An Overview of Medication Policy and Procedure for Assisted Living

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Medically reviewed by Amanda Lundberg, RN, family medicine expert , RN Amanda Lundberg is a registered nurse with over 10 years of experience in clinical settings, working extensively with seniors and focusing on wellness and preventative care.

With the vast majority of adults 65+ in the U.S. taking prescription medications regularly, understanding how senior living communities administer and manage medications can influence the decision you and your loved one make in selecting a community. While each state dictates precise guidelines, it remains important to understand the basics of medication administration, medication management, and what traits indicate a quality assisted living medication management program. Although human errors can occur, the use of medication management programs can help reduce the chance of medication errors in assisted living facilities.

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Key Takeaways

1. Medication administration and medication management are not the same thing. Medication administration refers to the way medication is given to a patient, while medication management is the overarching framework that tracks medications.
2. Medication policies can differ by community. To learn specifics, ask communities about their medication administration and medication management policies and procedures.
3. Some communities may allow self-administration. This means a resident can take medication on their own while living in the community.
4. A community’s medication management program can potentially reduce medication errors. Close control and monitoring of medications may prevent accidental overdose, identify drug interactions, and flag possible drug allergies.

Medication management vs. medication administration

While medication administration focuses on the route and the handling of and proper dispensing of medication, medication management remains a larger umbrella above the former. It focuses on overall medication safety, including medication administration, medication compliance, drug interaction prevention, drug allergy detection, and education of caregivers and residents.

Medication management can be understood as the process of overseeing the medications themselves and tracking them as they’re administered to residents in senior living communities. Programs for medication management in elderly care environments may also be built around the concept of the “seven Rs” (described below), along with applicable state regulations and best industry practices.

Medication administration refers to the methods by which medications can be given to or taken by a resident, and to those overseeing the process. Often referred to as routes of medication, methods of administration may include taking medication orally, injecting the medication into the body, applying the medication to the skin, or inhaling the medication. [ 02 ] Keep in mind that the term medication typically refers to prescriptions and may include medical marijuana in states where medical marijuana is legal.

When administering medication, all administrators must adhere to the following checkpoints, called the seven rights, or seven Rs, of medication administration:

• Right resident. The person administering should always confirm the resident’s identity.
• Right drug. With many drugs having similar names, suffixes, and prefixes, the administering person should verify the drug name as prescribed by the physician.
• Right route. Some medications may be given in multiple ways. The administering person should confirm that the correct route is being used.
• Right time. Medication timing can be key to the effectiveness and prevention of overmedicating or undermedicating the resident. The administering person should verify the time intervals prescribed by the physician.
• Right dose. Medications may not always be packaged the same. The administering person should verify the dosage and confirm any conversion of units or substance concentrations as a way to prevent medication errors. [ 03 ]
• Right documentation. The person giving the medication needs to record giving the medication on the right chart. If it is placed on the wrong chart, this would be a medication error.
• Right response. Prior to administration, the person giving the medication should confirm that the medication will have the right effect or that they’re using the right medication for the right reason. For example, if a nurse is preparing to administer blood pressure medication for high blood pressure in a resident, they should confirm that the resident currently has high blood pressure. If the resident’s blood pressure was already low, giving blood pressure medication intended for high blood pressure would be wrong.

Medication administration may be performed by a variety of people, depending on the route and other factors. In some cases, this may be referred to in the community as “passing meds.”

Each state dictates who may administer medications to residents in what types of senior living communities, and what qualifications they must have to do so. Generally, the following people may be seen administering medicines in assisted living :

• Physicians
• Nurses
• Certified medical technicians
• Allied health professionals, such as respiratory therapists

In most states, residents may also administer medications to themselves under specific circumstances.