Assisted living nursing practice: medication management: Part 1. Assessing the resident for self-medication ability

Self-administration of medication suggests that individuals are functionally and cognitively competent to manage their health care. Older adults take a significant number of medications (borderline polypharmacy) as well as an unaccounted for number of over-the-counter, as necessary, and herbal remedies. Assisted living residences, moving from a social to a more medical model, are responsible for the safety and well-being of their residents. In addition, the prospect of aging-in-place in the residence is increasingly associated with appropriate medical and medication management. Assisted living services in most states include assistance with medication, but the nature of the assistance varies widely, at times approaching what even a nonclinical observer would regard as medication administration. Although state assisted living regulations can be quite specific regarding medication storage, there are scant guidelines about the components of a thorough assessment as to whether a resident can safely self-administer his or her medications. This article discusses assessment criteria of self-medication ability, drawn from a variety of instruments. In keeping with assisted living nursing standards of practice, the assisted living nurse has a critical responsibility in assessment of this self-care ability.