Understanding care
Medication reminders and nursing administration: the difference
"Help with medicines" can mean two very different things. Knowing which one the person needs protects their safety and makes sure the right person is doing the job.
Medicines are one of the most common reasons families look for help at home, and one of the areas where mistakes matter most. The World Health Organization identifies unsafe medication practices and errors as one of the main causes of avoidable harm in health care around the world. At home, the risks are usually simple ones: doses missed, doses taken twice, old and new prescriptions mixed up, or medicines stored in the heat.
Before you arrange help, it's worth being clear about which kind of help the person needs.
Two different services
| At a glance | Medication reminders | Medicines given by a nurse |
|---|---|---|
| What happens | A caregiver prompts the person at the right time; the person takes their own medicine | A nurse gives the medicine exactly as prescribed |
| Who decides to take it | The person | The person consents; the nurse gives it |
| Who provides it | A caregiver | A nurse |
| Typical examples | Tablets from a labelled pill organiser, at set times | Injections, eye drops the person can't manage, medicines that need measuring or checking first |
| Records | A simple chart noting the prompt and whether the medicine was taken | A medicines record for each dose given |
| Needs a current prescription? | The medicines must be the person's own, as prescribed | Yes, always |
Medication reminders
A reminder is the right kind of help when the person can still take their own medicines but sometimes forgets, or needs encouragement. The caregiver checks the time, prompts the person, watches that the medicine is taken, and notes it down. If a dose is missed or refused, the caregiver reports it rather than "making up" the dose later.
Medicines given by a nurse
Some people can no longer manage their medicines safely, or need medicines that require clinical skill, such as injections. In these cases a nurse gives the medicines, following the current prescription. The nurse also watches for side effects and tells the person's doctor if something seems wrong.
Why the difference matters
- Safety. Giving medicines involves checking the right medicine, dose, time and person, and knowing what to do when something isn't right. That is a professional responsibility.
- Clarity. When everyone knows who is responsible, doses are less likely to be missed or doubled.
- Consent. People have the right to refuse a medicine. Nobody should be given medicine without their consent, or have it hidden in food or drink without a decision made properly by their doctor and family. If someone keeps refusing, talk to their doctor or pharmacist, who may suggest a different form of the medicine.
What no carer or nurse should do
Whoever is helping, some decisions belong only to the prescribing doctor:
- Never start, stop or change a dose. Even if a medicine seems not to be working, or seems to cause side effects, talk to the doctor first.
- Never use someone else's medicine, or old medicine left over from a previous illness.
- Never buy medicine without authorisation. If a caregiver collects or buys medicines for the person, it should be agreed in writing, with receipts kept.
Keeping medicines safe at home
- Keep one up-to-date list of every medicine: name, strength, dose, time and reason. Include herbal and traditional remedies too, because some interact with prescribed medicines. Share the list with the doctor and anyone helping.
- Store medicines properly: in a cool, dry place out of direct sun, and in the fridge only if the label says so. In hot weather, a hot room can damage some medicines.
- Keep them out of reach of children and of anyone who might take them by mistake.
- Use a pill organiser (sometimes called a dosette box) with compartments for each day and time, if a pharmacist or nurse has filled it or shown the family how. It makes it easier to see whether a dose has been taken.
- Check the supply so medicines don't run out, especially before public holidays or family events away from home.
- Bring all medicines to doctor's appointments, or a photo of every label, so the doctor can review them together.
Questions to ask the doctor or pharmacist
- What is each medicine for, and how long should it be taken?
- Should it be taken with food or on an empty stomach, and at what times?
- What should we do if a dose is missed?
- What side effects should we watch for, and which mean we should call you?
- Could any of these medicines cause dizziness, drowsiness or confusion?
- Can the number of medicines or doses be simplified?
Deciding what kind of help is needed
Some questions that help:
- Can the person tell you what each medicine is for and when to take it?
- Can they open the packets and bottles, read the labels and handle small tablets?
- Are any medicines injected, measured or given in a way that needs clinical skill?
- Have there been missed or doubled doses recently?
- Is anyone currently checking that medicines are taken?
If the answers point to occasional forgetting, reminders may be enough. If they point to difficulty managing medicines, or to medicines that need clinical skill, a nurse should be involved. An assessment, carried out by a nurse, reviews the current prescriptions and how medicines are stored and taken now, and recommends the safer option. You can read how each service works, and its limits, under medication reminders and administration.
If someone has taken too much medicine, the wrong medicine, or becomes suddenly unwell, call 112 or go to the nearest emergency department, and take the medicine packets with you.
Sources
- Medicines: tips for carers, NHS (UK) (checked Invalid Date).
- Medication Without Harm (Global Patient Safety Challenge), World Health Organization (checked Invalid Date).
This guide is general information, not medical advice for a particular person. Talk to the person's doctor about their health, treatment and medicines.