How to Manage an Elderly Person's Medication in a Care Home

When a parent or loved one moves into a care home, one of the family's main concerns is the proper management of medications. It's natural to wonder: who is responsible for their treatment? Can medications from home be brought in? How do I know they're receiving exactly what the doctor prescribed, at the right times?

Medication management in care homes for seniors is a regulated and structured process, yet for many family members it remains unfamiliar territory. A lack of information can cause anxiety and, sometimes, confusion that affects the quality of care. The good news is that once you understand how the system works, you can become an active partner in ensuring your loved one's treatment is safe.

This guide explains step by step what rights you have as a family member, what documents to look out for, and how to ensure that medication is administered correctly and safely.

Contents

1. What medications you bring from home and what the care home provides
2. The official medication handover procedure
3. How to verify that medications are being administered correctly
4. The medication record: what it is and how to access it
5. Signs that the treatment has changed without your knowledge
6. Coordination between the GP and the care home's medical staff
7. Documents and rights you need to know about
8. Frequently asked questions

What medications you bring from home and what the care home provides

Most care homes operate on a mixed system when it comes to medication supply. It's important to understand from the outset what falls to the family and what the care home provides, so as to avoid any interruptions in treatment.

As a rule, the care home provides basic medications for common conditions — simple analgesics, standard vitamins, wound care solutions — from its own stock or through contracted suppliers. These are either included in the monthly fee or billed separately, depending on each care home's policy.

Medications the family must provide

• Specific chronic treatments prescribed by the GP or a specialist (for diabetes, hypertension, cardiac conditions)
• Subsidised medications requiring a special medical prescription
• Preparations the resident was using prior to admission and for which an established treatment regimen already exists
• Dietary supplements or dermocosmetic products for personal care
• Any medication not listed on the care home's standard supply list

Before admission, request a written list of which categories of medication the care home provides and which ones you will need to supply yourself. This document will help you anticipate monthly costs and organise regular restocking.

Recommended quantities

Experts recommend bringing medications for a period of 30 to 45 days, in original blister packs with a legible leaflet and label. Avoid bringing excessively large quantities — the treatment regimen may be adjusted by the doctor, and unused medications may expire or become unnecessary.

The official medication handover procedure

Handing over medications is not done informally; it follows a documented process that protects both the family and the care home. This protocol ensures traceability and clear accountability in treatment administration.

Upon admission, or whenever you bring new medications, the care home's nurse or doctor must draw up a formal handover record. This document includes:

• The brand name and International Nonproprietary Name (INN) of each medication
• The dosage, pharmaceutical form (tablets, capsules, solution) and exact quantity handed over
• The expiry date of each product
• Any special instructions for administration or storage (refrigerate, keep away from light, etc.)
• The signature of the doctor or nurse receiving the medications and your signature as the family member

Keep a copy of this document for your own records. If, at the time of handover, someone refuses to sign or says "there's no need for paperwork", this is a serious warning sign about how the care home manages its responsibilities.

What to do with surplus medications from home

If your parent had a large stock of medications at home, don't bring them all to the care home at once. Keep them in a safe, cool and dry place, and replenish the care home's stock as it runs out. If the treatment is modified, you may be able to return unused medications to the pharmacy (if subsidised) or keep them in case the original regimen is resumed.

How to verify that medications are being administered correctly

Once medications have been handed over, responsibility for administering them passes to the care home's staff. Nevertheless, as a family member, you have the right — and the moral responsibility — to verify that everything is proceeding in accordance with the medical prescription.

The most reliable methods of verification include:

1. Periodically reviewing the administration record — a daily document in which nurses tick off each medication administered, along with the exact time and dose
2. Direct discussions with the nurse on duty — ask about the exact administration times and whether there have been any refusals or adverse reactions
3. Direct observation during visits — if you visit at the time medications are being administered, you can see the process for yourself
4. Checking remaining quantities — calculate roughly how many tablets should remain based on the handover date and the daily regimen

If you notice any discrepancies — for example, more tablets have disappeared than the regimen would account for — request an explanation in writing immediately. Don't automatically assume mistakes or negligence, but don't ignore warning signs either.

Electronic monitoring systems

Some modern care homes use digital medication management systems with automatic alerts and barcode scanning. If you are choosing between several care homes, this can be an important differentiating factor — it significantly reduces the risk of human error.

The medication record: what it is and how to access it

The medication record is the central document governing a resident's treatment in the care home. It is drawn up by the care home's doctor based on specialists' prescriptions and an assessment of the resident's current health status.

This document contains:

• A complete list of active medications, with precise dosages and administration schedules
• The route of administration (oral, topical, subcutaneous) and any special instructions (before meals, at bedtime)
• The reason for prescribing (the diagnosis or symptom being treated)
• The start date and prescribed duration of treatment (ongoing or a limited course)
• The signature of the doctor who drew up or amended the record

How to request access to the record

Under legislation on patients' rights, you are entitled to view the medical record of the person you legally represent or for whom you hold notarised power of attorney. The standard procedure is as follows:

1. Submit a written request to the care home's management, stating the resident's identifying details and your relationship to them
2. Present your identity document and, where applicable, the power of attorney or court order for guardianship
3. The care home is obliged to make the record available to you within 48 hours of your request
4. You may request either to view the record on site (with the option to take photographs) or to receive certified copies

If access is refused without a legal justification, this constitutes a serious violation of patient rights, and you may report it to the Public Health Directorate in your county.

Signs that the treatment has changed without your knowledge

On occasion, the care home's doctor may adjust the treatment in an emergency or when side effects arise. This is normal and necessary, but you must be promptly informed of any changes.

