Managing Multiple Medications and Their Packaging for Older People in Home Care Nursing: An Interview Study.

Giana Carli Lorenzini

doi:10.3390/healthcare9101265

Abstract

Home care nurses assist older people in their daily living and well-being, including medication management. Medication management can be challenging for older people with functional constraints and several chronic conditions. This paper presents how home care nurses manage medications and their packaging for older people at their homes. This study followed an explorative qualitative research design, in which semi-structured interviews were conducted with home care nurses in Sweden (n = 14). The study revealed that home care nurses need to coordinate a multitude of interrelated tasks, with documentation being paramount. Regarding medication management, automated systems were preferred, as they reduce medication errors and facilitate dispensing of medications for each patient when compared with analogue systems still in use (i.e., dosing boxes), commonly used by older people. Importantly, the lack of a common journal system for updates on prescribed medication among health care providers and analogue communication still in place creates space for outdated prescription of medications for patients. There are opportunities for further investigation on how technology can help home care nurses in coordinating medication management tasks with other health care providers, and on receiving updates about medication intake by older patients when the nurse is not at their homes.

Highlights

The aging population, as a global phenomenon, is a positive outcome of advancements in medicine and improved life habits
Older people are commonly affected by chronic conditions and geriatric syndromes [1], which lead to daily intake of multiple medications [2]
The home care nurses interviewed reported that some older people with capabilities of taking care of themselves might need help only with their medication because of the way the medication packaging is designed, which increases the demand for home care services and limits the independent living of the older person

Summary

Introduction

The aging population, as a global phenomenon, is a positive outcome of advancements in medicine and improved life habits. Whereas some older people might be able to self-care, frail older people living at home with multiple conditions, polypharmacy, and cognitive impairment are at a high risk of adverse outcomes and inappropriate medication intake if not offered appropriate health care services [3,4]. Many developed countries such as Sweden have a large population of older people and an increasing demand for home care services [5]. The majority, 310,000 people, were 65 years or older, most of them women [8]

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Discussion

Conclusion