mother has meds that she can't take unassisted (appropriately and at the correct time) they need to ensure that the care workers involved have the appropriate training. They can't simply turn around and say "we aren't trained".
     
  3. 117katie

    117katie Guest

    Just to let you know my own experience of meds and carer workers, not to mention GPs:

    To start with the GP: my aunt's GP - Senior Practice Dr!! - placed into the hands of my 83 year old with dementia a prescription for 100 paracetamol! Becasue she had turned up at surgery to say she had backache. Yes, I hit the roof, and fortunately I visited the day after, so removed the box, wishing only that I could have removed the GP too. Unbelievable!

    I made sure that my relative's record at the surgery had a large note on screen to say DO NOT GIVE PRESCRIPTIONS OF ANY KIND TO HER. All her prescriptions were faxed to the Pharmacy, all the meds were put into blister packs, and then delivered. We introduced a lockable box, with the meds in the box, and the box and key kept out of sight and out of reach. On top of a cupboard in the kitchen. The Care Workers were allowed to PROMPT her to take the meds out of the blister packs, and hopefully to pop them out for her, if need be. But they were not allowed to give any meds that were not contained in the blister packs. Or so I was told then by the SW.

    This was while my aunt was still living in her own flat. After she moved into extra-care sheltered housing, the domicilliary care workers there were also allowed to PROMPT the medications out of the packs, but they were not allowed to give any meds not in a blister pack. So I was told by the manager.

    But it still didn't stop the care workers putting the tabs into a little plastic container, with the wrong label on, and telling her to "take them later, when you're ready"!! Roof hit again, of course, especially the day she opened her handbag at lunchtime to reveal box containing various meds that she had kept till later "well, I didn't need them then, so I thought I'd take them later"!!!!!

    So, if and when my relative was prescribed an antibiotic, I made sure that that too was put into the blister packs, even though it was a nuisance for the pharmacy because they had to repack all the tablets, but they were extremely helpful and willing to do that. As a result, no meds were ever prescribed which were not contained in a blister pack, and it was the responsibility of the Care Workers to ensure they were PROMPTED at the right time. Wasn't always perfect, because one of the care workers didn't know the difference between AM meaning morning, and PM meaning afternoon!!! Heaven help us all!

    But, if I had had the choice with some of the meds, I would have loved a DN to be able to visit, but it just was not achievable, so I went for the next best option of making sure that all the meds were in the blister packs, and never never never prescribed by the GP direct to my aunt, and always made up by the pharmacist into the blister packs but never in a box.

    Hope that my experience helps in some way.

    Take care
    Katie
     
  4. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Hmmm everyone,

    I haven't had this with my mum, but my mother in law who passed away 3 years ago had certain permanent pills, and occasionaly extra pills, and they were all put into the blister pack, even though she was probably capable of taking the new ones herself. All Credit to Tytherington Pharmacy in Macclesfield. ADVERT, probably will be removed by one of the moderators! Go on! (Laughing).

    Can't imagine how you are managing.

    Let us know, cos we might all encouter this at some point.

    Regards

    Margaret
     
  5. Nels

    Nels Registered User

    Jul 25, 2006
    61
    Romford Essex
    Mum never remembers to take any tablets except her warfarin (she was prescribed these years ago so remembers!). However when I tried to get her medication put into blister packs I was told by the pharmacist that only 1 of her tablets could go into a blister pack, something to do with being reacting to the light... did not query it at the time (in the summer) but it would certainly make life easier for me if they were and that Aricept could not be put into a pack because of this.
     
  6. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,439
    Nels - my mother had several different types of blister packs over time (every pharmacy seems to have their own system) and at a least 2 of them would have protected the medications from the light I think. One was in a sort of ring binder, and one was on something that reminded me of a roladex (two large rings attached to base with a cover on top.) On both of these the meds were on the underside, so if the cover wasn't closed, they'd still be protected. I think you should probably check with a different pharmacy!
     
  7. elaineo2

    elaineo2 Registered User

    Jul 6, 2007
    945
    leigh lancashire
    Hi all,just a quick one.There are certain meds that cannot be put in a nomad or blister pack.Some have to be dispensed as packed by the pharmaceutical company.eg nicorandil,omeprazole 20 mg,.Sometimes the medication can be changed by the G.P to an equivalent alternative that can be blistered.Aricept can be blistered,there are many on it in the home i work in and it is blistered by the pharmacy.love elainex
     
  8. Nels

    Nels Registered User

    Jul 25, 2006
    61
    Romford Essex
    Thanks for the replies, have not been online much lately, really manic at work at the moment, am only supposed to be working mornings but am doing a lot more and when I get home just fall into bed after sorting mum and sister out. Thanks again will look into it again when I have a bit more time.
     

Share This Page

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.