Be alert to the following signals, which may indicate undisclosed changes:

• Your parent mentions that "they're giving me different pills now" or "I no longer take what I used to in the morning"
• During visits, you notice new boxes of medication on the bedside table or in the personal storage area
• Behavioural or mood changes that may indicate adjustments to psychotropic medication
• The appearance of new side effects (excessive drowsiness, nausea, confusion) suggesting the introduction of a new medication
• Medications running out too quickly or too slowly compared to the original regimen

How to respond appropriately

If you suspect the treatment regimen has been changed without notifying you, follow these steps:

1. Request a meeting with the care home's doctor for clarification — avoid an accusatory tone, as it may simply be a lapse in communication
2. Ask to see the updated medication record and compare it with the most recent version you have
3. Ask what prompted the change — improved efficacy, side effects, or a specialist's recommendation
4. If the change is medically justified, request that in future you are notified in writing within 24 hours of any adjustment
5. If the change seems unjustified or causes you concern, you have the right to seek a second opinion from the GP or a specialist

Document everything you discuss — either by making written notes immediately after the meeting or by requesting email confirmation. This record may prove essential if complications arise later.

Coordination between the GP and the care home's medical staff

One of the common challenges in caring for older residents is coordinating between different healthcare providers. The GP, the care home's doctor and specialists (cardiologist, neurologist, endocrinologist) must communicate effectively to avoid duplicating treatments or creating harmful drug interactions.

Ideally, the GP remains the primary coordinator of care, while the care home's doctor handles day-to-day management and emergency interventions. In practice, however, this coordination does not always happen automatically — you, as a family member, can play an essential role in facilitating it.

Practical steps for effective coordination

• Make sure the GP has the care home doctor's contact details and vice versa
• When the GP prescribes a change to the treatment, request a copy of the prescription and deliver it personally to the care home's doctor
• After specialist appointments, request a written summary of the consultation and its recommendations — pass it on to both doctors
• Create a centralised medical file (physical or digital) containing all recent prescriptions, test results and medical interpretations — update it after every consultation
• For complex treatment regimens, arrange a teleconference or joint meeting between the doctors involved to ensure everyone is aligned

When recommendations conflict

If the GP recommends a treatment and the care home's doctor refuses to administer it, citing internal protocol or contraindications, don't panic. Request detailed explanations from both parties and, if necessary, consult an independent specialist to mediate. Your loved one's health is the priority — not professional egos.

Documents and rights you need to know about

Knowing your legal rights as a family member empowers you to intervene effectively when necessary and to prevent potential neglect.

Here are the key documents you are entitled to request at any time:

• The clinical observation record — containing the daily record of the resident's health, including blood pressure, temperature and blood glucose readings
• The medication administration register — an hourly record of all medications given
• Medication handover records
• The up-to-date medication record including all amendments and their dates
• Reports from medical consultations carried out at the care home or externally
• Informed consent documents for any medical procedure or new treatment

When you can refuse a treatment

If your parent is of sound mind, they have the right to refuse any treatment. If they are under guardianship and you are their legal guardian, the decision rests with you — but it must be made in the best interests of the person in your care, not out of convenience or personal bias. The doctor is obliged to inform you of the consequences of refusal and to document the decision.

Frequently asked questions

Can I bring herbal remedies or supplements that my parent was taking at home?

Yes, but the care home's doctor must be informed and should assess any potential interactions with the prescribed treatment. Some supplements can reduce the effectiveness of medications or amplify side effects. Provide the doctor with a complete list and follow their professional recommendations.

What happens if we forget to bring medications on time and the stock runs out?

The care home is obliged to notify the family when a medication's stock falls below a safe threshold (usually when there are 7 to 10 days of treatment remaining). Should the stock nonetheless run out, the care home must provide a therapeutic equivalent from its own supplies or urgently purchase the medication, with the cost to be recovered from the family. Avoid this situation by setting up a reminder system — notes in a calendar or alerts on your phone.

How do I know that medications are being stored properly?

Medications must be stored in a dedicated space, away from direct sunlight, at a controlled temperature (usually below 25°C), and those requiring refrigeration must be kept in a dedicated refrigerator fitted with a thermometer. During visits, you can ask to see the storage area. Registered care homes are subject to periodic inspections by the Public Health Directorate, which also checks storage conditions.

Can I request to be present when medications are administered?

Yes, you have this right, but you should coordinate with the staff to avoid disrupting the care routine. Let them know in advance that you wish to observe medication administration on a particular day. This is an excellent way to understand the process and reassure yourself that everything is proceeding correctly, but avoid making it a daily practice, as this can create tension with the staff.

What should I do if I suspect that medications are not being administered at all?

Request an immediate meeting with the care home's management and the responsible doctor. Ask to see the administration register and compare the remaining quantities in the blister packs with what should be there. If your suspicions are confirmed, this constitutes serious neglect that endangers the resident's life — report it to the Public Health Directorate and, if necessary, to the police. Document everything with photographs and written statements.

How often should the medication regimen be reviewed?

The doctor should evaluate the treatment regimen at least once every 3 to 6 months for stable chronic treatments, and more frequently if changes in health status occur. As a family member, you can request a review at any time if you observe side effects, a lack of efficacy, or if a specialist has recommended changes.

Managing medications in a care home need not be a mystery or a constant source of anxiety. With the right information, the right questions and your active involvement, you can have peace of mind that your loved one is receiving the medical care they deserve. Speak openly with the care home's staff, request the documents you are entitled to, and don't hesitate to ask for clarification whenever you feel the need. You are your parent's best advocate.

This article is for informational purposes only and does not replace medical advice. For specific situations, please consult a specialist.