Assisted Living: Medication Monitoring

When residents take medications, staff should watch for three common issues:

Is a medication working?

Staff first should understand why a medication is being used. What is it being used to treat? Then, staff should collect information to learn if the medication is working.

Example: A resident is taking medication for pain. Staff should check a resident's pain levels to learn if a medication is working.

Is the medication causing unexpected, harmful reactions?

Many medications have well known side effects. Medications also can have "adverse effects." These are unexpected, harmful reactions. Staff should know these adverse effects. This can help staff easily spot them. Staff also should watch for less obvious adverse effects.

Example: A resident starts sleeping less. Staff who work with this resident know this isn't normal. It may be an adverse effect of medication.

Are medications causing a resident to fall?

Some medications increase the risk of falling.

Example: Blood pressure medication can cause dizziness. This dizziness may cause the resident to fall.

Regulations

• Community-Based Residential Facility
  • Wisconsin Admin. Code § DHS 83.37(1)(e)
  • Wisconsin Admin. Code § DHS 83.37(1)(h)
  • Wisconsin Admin. Code § DHS 83.37(1)(i)
  • Wisconsin Admin. Code § DHS 83.37(1)(L)
• Residential Care Apartment Complex
  • Wisconsin Admin. Code § DHS 89.13(22)

Resources

Medication and falling

• Compendium of Effective Fall Interventions - From the CDC (Centers for Disease Control and Prevention)
• CDC Preventing Falls: How to Develop Community-Based Fall Prevention Program for Older Adults - From the CDC
• Falls Prevention for Older Adults - From the Wisconsin Department of Health Services (DHS)
• Fall Prevention Center of Excellence and the National Resource Center on Home Modification

Medication and dementia

Some medications can be used to treat behaviors caused by dementia. These are called psychotropic medications. However, this isn't common. There are other treatments that don't involve medication. These are safer and more effective.

Use the links below to learn about ways to manage dementia behaviors.

• Dementia Care & Psychotropic Medications: Create Improvement
• DHS Dementia Care System Redesign

FAQs (frequently asked questions)

Who can review medications in a community-based residential facility?

Staff should review what medications a resident is taking. These reviews help ensure medications aren't causing problems.

A pharmacist or physician can review medications at least once a year. A pharmacist, physician, or RN (registered nurse) can do required psychotropic medication reviews. Staff who manage a facility also can complete some monthly reviews of psychotropic medicines.

How do you record medication reviews in a community-based residential facility?

Staff should record medication reviews every month, four months, and 12 months. Read the rule under DHS 83.37 Medications. Staff must document when reviews were completed. Reviews should:

• Offer proof that reviews were completed on time.
• Record that all required information has been reviewed.