Managing medications: the role of informal caregivers of older adults and people living with dementia. A review of the literature

Aims and objectives. To explore published literature that describes what is known about the role of informal caregivers as they manage medications for older adults and/or people living with dementia residing in the community. Background. The number of informal caregivers of older adults, including people living with dementia, is growing worldwide. Good medication management by informal caregivers contributes to improved health outcomes and reduced institutionalisations for the care recipient; however, little is known about this domain of care. Design. Narrative review. Methods. A literature search was conducted to identify relevant research articles written in English between January 2000-April 2013, sourced from online database searches using multiple keywords, reviewing reference lists and citations of key articles and Internet searches. Articles were included if they described informal caregiver medication management for older adults and/or people living with dementia. Results. Ten articles were found that described this role from the perspective of the informal caregiver. The evidence suggests that this role is complex and is often made more difficult because of increasing medication regimen complexities, aspects of the relationship between the caregiver and the care recipient, healthcare system practices and a lack of information and/or training available to the informal caregiver, especially when caring for people living with dementia. Conclusion. Responsibility for managing medications for older adults and/or people living with dementia in the community often falls to informal caregivers. More information resources are required for this role, which requires specific medication management skills and knowledge and is further complicated by the cognitive decline of the care recipient. Relevance to clinical practice. Informal caregivers are often expected to manage medications in a safe and effective manner for their older care recipient, who may also have cognitive impairment. Nurses, who may be in frequent contact with community-living older adults/people living with dementia, can be an important source of information, training and support for informal caregivers.