4.4 What is medication management?

Medication management is a key learning area for any professional working with people with Parkinson’s. Even if you don’t administer medication, it’s vital that you understand the importance of medication timing and the main issues around medication side effects, including impulsive and compulsive behaviour.

Medication is usually the main treatment for Parkinson’s. Some of these drugs work by replacing or mimicking the actions of dopamine, the chemical that is in short supply in the brains of people with Parkinson’s. When someone with Parkinson’s doesn’t get their medication at the time prescribed for them their symptoms become uncontrolled – increasing their care needs considerably. In rare cases, it can lead to more severe problems, such as neuroleptic malignant syndrome.

The drug regime for someone with Parkinson’s will not remain the same throughout the illness. As the condition progresses, doses can be increased and different combinations of drugs may be tried [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] .

Someone with Parkinson’s may take lots of different drugs. The timing of this medication is very important. If people are unable to take their Parkinson’s medication at the right time, the balance of chemicals in their body can be severely disrupted. This can make their Parkinson’s symptoms worse. You will learn more about the importance of medication timing in Section 4.6.

Part of your duty of care includes maintaining the dignity of those you care for. One aspect of this will be to support the person in maintaining their freedom and independence. This includes giving people control over when they take their medication.

It’s good practice for an expert to carry out a medical usage review. If you are working in residential care, your resident’s GP, specialist or Parkinson’s nurse should do this a couple of months after they have arrived. This will make sure that the medication is tailored to the patient’s current needs. These may be different from when they were at home.

Actions to take

  • Make sure everyone involved in caring for a person with Parkinson’s knows how important the timing of Parkinson’s medication is.
  • A person with Parkinson’s may have a medication diary, so check this regularly. Ask them how their symptoms change when they need medication.
  • A pill timer is a box with sections for different doses. It may have an alarm that sounds when different doses need to be taken. Use pill timers or alarm clocks to remind staff whose medication is due at different times from set drug rounds.
  • Where you can, encourage people with Parkinson’s to look after their own medicines. Some people are able and will prefer to self-administer medication. Reassure them that you will support this routine, and offer pill timers or reminders to help them.
  • If the person with Parkinson’s can’t swallow tablets, report this to your manager or make a referral. Other forms of Parkinson’s drugs are available.
  • It is important to note that it is dangerous to stop medication suddenly. If the person you are caring for is going into hospital to have an operation, the timing of their medication needs to be carefully planned.
  • If you notice that someone has missed a dose of their Parkinson’s medication you should report this to your manager or take appropriate action yourself.

Think about your current practice regarding medicines management for Parkinson’s. Your role may be minimal or you may be involved in administering medication. Use your reflection log to write 150–200 words comparing the information and actions outlined here to your current practice.

How many of these actions have you taken in the past? Discuss with your peers when you took these actions or in retrospect when you should have.

4.3 Who is in the multidisciplinary team?

4.5 What are the main drug treatments for Parkinson’s?