Sally-Anne Francis1, Felicity Smith, Nicola Gray, Michael Denham. 1. Senior Lecturer, Department of Practice and Policy, School of Pharmacy, University of London, Brunswick Square, London, UKProfessor, Department of Practice and Policy, School of Pharmacy, University of London, Brunswick Square, London, UKLecturer, Center for Pharmacy, Health and Society, University of Nottingham, University Park, UKHonorary Consultant Physician Care of the elderly, Northwick Park Hospital, Harrow, Middlesex, UK.
Abstract
UNLABELLED: Background. Responsibility for medication can be an integral part of the informal caring role. Aims and objectives. To explore partnerships between older people and their carers in the management of medication and consider the implications for health professionals. Methods. Older people and their carers were identified through community pharmacies in four randomly selected areas of England. Data regarding their activities, responsibilities and experiences of managing medication were collected in semi-structured interviews conducted in respondents' own homes. Ninety-four transcripts relating to 47 older people and their associated carers were analysed using a qualitative approach. Results. Responsibility for medication was shared to varying extents between older people and their carers, and different patterns of partnership were identified. Differing perspectives between older people and their carers regarding the role, purpose and need for medication were revealed. Underlying these perspectives were issues concerning the sharing/concealment of information, autonomy and control. Caring was also described as a dynamic process. Older people and carers commented on how sharing responsibilities for medication varied on a day-to-day basis, as well as expressing concern regarding the changing needs of the older person and the carer's capacity to cope. CONCLUSIONS: Older people and their carers work together in diverse and sometimes complex ways to manage medication. Problems included dilemmas relating to the sharing of information, patient determination, disputes about the control of medication and concerns about the future. RELEVANCE TO PRACTICE: These patterns of partnership need to be recognized and taken into account by health professionals when providing information, advice and support. They need to listen for indications of differing perspectives and be aware of their possible implications for adherence to medication regimens. In caring for older people, health professionals need to find a balance that respects their autonomy whilst providing support for carers to enable them to be effective in their roles.
UNLABELLED: Background. Responsibility for medication can be an integral part of the informal caring role. Aims and objectives. To explore partnerships between older people and their carers in the management of medication and consider the implications for health professionals. Methods. Older people and their carers were identified through community pharmacies in four randomly selected areas of England. Data regarding their activities, responsibilities and experiences of managing medication were collected in semi-structured interviews conducted in respondents' own homes. Ninety-four transcripts relating to 47 older people and their associated carers were analysed using a qualitative approach. Results. Responsibility for medication was shared to varying extents between older people and their carers, and different patterns of partnership were identified. Differing perspectives between older people and their carers regarding the role, purpose and need for medication were revealed. Underlying these perspectives were issues concerning the sharing/concealment of information, autonomy and control. Caring was also described as a dynamic process. Older people and carers commented on how sharing responsibilities for medication varied on a day-to-day basis, as well as expressing concern regarding the changing needs of the older person and the carer's capacity to cope. CONCLUSIONS: Older people and their carers work together in diverse and sometimes complex ways to manage medication. Problems included dilemmas relating to the sharing of information, patient determination, disputes about the control of medication and concerns about the future. RELEVANCE TO PRACTICE: These patterns of partnership need to be recognized and taken into account by health professionals when providing information, advice and support. They need to listen for indications of differing perspectives and be aware of their possible implications for adherence to medication regimens. In caring for older people, health professionals need to find a balance that respects their autonomy whilst providing support for carers to enable them to be effective in their roles.