DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
Understand the administration of medication to individuals with dementia using a person centred approach
Level 3 Diploma in Health and Social Care Unit DEM 305 Page 1 of 15 aspecmaps.free.fr/DEM305.pdf
DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
Assignment task – DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach Unit summary; purpose and aim This unit is about knowledge and understanding of individuals who may have specific needs for receiving medication because of their experience of dementia.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
1 Understand the common medications available to, and appropriate for, individuals with dementia
1.1 Outline the most common medications used to treat symptoms of dementia
1.2 Describe how commonly used medications affect individuals with dementia
1.3 Explain the risks and benefits of anti-psychotic medication for individuals with dementia
1.4 Explain the importance of recording and reporting side effects/adverse reactions to medication
1.5 Describe how ‘as required’ (PRN) medication can be used to support individuals with dementia who may be in pain 2 Understand how to provide person centred care to individuals with dementia through the appropriate and effective use of medication
2.1 Describe person-centred ways of administering medicines whilst adhering to administration instructions
2.2 Explain the importance of advocating for an individual with dementia who may be prescribed medication Page 3 of 15 aspecmaps.free.fr/DEM305.pdf
DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
What is the person centred approach? The person centred approach is a way of working developed from the work of the psychologist Dr Carl Rogers (1902 – 1987). In health and social care settings, the person centred approach is a way of working that put the individual at the heart of the care planning process. This will provide a framework for the individual to plan and set a direction of their care planning process according to the individual's physical and psychological needs, spiritual beliefs, culture, likes and dislikes, family and friends. The person centred approach method is linked with the active participation method, which is a way of working that recognises an individual’s right to participate in the activities and relationships of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than a passive recipient.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
Exemplification Administering e.g. fitting with the routines of the individual; meeting the preferences of the individual (tablets/solutions); enabling techniques; self-administration Dementia is a term used to describe the deterioration of brain function that results in loss of memory, reduced language skills, impaired reasoning and loss of daily living skills. This is the dementia syndrome; however, as a person tries to live with their dementia they may display behavioural and emotional problems. There are over 100 different types of dementia. The most common types are Alzheimer’s disease, vascular dementia and dementia with Lewy bodies. An individual may have a combination of different causes of dementia; in particular Alzheimer’s disease and vascular dementia. Each of these diseases tends to affect particular areas of the brain and will cause different changes in a person’s behaviour. Person centred care include values: individuality; rights; choice; privacy; independence; dignity; respect; partnership.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
Assignment task – DEM 305 Answers 1 Understand the common medications available to, and appropriate for, individuals with dementia
1.1 Outline the most common medications used to treat symptoms of dementia
The most common medications used to treat symptoms of dementia in the UK are: antipsychotic drugs, tranquilizers, hypnotic drugs, anti-depressive drugs, anti-anxiety drugs, pain killers, antibiotics. For example: donepezil, rivastigmine, galantamine and memantine. They do not cure dementia.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
1.2 Describe how commonly used medications affect individuals with dementia
Commonly used medications e.g. donepezil, rivastigmine, galantamine and memantine affect individuals with dementia as followed: Donepezil is a medication used is in the palliative treatment of Alzheimer's disease. Donepezil is used to improve cognition and behavior of individuals living with Alzheimer's, but does not slow the progression of or cure the disease. Common side effects include loss of appetite, gastrointestinal upset, diarrhea, difficulty sleeping, vomiting, or muscle cramping. Rivastigmine is a medication used for the treatment of mild to moderate dementia of the Alzheimer's type and dementia due to Parkinson's disease. The drug can be administered orally or via a transdermal patch; the latter form reduces the prevalence of side effects, which typically include nausea and vomiting. The drug is eliminated through the urine. Galantamine is used for the treatment of mild to moderate Alzheimer's disease and various other memory impairments, in particular those of vascular origin. Memantine is the first in a novel class of Alzheimer's disease medications acting by blocking receptors in nerve cells.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
What are the positive effects of commonly used medications that affect individuals with dementia? Positive effects: brighter mood; ability to perform activities e.g. going shopping, social functions; reduced memory loss; reduction in hallucinations; has a calming effect; enables sleep; controls infections; less likely to worry; less pain, reducing aggression; reducing restlessness.
What are the negative effects of commonly used medications that affect individuals with dementia? Negative effects: nausea; restlessness; stomach ache; headache; loss of appetite; tiredness; diarrhoea; muscle cramps; poor sleep patterns; dizziness; loss of balance.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
1.3 Explain the risks and benefits of anti-psychotic medication for individuals with dementia
The risks and benefits of anti-psychotic medication for individuals with dementia are different between two individuals living with dementia, depending on how dementia affects the brain. Individuals living with dementia may develop behavioural and psychological symptoms including restlessness, aggression, delusions, hallucinations, lack of interest and sleep disturbances. Other psychological symptoms that individuals living with dementia may develop include depression and anxiety. The risks due of the side-effects of anti-psychotic medication can be very harmful and can rob the quality of life of the individuals living with dementia. Side effects include excessive sedation, dizziness and unsteadiness, which can lead to increased falls and injuries, body restlessness, reduced wellbeing, social withdrawal and accelerated cognitive decline. Anti-psychotic medications only have modest benefits for specific symptoms and for a short time period. Benefits of anti-psychotic medications mean individuals are less likely to be hospitalized or to behave aggressively or violently.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
What are the risks of anti-psychotic medication for individuals with dementia? Risks of anti-psychotic drugs: restlessness; irritability; becoming addicted to the drug; becoming dependant on others; emotional instability; loss of inhibitions; increased risk of stroke e.g. cerebral vascular insult (CVI); increased risk of pneumonia; less able to make own choices/judgements.
