Lindsey Harrison

Managing medications: the role of informal caregivers of older adults and people living with dementia. A review of the literature

AIMS AND OBJECTIVES To explore published literature that describes what is known about the role of informal caregivers as they manage medications for older adults and/or people living with dementia residing in the community. BACKGROUND The number of informal caregivers of older adults, including people living with dementia, is growing worldwide. Good medication management by informal caregivers contributes to improved health outcomes and reduced institutionalisations for the care recipient; however, little is known about this domain of care. DESIGN Narrative review. METHODS A literature search was conducted to identify relevant research articles written in English between January 2000-April 2013, sourced from online database searches using multiple keywords, reviewing reference lists and citations of key articles and Internet searches. Articles were included if they described informal caregiver medication management for older adults and/or people living with dementia. RESULTS Ten articles were found that described this role from the perspective of the informal caregiver. The evidence suggests that this role is complex and is often made more difficult because of increasing medication regimen complexities, aspects of the relationship between the caregiver and the care recipient, healthcare system practices and a lack of information and/or training available to the informal caregiver, especially when caring for people living with dementia. CONCLUSION Responsibility for managing medications for older adults and/or people living with dementia in the community often falls to informal caregivers. More information resources are required for this role, which requires specific medication management skills and knowledge and is further complicated by the cognitive decline of the care recipient. RELEVANCE TO CLINICAL PRACTICE Informal caregivers are often expected to manage medications in a safe and effective manner for their older care recipient, who may also have cognitive impairment. Nurses, who may be in frequent contact with community-living older adults/people living with dementia, can be an important source of information, training and support for informal caregivers.

Medication management concerns of ethnic minority family caregivers of people living with dementia

This qualitative study explored the medication management experiences of Australian ethnic minority family caregivers of people living with dementia. From the perspective of this group of caregivers, medication management was a source of stress resulting from the progressive loss of ability of care recipients to manage their own medications; the complexity of the medication regime and the caregiver’s lack of trust of the care recipient to safely and effectively manage medications. Caregivers used various strategies to manage medications and avoid conflict with care recipients including being watchful and involving other family members in medication management tasks. Family caregivers indicated that a lack of information and access to support to inform their medication management role added to their stress, which was exacerbated in some cases by limited English proficiency. Supportive factors noted by caregivers included a well-established relationship with a community pharmacist, involvement of a geriatrician, family support and caregiver support group participation.

Deprescribing medications for older adults in the primary care context: A mixed studies review

This review investigates the factors that influence deprescribing of medications in primary care from the perspective of general practitioners (GPs) and community‐living older adults.

Medication Management for People Living with Dementia: Development and Evaluation of a Multilingual Information Resource for Family Caregivers of People Living with Dementia

The aim of this chapter is to describe the development and evaluation of an online multilingual information resource focused on medication management, targeting people living with dementia and their family caregivers. Maintaining effective medication management is important to allow ongoing quality of life within the community setting and avoiding medication-related preventable hospitalisations for the person living with dementia. Family caregivers are likely to assume the role of medication management on behalf of the person in their care as dementia progresses. Little training or information is available to family caregivers to assist them with this role. A pilot online information resource was developed and evaluated. Responding to the evaluation, this resource was improved, and a more extensive evaluation process was undertaken. The development and evaluation process are outlined with a view to guiding the development of similar resources, especially those targeting linguistically diverse family caregivers and those with dementia. This is especially important given that many older adults will migrate during their lifetime, often to a country where they are not familiar with the language or health services. Extra support is needed to assist older immigrants who are themselves at risk or are caring for someone with dementia. Disciplines Medicine and Health Sciences | Social and Behavioral Sciences Publication Details Gillespie, R., Burns, P., Harrison, L., Baker, A., Win, K., Traynor, V. & Mullan, J. (2016). Medication management for people living with dementia: development and evaluation of a multilingual information resource for family caregivers of people living with dementia. In D. V. Moretti (Ed.), Update on Dementia (pp. 493-514). Rijeka, Croatia: InTech. Authors Robyn Gillespie, Pippa Burns, Lindsey Harrison, Amanda Ann Baker, Khin Than Win, Victoria Traynor, and Judy Mullan This book chapter is available at Research Online: http://ro.uow.edu.au/smhpapers/4598 2,900+ OPEN ACCESS BOOKS 99,000+ INTERNATIONAL AUTHORS AND EDITORS 92+ MILLION DOWNLOADS BOOKS DELIVERED TO 151 COUNTRIES AUTHORS AMONG TOP 1% MOST CITED SCIENTIST 12.2% AUTHORS AND EDITORS FROM TOP 500 UNIVERSITIES Selection of our books indexed in the Book Citation Index in Web of ScienceTM Core Collection (BKCI) Chapter from the book Update on Dementia Downloaded from: http://www.intechopen.com/books/update-on-dementia PUBLISHED BY Worlds largest Science, Technology & Medicine Open Access book publisher Interested in publishing with InTechOpen? Contact us at book.department@intechopen.com