Difficulty of Adminitering Medicine to the Elderly in Long-term Facilities

The significance of administering medicine, to which little attention has been given, has been increasing because of the rapid increase of elderly people. This has resulted in a greater number of cognitively deteriorating elderly who often refuse to take medicine, and physically dysfunctional elderly who incur difficulty in swallowing tablets. In this research, interviews focusing on the caregivers' struggle to assist the elderly with their drug taking were conducted in six long-term health care facilities in Japan, including two gerontology hospitals, two intermediate facilities and two nursing homes. Each resident's data concerning his or her functional levels and medication parameters were also collected by questionnaire. The analysis of this data led to the results as shown below.1) A wide range of difference was evidenced in the number of medicines prescribed among facilities.2) Some transformation of medicine (i.e. crushing of tablets and opening the capsules and taking out the drug) and some unavoidable procedures for administering drugs to the fragile elderly (i.e., mixing medicine with the patients meal) were widely done.3) A strong relationship was found between the special treatment mentioned above and the functional level of the elderly patients. The most time-consuming cases of drug administration were those involving patients in whom both their mental and physical functions were fully deteriorated.4) Because of the large proportion of delicate patients in the gerontology hospitals, administering medicines was the most troublesome.