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The need for medication management doesn’t require a senior to move to Assisted Living. This type of scheduled care can be handled easily in an Independent Living setting. In this article I’m going to describe the process often used by a licensed Personal Assistance Services company to provide medication management in an Independent Living community. Note that this process is very different from how medications are handled in Assisted Living and Memory Care communities, and you can watch my video or read my blog covering that scenario. Also, there is a wider variation in how med management works in Independent Living than there is in Assisted Living, which is a regulated industry.
The Delivery
In short, in a typical scenario a resident in an Independent Living community has their medications in a weekly pill case that may have room for one pill pass a day, or two or three, depending on a resident’s pill volume and schedule. That pill case is in a locked container, often just a fishing tackle box with a small combination padlock. The tackle box may live in a cupboard in the kitchen or other accessible location.
A caregiver comes into the apartment, unlocks the tackle box, empties the pills into a plastic cup, gets a cup of water, puts the pills and water on the table, and asks the resident to take the pills while she is there. Then the caregiver locks the tackle box away and leaves. This whole process may only take five minutes.
But there is a lot to know about what goes on to get the pills into the pill case in the first place. So in the rest of this video I’m going to tell you how much this can cost, who prescribes the pills, and how the process is managed.
Preparing the Weekly Pill Box
The weekly pill box is usually prepared by an agency employee who is medication management aide, but the family can prepare the pill box if they want to save money. The inventory of pills is usually kept in the same tackle box, because the agency doesn’t always have a secure location to keep medications. The agency usually handles the reordering of prescriptions.
The Cost
The cost of medication management varies depending on how many pills are involved, how many times a day the medications need to be given, and the agency providing the services. Some examples are helpful. One agency may set a fixed price per caregiver visit of $10. So if the resident takes pills three times a day, then that’s $30 per day and $900 for a 30 day month.
Another agency may give quantity discounts, and charge $10 for the first medication pass of the day, $7.50 for the second and $5 for the third, making it $22.50 for the day and $675 for the month. Usually the management of the prescriptions is included in a monthly contract, but sometimes if there are an excessive amount of pills the agency will include an additional charge of $100 to $200 per month.
Therefore the cost of medication management in an Independent living community will generally range from $300 to $900 per month, and sometimes more.
The Independent Living Setting
One thing to remember is that any care services can’t be provided by the Independent Living community. This is by regulation, and so you should think of Independent Living as a hospitality community, as compared to custodial care in Assisted Living. Therefore, medication management is provided by an outside Personal Assistance Services agency, licensed by the state.
As noted in my blog “How Independent Living Works,” the agency usually has an arrangement with the community, maybe where they rent an office in the building, but are the preferred provider. This means that for the family of a loved one in Independent Living, there are two different organizations to deal with and to pay.
The Doctor
As is true for medication management in an Assisted Living setting, the only person who can prescribe medications is the patient’s doctor or the doctor’s nurse practitioner. The Independent Living resident has the right to choose his healthcare provider. Using any physician’s group that visits the community is completely optional.
When a drug prescription changes, the doctor’s office is supposed to consult with the medical power of attorney and inform them of the recommend change to the prescription, and ask if the power of attorney approves. The prescription change can not happen without proper consent. At this point it is usually up to the Medical Power of Attorney to coordinate delivery of the new prescription to the agency providing medication management services. Direct coordination of prescriptions between the doctor’s office and the medication manager is not as common as it is in Assisted Living. The agency providing the medication management services often has no communication with the doctor’s office, and can only deliver the prescribed medications as ordered, no less, no more.
The Pharmacy
The agency will usually have a medication management software with links to a preferred pharmacy. The software will automatically order medications as necessary, and the pharmacy will deliver them to the community without cost, often on a daily basis. A resident’s family can choose to pick up the prescriptions at a pharmacy if they prefer.
The Caregiver
While the person organizing the medications may be a certified medication aide, the person coming into the apartment is only a caregiver, with no certifications. Whatever training this caregiver has comes from the agency employing them. While they may be caring individuals, you should be mindful their training is minimal.
A Precaution
Communication with the agency providing medication management services is important. The family needs to know if a resident is refusing to take their medications for whatever reason. In addition, I always recommend some family oversight of medications, such as checking on what is being given and when. The medication management process generally works smoothly, but mistakes can happen at any step in the process. A prescription addition, cancellation or dosage change may not happen by human error, so family participation can be invaluable.
I hope this discussion of how medication management works has been helpful. Please read my other Senior Living articles for more information on how Assisted Living and Memory Care communities function. My name is Michael Gill, and if you are interested in Assisted Living, Independent Living, or Memory Care in the Austin Texas area, please call me at (512) 630-7133.
