Medication Set up in the home

[AuntieLUU]

I am an RN Wellness Coordinator for a company that offers assistance and management-lifetime care, to private pay Seniors in their own home. I went out out for a weekly Mediset -set up. I had only saw this person 1 time previously in the last year. The Member has 24 hr Private pay caregivers—She has mild to moderate cognitive issues. The caregiver present that day told me that the member has outbursts— yelling— negative behavior, refusing to bathe etc. as well as anxious moments throughout the day. One caregiver had quit due to the behavior. The caregiver told me that their company is aware. The PCP has ordered Ativan 0.5 mg PO Q 8-12 H daily as needed. When the caregiver told me this I then added the Ativan for AM & PM along with all the other prescribed medications. I received a phone call from the other caregiver at the end of the week Thanking me for putting the Ativan in the Mediset as they could see changes for the better in the member. But my question is this: the caregiver said another Nurse will not put the Ativan in the Mediset as it is PRN and the member had told her “I don’t want that and you can’t make me”. The caregivers had asked the nurse multiple times to put the Ativan in the pill box— and the nurse said she would not as this member said she doesn’t want it and that would be considered “ Chemical Restraint” if it was done. Now I just added the Ativan in with all the meds as I did the Mediset. I did the Mediset in front of her at her kitchen table. The member did not question me nor did I sit and tell her every pill I was putting in as I did. I was following the mediation list. I felt I was acting prudently in providing PRN medication prescribed to the member in response to reported behaviors. What are your thoughts? Would this be a form of Chemical Restraint? Thank you!

[caliotter3]

Contact the PCP for a routine order to solve the problem. No reason why the other nurse could not have done this already.

[AuntieLUU]

Thanks for your quick reply! Yes! That makes perfect sense!