Beyond the Medication Record

A medication administration record can tell you a lot.

It can tell you what medications a person takes.

It can tell you the dose.

The time.

The route.

Whether the medication was administered.

Those things are important.

But a MAR cannot tell you who the person is.

And it certainly cannot tell you everything they need.

At True North Living, medication management will be an important part of residential care—but it will never be the entirety of someone’s care.

Medication is a tool.

Medication can be incredibly helpful.

It can treat medical conditions.

It can reduce symptoms.

It can improve someone’s ability to participate in daily life.

It can help a person sleep, focus, regulate or function more comfortably.

When someone needs medication, we want them to receive the medication that has been appropriately prescribed for them.

But we also believe in asking an important question:

“What are we treating?”

That question matters.

Medication should have a purpose.

And that purpose should be understood by the people responsible for supporting the individual.

A medication list isn’t a personality.

Consider how much information can be missing from a medication record.

It doesn’t tell us that someone loves country music.

It doesn’t tell us that they are an incredible artist.

It doesn’t tell us that they hate wearing certain fabrics.

It doesn’t tell us that they become overwhelmed by crowded stores.

It doesn’t tell us that they are really good at remembering directions.

It doesn’t tell us that they want to have a job.

It doesn’t tell us that they are hilarious.

It doesn’t tell us what makes them proud.

And it doesn’t tell us what they dream about.

The person is much bigger than the medication list.

We don’t want “medication compliance” to become the goal.

Taking medication as prescribed is important when medication is part of someone’s treatment plan.

But the goal isn’t simply to have a person take every medication without question.

The goal is for the medication to contribute to the person’s health and quality of life.

That means staff need to understand what medications are for, how they are supposed to be administered, what side effects to watch for and what changes should be reported.

It also means recognizing when something seems different.

Is the person unusually sleepy?

More restless?

Less engaged?

Eating differently?

Sleeping differently?

Moving differently?

Acting differently?

A medication record may document that the medication was given.

Observation tells us what happened afterward.

Both matter.

“They’re just behavioral” shouldn’t be the end of the conversation.

One of the biggest mistakes we can make is assuming that every change in behavior is behavioral in origin.

A person who suddenly becomes irritable may be in pain.

A person who stops participating may be exhausted.

A person who becomes unusually restless may be experiencing a medication effect.

A person who suddenly behaves very differently may be sick.

Sometimes the answer really is behavioral.

But sometimes it isn’t.

That’s why changes in behavior should prompt observation and appropriate follow-up rather than an automatic assumption.

Before treating a behavior, we should consider what might be causing it.

Medication should support the person—not replace support.

If someone needs help learning a skill, medication isn’t going to teach the skill.

If someone is lonely, medication doesn’t create friendship.

If someone is bored, medication doesn’t provide meaningful activity.

If someone is overwhelmed by sensory input, medication may not solve an environment that is overwhelming them.

If someone doesn’t understand what’s being asked of them, medication doesn’t automatically solve the communication problem.

Sometimes the answer is medication.

Sometimes it’s a change in environment.

Sometimes it’s teaching.

Sometimes it’s communication.

Sometimes it’s sleep.

Sometimes it’s medical evaluation.

Sometimes it’s sensory support.

Sometimes it’s simply giving someone more time.

And sometimes it’s several things working together.

We believe in individualized medication management.

There is no universal medication list for autism.

There is no universal medication list for intellectual disability.

And there is no universal medication list for people who live in residential settings.

Every person is different.

Their medical history is different.

Their response to medications is different.

Their goals are different.

Their bodies are different.

Their needs are different.

That’s why medication decisions belong with the appropriate medical professionals and the individual and their support team—not with residential staff simply because a medication makes someone easier to manage.

“Easier to manage” and “better for the person” are not necessarily the same thing.

Quiet isn’t the same thing as healthy.

This is something we take seriously.

A person who is quiet and compliant may be doing wonderfully.

Or they may be excessively sedated.

A person who suddenly stops engaging may have become more regulated.

Or they may be experiencing a problem that needs attention.

We don’t want to judge success simply by how quiet a household is.

We want to look at the whole person.

Are they participating?

Are they communicating?

Are they enjoying things?

Are they sleeping appropriately?

Are they eating?

Are they functioning at their baseline?

Are they gaining skills?

Are they engaged with the people around them?

Are they living their life?

Those questions matter.

Medication changes deserve observation.

Whenever medications are started, stopped, increased, decreased or otherwise changed, changes in the person’s functioning are important information.

Staff may be among the people who see the individual most often.

That gives them a valuable role.

Not in making medical decisions—but in observing and communicating what they see.

Documentation isn’t busywork.

It creates a record.

Patterns can matter.

A single difficult day may mean very little.

A pattern over several weeks may tell a completely different story.

Good documentation helps the people responsible for medical care make better-informed decisions.

The MAR is important.

We aren’t diminishing the importance of medication records.

Quite the opposite.

Accurate medication administration is a serious responsibility.

The MAR is one piece of the safety system.

It helps ensure that the right medication is given to the right person at the right time and in the prescribed manner, with appropriate documentation.

But the MAR is one piece.

Beyond the MAR is the person.

And that is where our attention needs to remain.

The True North philosophy

We aren’t anti-medication.

We’re pro-appropriate medication.

We believe medications should be used when they are medically appropriate and prescribed by qualified professionals.

We believe people should receive their medications safely and as ordered.

We believe side effects and changes in functioning should be taken seriously.

We believe medical concerns should be communicated promptly.

And we believe medication should be part of an individual’s overall support—not a substitute for understanding that individual.

Because ultimately, success isn’t:

“We got everyone to take their medications.”

Success is:

“This person is healthy, engaged, supported and living as independently and meaningfully as possible.”

That’s the standard we’re aiming for.

Because there is a whole person beyond the medication record.

And that’s the person we came here to support.