When my mom still lived in her home, we used three tools to keep track of her medications (and supplements) so she, as well as all involved with her care, would know which medications she had taken and when and if there were any new side effects. I can’t overstate the importance of each of these in helping me be a “keeper of the baseline.” Two of the most critical ways it helped to have these were:
Anytime my mom was admitted to the hospital, this piece of paper became critical. First, it was easy for the staff to photocopy and insert into her chart. It was typed and clearly labeled. We weren’t handwriting the med list onto their forms. Second, since she sometimes had problems with new medications, when I gave the list to the ER staff, I stressed the importance of not changing any of her medications without consulting me first.
In many cases, changes were made depending on the doctor’s recommendations/preferences, insurance issues with covering the medication while in the hospital, or delays in obtaining the medication on time. Most of the time, we could figure out a solution so that her meds stayed the same. A lot of it hinged on making good communication connections with the doctors and nurses and emphasizing the importance of not making any changes (unless, of course, they thought one of the meds might be related to why she was in the ER in the first place!). I believe that, most of the time, having the Medication List also resulted in better care. It became obvious right off the bat that I was an involved caregiver and that I would be watching over my mother’s care with a keen eye. I had more doctors and nurses than I can count tell me how true this is: that better care is often correlated with patient involvement and caregiver advocacy. Squeaky wheel…
The Medication List was also helpful for new doctor visits. The office staff could photocopy the list; we wouldn’t have to risk getting carpel tunnel writing out her list of meds on their forms. In addition, it often helped to have this when at the cancer center, where they would check on her medications at each visit.
The other document that I kept with me and mom had in her purse was the Problem Med List wherein we had listed the pain medications and anti-nausea medications she had tried that did not work or caused a negative or allergic reaction. I listed the medication, dose, frequency, and symptoms/reasons for being on the list. This was another very helpful document for situations where my mom’s doctors changed or when she was admitted to the hospital. In cases where a doctor did want to switch her to a different medication, they also had this as a guide in figuring out which med to try next—avoiding families of medications that were related to ones she had already tried and had a problem with.
The third tool we came up with was a spiral notebook, Medication Schedule Chart, where we wrote down the name of the medication my mom took, the dose, and the time she took it and whether there were negative side effects. If she had a new symptom arise, this was the most helpful way to know which med might be a problem since we could see when she had started it. Sometimes only after she had taken a new medication for a day or two did either a negative side effect such as intense drowsiness (so the dose might have needed to be lowered or the med changed) or the ineffectiveness of the medication became apparent. And, if there was an emergency, we (or a hired caregiver) could look back and tell the ER staff when my mom had last taken certain medications (very important info for them to have).
When my mom lived in assisted living and then a nursing home, the facilities had their own ways of keeping track of medications (called MARS—medication administration record). In cases of emergency, they would copy the MARS and send it with the paramedics. But I found that we still needed the Medication List, since at times the MARS, which is handwritten, was illegible because of the handwriting or some other issue or it had been copied too lightly. In addition, it is pages and pages long and was sometimes a mess for ER staff and docs to interpret due to meds or med schedules being changed, therefore scratched out and re-written elsewhere. So it was easier to have a one-page summary of her meds in addition to the MARS. What we didn’t have, then, was a record of when certain medications were administered, but the staff could check with the facility on that to clarify what was in the MARS but illegible.
And, the Medication List was still an important document to have for new doctors and for coordinating with the cancer center. In addition, I had a record of mom’s meds with me at home to troubleshoot issues that came up and could be resolved over the phone.
Good luck, caregivers. Squeak on…
- I used them to track changes in symptoms related to medications. This helped us more readily figure out whether changes were from a medication or something else (sometimes an exquisitely complex knot to untie…).
- These helped prevent medication mishaps when entering or being discharged from a hospital or rehab center (or helped them get ironed out). A LOT OF MISTAKES HAPPENED AT THESE JUNCTURES. So many times, nearly 1/3 of mom’s medications would be incorrect in some way: the type (a med had been changed), the dosage, or the frequency. It helped to sit down with the discharge nurse and go through the discharge forms from the hospital and compare their medication list with mom’s med list. And then at the re-entry point of where mom was living, I would go through the list again with the doctor, nurse, or PA there (yes, often sleepily waiting for them to have time).
Anytime my mom was admitted to the hospital, this piece of paper became critical. First, it was easy for the staff to photocopy and insert into her chart. It was typed and clearly labeled. We weren’t handwriting the med list onto their forms. Second, since she sometimes had problems with new medications, when I gave the list to the ER staff, I stressed the importance of not changing any of her medications without consulting me first.
In many cases, changes were made depending on the doctor’s recommendations/preferences, insurance issues with covering the medication while in the hospital, or delays in obtaining the medication on time. Most of the time, we could figure out a solution so that her meds stayed the same. A lot of it hinged on making good communication connections with the doctors and nurses and emphasizing the importance of not making any changes (unless, of course, they thought one of the meds might be related to why she was in the ER in the first place!). I believe that, most of the time, having the Medication List also resulted in better care. It became obvious right off the bat that I was an involved caregiver and that I would be watching over my mother’s care with a keen eye. I had more doctors and nurses than I can count tell me how true this is: that better care is often correlated with patient involvement and caregiver advocacy. Squeaky wheel…
The Medication List was also helpful for new doctor visits. The office staff could photocopy the list; we wouldn’t have to risk getting carpel tunnel writing out her list of meds on their forms. In addition, it often helped to have this when at the cancer center, where they would check on her medications at each visit.
The other document that I kept with me and mom had in her purse was the Problem Med List wherein we had listed the pain medications and anti-nausea medications she had tried that did not work or caused a negative or allergic reaction. I listed the medication, dose, frequency, and symptoms/reasons for being on the list. This was another very helpful document for situations where my mom’s doctors changed or when she was admitted to the hospital. In cases where a doctor did want to switch her to a different medication, they also had this as a guide in figuring out which med to try next—avoiding families of medications that were related to ones she had already tried and had a problem with.
The third tool we came up with was a spiral notebook, Medication Schedule Chart, where we wrote down the name of the medication my mom took, the dose, and the time she took it and whether there were negative side effects. If she had a new symptom arise, this was the most helpful way to know which med might be a problem since we could see when she had started it. Sometimes only after she had taken a new medication for a day or two did either a negative side effect such as intense drowsiness (so the dose might have needed to be lowered or the med changed) or the ineffectiveness of the medication became apparent. And, if there was an emergency, we (or a hired caregiver) could look back and tell the ER staff when my mom had last taken certain medications (very important info for them to have).
When my mom lived in assisted living and then a nursing home, the facilities had their own ways of keeping track of medications (called MARS—medication administration record). In cases of emergency, they would copy the MARS and send it with the paramedics. But I found that we still needed the Medication List, since at times the MARS, which is handwritten, was illegible because of the handwriting or some other issue or it had been copied too lightly. In addition, it is pages and pages long and was sometimes a mess for ER staff and docs to interpret due to meds or med schedules being changed, therefore scratched out and re-written elsewhere. So it was easier to have a one-page summary of her meds in addition to the MARS. What we didn’t have, then, was a record of when certain medications were administered, but the staff could check with the facility on that to clarify what was in the MARS but illegible.
And, the Medication List was still an important document to have for new doctors and for coordinating with the cancer center. In addition, I had a record of mom’s meds with me at home to troubleshoot issues that came up and could be resolved over the phone.
Good luck, caregivers. Squeak on…