What are the benefits of anti-psychotic medication for individuals with dementia? Benefits of anti-psychotic drugs: less likely to have aggressive responses; increase in sleep; more co-operative; likely to be more aware of people/environment; able to participate in daily living tasks; increased likelihood of social interaction; able to participate in leisure activities; able to make own decisions.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
1.4 Explain the importance of recording and reporting side effects/adverse reactions to medication
Possibly the most common side effects/adverse reactions of any medications are gastrointestinal issues, including nausea, constipation and diarrhoea, because most medications go through the digestive system to be absorbed. Other common side effects/adverse reactions include drowsiness, pain and skin reactions. Sometimes rare side effects/adverse reactions aren't known until many individuals have used a medication for a long time. Recording and reporting side effects/adverse reactions to medication help to ensure the medications are made safer in the future. Side effects/adverse reactions are unwanted symptoms caused by medications. All medications can cause side effects/adverse reactions, particularly if they’re not used as prescribed. Side effects/adverse reactions can range from mild, such as drowsiness or feeling sick, to severe, such as life-threatening conditions. The risk of getting side effects/adverse reactions varies from individuals to individuals. The importance of recording and reporting side effects/adverse reactions to medication will help to increased awareness of the individual’s condition; monitoring controls enables management of condition; accurate judgements can be made; more likely to achieve stability of condition; able to use the individual’s history to make judgements; pain can be controlled; mental ill health can be supported; monitoring clinical changes; monitoring the safety of medicines. Staff duty to recording and reporting side effects/adverse reactions to medication that are not listed in the individual's information side effect/adverse reactions leaflet.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
1.5 Describe how ‘as required’ (PRN) medication can be used to support individuals with dementia who may be in pain
What is the meaning of PRN medication? PRN means Pro Re Nata, and is a Latin phrase meaning in the circumstances or as the circumstance arises. Some medications come with specific instructions for use every day, such as take 1 tablet by mouth every 8 hours. PRN medications are only used when needed for a specific situation, such as intermittent chest pain, the common cold, allergies, constipation, or pain.
Administering medication is one of the most important tasks carried out within a care setting. PRN medication can be used to support individuals with dementia who may be in pain when the individual living with dementia lacks capacity to describe and express pain. Duty of staff to observes the individual when handling medications to know if PRN medication needs to be administered. Generally PNR medication such as Ibuprofen pain killer in a liquid form is prescribed on the individual's MAR (Medication Administration Record) as when required. PRN medication will help to bring stability; to reduce pain; to prevent aggressive behaviour; to help with mental ill health conditions; to enable the individual to obtain rest/sleep; to give individuals with dementia some control over their own lives. For example staff to assist the individual taking 10 ml of Ibuprofen pain killer in a liquid form using a plastic measuring cup. Duty of staff to ensure the individual living with dementia feels free of pain at all time.
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DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
2 Understand how to provide person centred care to individuals with dementia through the appropriate and effective use of medication
2.1 Describe person-centred ways of administering medicines whilst adhering to administration instructions
Person centred approach mean putting the individual at the heart of the care planning process. In a health and social care setting, person centred values must influence all aspects of health and social care work because those values recognise that the individual is the expert on their own needs and how these should be met. It recognises the value of working in partnership with an individual. Person centred planning refers to the process of life planning for an individual. The individual is consulted and their views and aspirations inform decision making. The principles of inclusion are incorporated to ensure the individual is not isolated from the rest of other individuals within the care home. Person-centred ways of administering medicines whilst adhering to administration instructions mean staff to ask how the individual would like to take is medications e.g. with a glass of water, orange juice, cup of tea. The level of support when administering medications will vary according to the individual mental capacity. For example, self-medication assessment must be completed by staff to answer final decisions regarding self-medication questions. Does the individual shows signs of confusion or suffer from memory impairment? Is the individual able to pen the packaging which their medications is supplied in? Does the individual have any physical disability which may hamper the ability to self-medicate? Can the individual understand the medication label and interpret the dose instructions? Does the individual understand the process of selfadministration? Does the individual have sufficient information regarding the medications to understand the need to take medication as prescribed? Does the individual understand the implications of not taking the medication as prescribed? Does the individual have a lockable storage area in the room? Page 14 of 15 aspecmaps.free.fr/DEM305.pdf
DEM 305 - Understand the administration of medication to individuals with dementia using a person centred approach by Gaël Romanet
All these questions are part of the self-medication assessment that staff should complete before taking final decision. The individual is safe to self-medicate or the individual is not safe to selfmedicate. In case the individual has capacity to be self-medicate, staff duty to ask to the individual if the individual is feeling comfortable with the decision made regarding the selfmedication assessment. Person centred administration of medication will ensure fitting with the routines of the individual; meeting the preferences and needs of the individual; seeking consent to administer the medication; providing information and advice about the medication; answering questions asked by the individual with dementia about the medication; providing a choice when possible; enabling the individual to make decisions; respect of privacy; respect of dignity.
2.2 Explain the importance of advocating for an individual with dementia who may be prescribed medication
The importance of advocating for an individual with dementia who may be prescribed medication will help ensuring principles of care are observed; speaking on behalf of the individual; maintaining the rights of the individual; monitoring dosage; identifying clinical changes. For an individual living with dementia that lacks mental capacity regarding choices and decisions over care e.g. medication, in the individual best interests supervised by an advocate will ensure there is no abuse regarding medication administered by staff. Medication abuses e.g. staff covering medications inside the individual's cup of tea or meals. Human rights don't stop when dementia comes. An individual living with dementia is still a human being with the same rights as others.
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