Part 4: Medication, Emergency Procedures, & Abuse

(Text Used from CTDSSMAPS Training (9/23/2020). 

8.  MEDICATION POLICIES

 

PCAs may assist with self-administered medication: Medication taken by mouth, injection, nebulizer or insertion, or applied topically without the need for assistance.  Means the client directly swallows, applies, inhales, inserts, or injects a medication into his or her own body.

 

A personal care assistant (PCA) may assist with medication.

Assisting includes:

  • Reminding the client when to take the medication

  • Reading the prescription label for the client

  • Bringing the medication and any necessary supplies or equipment to the client

  • Opening the pill bottle or container

  • Positioning the client in a good position to take the medication

  • Providing water or other liquid for swallowing medication

  • Storing, cleaning and disposal of used supplies and equipment

  • Putting away and storing medication properly

 

Once the task to supervise self-administration of medication is delegated to the PCA, a supervisor or family member should train the PCA specific to the task.

 

A PCA must follow the care plan and be directed by either the client who can direct their own care or a responsible party.  A responsible party does not have to be present when the PCA assists with taking medication. However, the responsible party must assure the medication is set up as individual doses and labeled with:

 

  • Name and dosage of the medication

  • Time the medication is to be given

  • Method to assist the person to take the medication

 

For medications given on an as needed basis the client must self-direct the PCA or the PCA must notify the responsible party before assisting with the medication.

PCAs do not:

  • Determine the dose or what time the medication should be given.

  • Decide if the client needs medication or decide if the medication is working or not.

  • Inject fluids and medications into veins, muscles, or skin.

  • Cannot crush medicine and put it in applesauce, or pudding, or similar substance.

  • Put medication in the person’s mouth.

  • Insert vaginal or rectal suppositories.

  • Apply prescription or non-prescription cream or ointment to a wound or a sore.

  • Cannot EVER pre-fill medication boxes

 

If you drop a medication, or the med box, if the pills do not appear to be correct, do not administer the pills, call your supervisor.

 

If family members are telling you or trying to convince you to administer medication, contact your supervisor.  PCAs cannot administer medication.

 

 

 

 

 

 

9.  EMERGENCY PROCEDURES

 

All emergencies should be immediately reported to your supervisor.

 

DO NOT TRANSPORT THE CLIENT TO THE EMERGENCY ROOM

DO NOT GO TO THE EMERGENCY ROOM WITH THE CLIENT UNLESS THE CLIENT HAS DEMENTIA, ALZHEIMER’S DISEASE OR IS UNABLE TO SPEAK.  NOTIFY YOUR SUPERVISOR BEFORE YOU GO.   LEAVE AFTER THE CLIENT IS TAKEN TO A ROOM.

 

 

When to call 911

  • Medical Emergencies

  • Bleeding

  • Heart Attacks

  • Strokes

  • Choking

  • Shock

  • Burns

  • Falls

  • Broken bones

 

Falls

If the client falls, call 911 for help.  Help the client find a comfortable position until help arrives.  Falls must be reported to your supervisor.

Fall Prevention

Home can be a hazardous place for seniors. Everyday objects and decorative items can create fall hazards and pose dangers. Falls are the leading cause of fatal injury among older adults. If these hazards are present in the home, the PCA can be observant to help prevent a fall.

 

Below are some common hazards:

      

  • Throw rugs: Throw rugs move and the edges can flip up while the client is walking.

  • Piles of clutter:  Piles on the floor can easily be tripped over. 

  • Poor lighting: Stairs, walkways and hallways that are not well lit create a significant fall hazard. Clients often have problems with vision and need bright lighting to notice changes in walking surfaces.

  • Remove furniture or other things in the way to create a clear path so the client may avoid bumps or falls.

  • Assist clients with sitting and standing if they are likely to fall.

  • Encourage the client to use their cane or walker.

  • Encourage the client to use handrails if they are available.

  • Make sure the client is wearing shoes or non-slip footwear.

 

 

Fire Safety

Be aware of the client’s ability to exit the home in the event of a fire and accessible exits. Make sure you remember the client’s street address.

 

Oxygen

  • There should be no smoking, open flame or heat source close to the oxygen. This will increase the risk of a fire.

  • Keep oxygen away from heaters, radiators, and hot sun.

  • Never let oil, grease, or highly flammable material to touch or get on oxygen cylinders.

  • Do not use aerosol cans like hair spray or air fresheners near oxygen.

  • Never put anything over an oxygen gas tank.

 

Immediately report to your supervisor if the client is smoking around the oxygen.  Smoking near oxygen places both the client and the caregiver in danger. 

10.  REPORTING ABUSE, NEGLECT, EXPLOITATION, ABANDONMENT

 

Toll-Free Elder Abuse Referral Line
In State: 1-888-385-4225
After Hours Elder Abuse Emergencies
In State: Call Infoline at 211

 

 

As a PCA you and your agency are mandated reporters of any abuse, neglect by another person, self neglect or exploitation you observe toward your client. A mandated reporter is a person who is required to make a report if there is a reason to believe that the client has been a victim of abuse, neglect, exploitation or abandonment. You must contact your supervisor immediately if you observe the client being mistreated by another caregiver, family member, friend or other person. Contact your supervisor if you suspect abuse, neglect, self neglect, exploitation or abandonment.

 

Abuse is when another person injures, intimidates or punishes the client resulting in physical harm, pain or mental anguish. Abuse can include sexual assault, physical assault and verbal abuse.  The client should never be restrained or confined to a chair, room or other location. 

 

Neglect means that care is not being given by family or others who are supposed to care for the client when other help is not in the home. It can mean that the client refuses necessary services which may create a risk to the client’s health or safety.  You should report any home environment without heat, hot water, electricity and situations that may create a threat to life, health or safety such as lack of repairs, unsanitary or toxic conditions.

 

Self-neglect is when an individual neglects to take care of their basic needs, such as bathing, dressing, wearing clean clothing, eating, drinking, not going to the doctor when she/he is sick or not taking medications.

 

Exploitation is taking a client’s property without permission, the deliberate misplacement of client’s property or use of a client’s belongings or money without the client’s consent; deliberate damage, destruction, theft, misplacement or use of a client’s belongings or money without the client’s consent, including taking the client’s medications. The client’s money must be used on items the client needs such as food or medication.   

 

Abandonment refers to a caregiver leaving an elderly person alone during a working shift or if the next caregiver does not show up for their shift and/or failing to perform personal care attendant duties.

 

If you become aware of any of these situations, you must report it immediately to your supervisor. 

First Aid