Geriatric Care : Assessing Compliance Ability

• Review the patient's complaint, and obtain a comprehensive health and drug history.
• Keeping in mind that discharge planning begins at admission, evaluate the patient's physical ability to take drugs. Can he read drug labels and directions? Does he identify drugs by sight or by touch? Can he open drug bottles easily?

  If he's disabled by Parkinson's disease or arthritis, for example, or if he lacks manual dexterity for any reason, advise him to ask his pharmacist for snap or screw caps (rather than childproof closures) for his drug containers.
• Evaluate the patient's cognitive skills. Can he remember to take prescribed drugs on time and regularly? Can he remember where he stored his drugs? If not, refer him to appropriate community resources for supervision.
• Assess the patient's lifestyle. Does he live with family or friends? If so, include them in your patient-teaching sessions if possible. Does he live alone or with a debilitated spouse? If so, he'll need continuing support from a visiting nurse or other caregiver.
• Keep in mind that inadequate supervision may result in drug misuse. Make appropriate referrals and contact appropriate social agencies to ensure compliance and safety and to provide financial assistance if necessary.
• Assess the patient's beliefs about drug use. For example, the patient may believe that chronic use of medication is a sign of illness or weakness and therefore may take his medications erratically.