Number of Meds per Resident

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Curious about this...When in nursing school a few years ago I noticed Pt's were on numerous meds, upwards of 15 different meds in the morning. Many of these vitamins. What are your thoughts on the amount of meds given to residents...do you think they are extending life and its quality? Do your residents take these meds without a struggle? At what point do you discontinue medications? Thanks for your expertise!

Specializes in nursing home care.

Hi, I think residents are on too many meds, I'm sure many of them interact and many of them were probably only required in short term but due to poor reviews by pharmacy and GP they end up on repeat! I stop giving medication if the resident refuses (though consideration taken with insulin etc) or if the resident is dying at which point only medicines to aid comfort are administered.

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Specializes in Nursing Home ,Dementia Care,Neurology..
now try being 90yo with no teeth or dentures, taking 10-15 pills that have been crushed and added to 30ml applesauce. and some of it is for things like your cholesterol, crazy.

are you allowed to crush tabs then? we are not allowed to crush meds at all. if the resident has trouble swallowing then we try and get liquid equivalent.

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Specializes in Urgent Care.
Are you allowed to crush tabs then? We are not allowed to crush meds at all. If the resident has trouble swallowing then we try and get liquid equivalent.

well you can't crush gelcaps, enteric coated tabs, or extended or sustained release tabs ever. For others most are crushable with a few exceptions (prilosec is one) but your drug guide will tell you what cannot be crushed.

Do things like lasix, coreg, digoxin come in liguid, there must be many meds that only come in tabs

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Do things like lasix, coreg, digoxin come in liguid, there must be many meds that only come in tabs

i've given liquid digoxin and lasix (which is furoesmide i believe), these have been for a patient who's meds went down the PEG.

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Specializes in Nursing Home ,Dementia Care,Neurology..

Lasix and Digoxin definately come in liquid form here.When it gets to the stage that residents have difficulty swallowing then the doc.generally reviews all meds to see what they can do without.

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Specializes in Urgent Care.
i've given liquid digoxin and lasix (which is furoesmide i believe), these have been for a patient who's meds went down the PEG.

Most pt's who have meds I am crushing must have thickened liquids. Can you thicken these meds?

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Specializes in Gerontology, Med surg, Home Health.
Most pt's who have meds I am crushing must have thickened liquids. Can you thicken these meds?

Call your pharmacy to be sure,but I think you can added thickener to these liquid meds. The trouble with liquids is unless everyone shakes the bottle the same number of times, the dose isn't exact. I remember reading a study about liquid dilantin which said the bottle had to be shaken a precise number of times for the components to be well mixed and the results showed that the dose varied by 100's of milligrams!

I review the meds as often as I can and try to get the doc to get rid of the ones the patient doesn't really need. Come on...if you're 95 do you really need something to lower your cholesterol? Do you really need all those vitamins which don't get absorbed any way.

I had a patient who had 3 nasal sprays. I asked the doc why she needed 3 and he said it was because she complained of a runny nose. Right !! I said, all the nasal sprays are running out of her nose. He got rid of all of them and we gave her a box of tissues...she was much happier.

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Now try being 90yo with no teeth or dentures, taking 10-15 pills that have been crushed and added to 30ml applesauce. And some of it is for things like your cholesterol, crazy.

And add to that the huge Calc D and K tablets that they get, crazy indeed.

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Specializes in LTC,Hospice/palliative care,acute care.
Call your pharmacy to be sure,but I think you can added thickener to these liquid meds. The trouble with liquids is unless everyone shakes the bottle the same number of times, the dose isn't exact. I remember reading a study about liquid dilantin which said the bottle had to be shaken a precise number of times for the components to be well mixed and the results showed that the dose varied by 100's of milligrams!

I review the meds as often as I can and try to get the doc to get rid of the ones the patient doesn't really need. Come on...if you're 95 do you really need something to lower your cholesterol? Do you really need all those vitamins which don't get absorbed any way.

I had a patient who had 3 nasal sprays. I asked the doc why she needed 3 and he said it was because she complained of a runny nose. Right !! I said, all the nasal sprays are running out of her nose. He got rid of all of them and we gave her a box of tissues...she was much happier.

I just LOVE the little old ladies with tablets,lotions,potions and nostrums for every orifice.It's impossible to change that lifetime habit in my experience..The doc will cave every time..I had a gal this am-2 eye drops,2 nasal sprays daily,monthly debrox for 4 days with flush plus her slew of meds.Daily sorbitol,miralax,peri-colace and PRN LOMOTIL! She uses NSS nasal spray-I have watched her give a little squeeze every morning and not even get a drop and then run to the doc before he even gets to the unit to complain about her dry,itchy nose and sinus problems.I fixed that-I wrote an order "nurse to administer" and she gets 2 really good blasts...No more dry itchy nose...It's the highlite of my day! I love it when I can actually make a difference....teehe.But I have to laugh (inside,of course)when she spits,sputters and jerks around like I'm killing her.

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Specializes in LTC Pharmacy.

It's difficult to be an advocate for your residents when you have Dr. I'm-A-God getting all pissed off because the pharmacy consultant DARED to question his orders or write a recommendation to taper or discontinue a med, or because a nurse brought a like concern to his attention. Docs can't even seem to answer pharmacy letters correctly; writing "I agree" to a recommendation ISN'T an order, it's a statement. You'd think after several years of higher education they'd realize that.

Most doctors don't have a clue about actual medication administration. Then again, a lot of nurses don't take the time or trouble to educate themselves about it, either, which is sad.

Our standard here is 9 meds or fewer whenever possible.

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Specializes in ICU, PICC Nurse, Nursing Supervisor.

i have always wanted to get a yellow highlighter and pen after the med book. i bet i can get rid of about 80% of the junk they take. i had one woman once take 13 vitamins in the morning....that is just crazy.

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Specializes in Geriatrics, WCC.

Our consultant pharmacist is a gem. She scrutinizes each resident's meds monthly and makes her recommendations to the docs/NP's.... most of the time they follow along with what she suggests. With a 100 bed facility and only 17 on antipsychotics, we seem to be doing well. With the newer pharmacy regs in place, many are getting the number of meds they are on decreased and/or discontinued.

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