May is Better Hearing and Speech Month known to us as Speech Therapy Month! Speech language pathologists, or speech therapists, work within the full range of communication to evaluate and diagnose speech, language, cognitive-communication, and swallowing disorders and treat such disorders in individuals of all ages. The SLPs within Therapy Center work in many clinical settings, including skilled nursing facilities, outpatient therapy, and home health.
What is Medication Management?
Medication management is the monitoring of medications that a patient takes to confirm that he or she is complying with a medication regimen, while also ensuring the patient is avoiding potentially dangerous drug interactions and other complications. This is especially important for those taking large numbers of medications to address chronic illnesses and multiple diseases. Taking multiple medications is known as polypharmacy, and it is particularly common among older adults, as they are more likely to need medications to manage an array of chronic conditions. (Wisegeek.org)
Given the adult population we primarily service in long-term care, medication management plays a significant part in the speech therapists’ treatment plan.
Medication Management and Cognitive Retraining
In many cases, our therapists treat individuals who have been recently discharged from a hospital stay. These patients often return home or to a new setting with a cluster of medications to take on a daily basis, which can be confusing for those with cognitive disorders and memory loss. Speech therapy treatment for these types of patients is called cognitive retraining, which is a “therapeutic strategy that seeks to improve or restore a person’s cognitive skills in the areas of paying attention, remembering, organizing, reasoning and understanding, problem-solving, decision making and higher level cognitive activities.” (minddisorders.com)
In order to illustrate how medication management can help with cognitive retraining, we will use Mrs. F as an example. Mrs. F’s story is indicative of many other successful cognitive retraining experiences in our everyday treatment.
BEFORE: “Mrs. F was recently referred for skilled speech therapy services at the Road Home Therapy Center after hospitalization and sustaining a fall at home. This hospitalization resulted in noted and significant declines in her cognitive/linguistic function, reducing her safety awareness and independence with daily routine. During her skilled assessment, she stated that prior to her most recent hospitalization, she was organizing and managing her own medication independently. Following the hospitalization, new medications were administered and Mrs. F was unable to name or state the function of new medication. She also had difficulty recalling previous medication amounts and dosage.
AFTER: Medication management tasks were utilized throughout her speech therapy treatments at the Road Home Therapy Center with a focus on visual attention, visual scanning and problem solving. Our therapists worked with Mrs. F on comprehension of written instructions for reading labels and identifying medication errors. Upon reaching her goals, she was recently discharged to home at an independent level for complex home management and medication management tasks increasing her safety and returning her to her prior level of function.” – Kathryn, Speech-Language Pathologist at Acadia St. Landry Guest Home.
Tools for Medication Management
1. PROBLEM SOLVING QUESTIONS:
Our SLPs use tools such as the questionnaire below in order to help with skills like cognitive reasoning and memory recall.
- Will this medicine make you sleepy?
- Would you take this if you had a stomach ache?
- Would you take this medicine for fever?
- Would you take this medicine for heart burn?
- Have you ever taken this medicine before?
- Would this be ok to give a child?
- Does this medicine help with pain?
- If you have a runny nose, would this medication be effective?
- Do you think it is ok to mix any of these medicines with alcohol?
- Would you take this medicine for headache?
- Does this medicine help with anxiety?
- Do you need a prescription for this medicine?
- Do you store your medicine in a medicine cabinet?
- If you have already taken the maximum dose, should you take more?
- Do you have to measure this medicine?
- How do you know how many of these to take?
- What do you drink when you take this medicine?
- Where do you keep your medicines?
- Why should you take the appropriate dose of each medicine?
- When do you take most of your medicine?
- Whose advice do you listen to regarding over the counter medication?
- Whose advice do you take when considering prescription medicines?
- Where do you find the appropriate dosing information for this medicine?
- What do you use to organize your medication for daily use?
- Why is this medication dangerous for children?
- Who goes to the pharmacy for you?
- When do you get prescription medications refilled?
- What pharmacy do you use?
- When did you last take medicine?
- What do you prefer to take for pain?
2. MEDICATION PLANNING EXERCISE
Using color coded beads helps patient to understand and organize their meds appropriately.
–Take two blue pills Monday through Sunday morning
–Take one silver pill Monday through Friday afternoon.
–Take one green diamond pill Saturday and Sunday afternoon
–Take two purple pills Monday through Friday at bedtime
–Take one pink pill Saturday and Sunday at bedtime
–Take one round green pill every Thursday
–Take two red pills Monday morning and night
Sorting: Another exercise often used is medication sorting. Patients are encouraged to match the medication label with the class/purpose of that medication.
3. SIMPLE INSTRUCTIONS
“In working with my patients, I’ve found that I must often use language that is easily understood instead of medical jargon. I have a patient who uses an alarm on her phone to remind her of mid-day medication she needs to take while she is working.” – Jessica, Speech-Language Pathologist for Valley View Nursing Home.
Whether it is medication management or any other compensatory strategy used to help patients return back home successfully, Therapy Center strives for each of our patients to meet their goals and return to a level of function that enables them to live their lives to the fullest.