When is it okay to assist a person to take medication?
Published: 20 October 2011
It is often difficult to determine when and if it is okay to assist a person receiving aged care to take medication.
The law enabling an AIN or carer (however titled) to assist a person to take medication has strict conditions which must be met.
Carers who fail to meet these conditions risk substantial penalties. In addition, registered nurses must demonstrate professional practice by ensuring that medication management complies with all regulations, codes and guidelines that apply to nursing and/or aged care.
The Aged Care Accreditation Standards
These standards require that residents’ medication is managed safely and correctly (Standard 2.7).
The Health Drugs and Poisons Regulation 1996 (HDPR 1996) and its "carer provisions"
This regulation provides the legal parameters for a safe and correct medication system in residential aged care facilities in Queensland.
It includes provisions permitting carers (AIN/carer or however titled) to assist a person with their medication – so long as the person asks for help.
These provisions are known as the "carer provisions".
Even though Queensland Health no longer publishes guidelines regarding these provisions, the QNU has sought legal advice and can provide the following information about them.
When do the carer provisions apply?
Does the resident (an ‘assisted person’) have the capacity to make the request for, and to consent to the help? If so, then the carer provisions apply.
When can carers assist a person with medication?
Your employer may develop policy that requires AINs/carers (however titled) to play a role in medication management.
If the request is made in accordance with the conditions outlined below then the direction is lawful (AINs/carers should follow lawful and reasonable directions from their employer).
Carers may assist residents (assisted persons) with medications under the carer provisions when the following conditions are met:
1. The assisted person presently has capacity to ask for help from a carer.
Adults are presumed to have mental capacity, but where there is doubt as to a person’s capacity, the carer provisions should not be used. The Federal Government’s Guidelines for Medication Management in Residential Aged Care Facilities state that if an aged care recipient is unable to self-medicate (which also requires an assessment), the medicine should be administered by a registered nurse (or an enrolled nurse with authority to administer medicine).
2. The assisted person requests the carer’s help to take their medication.
That is, a clear request for help has been made by the assisted person. The carer should not assist a person if they do not consider it is safe for them to do so or if they are in doubt about a resident’s capacity. A resident’s request may be verbal or written.
3. The assisted person has made a request for assistance related to a specific medication which is prescribed at the time the request for help is made.
A request for assistance on one occasion should not be interpreted as a request for assistance to take all medications prescribed and supplied in the future.
For example, a written request for assistance from a carer does not operate as a request for assistance with medication not dispensed at the time the request was made. However, a resident’s request and consent for ongoing assistance with new medications may be implied by the resident’s actions, where the resident has capacity and indicates their wish for the carer to continue to assist them.
4. The assisted person has made a request for assistance to an identifiable person or persons.
Requests from residents cannot be made for assistance from a class of unidentifiable persons – such as a group of AINs or carers, or from future unknown employees (AINs/carers) who may be employed in a residential aged care facility. The resident must ask for the help of one or more specific carers to take the medication.
5. It is clear to the carer that the request and consent for help from the assisted person is current.
That is, that each time a carer helps an assisted person to take medication the carer must be confident that the assisted person is requesting and consenting to help on the particular occasion.
This may be clarified by a verbal check with the resident. If the resident declines assistance then the carer must not proceed to assist the resident and should inform the registered nurse or medical practitioner.
6. The carer may help the assisted person to take:
a. Schedule 4 or Schedule 8 medication that is supplied as dispensed medication (i.e. medication that is prepared for the assisted person by a pharmacist) – only under the directions on the label attached to the dispensed medicine’s container.
b. Schedule 2 poisons in accordance with the directions for use of that medication.
c. Schedule 3 poisons in accordance with the directions on the label attached to the medicine’s container.
The carer providing the help to an assisted person may open the assisted person’s medication container and take out the required dose of medication and help the assisted person take the medication as directed by the label or for Schedule 2 poisons as per the directions for use.
7. The medication is given to the assisted person at the immediate time that the carer renders assistance to the assisted person.
For example: the medication is handed directly to the assisted person at the appropriate time and the carer observes ingestion by the assisted person.
Summary – what does it all mean for me?
If you are a carer (AIN/carer or however titled) then you must ensure that you comply with the "carer provisions" contained in the Health (Drugs and Poisons) Regulation 1996, or risk substantial penalties.
If the resident lacks capacity to request assistance, then you cannot lawfully assist that person with their medication.
If your manager directs you to give medication when a resident lacks the capacity to request assistance then you should refuse to perform this task as it is not a lawful direction.
If you are a RN, then you are accountable for the delegation of medication management tasks. The Nursing and Midwifery Board of Australia requires that you:
- Ensure medication tasks delegated to carers are consistent with the carer provisions.
- Ensure that staff delegated medication tasks are suitably educated and have been assessed as competent to perform the task. (You must obtain evidence of this from your employer before you can consider making the delegation).
Only a RN can delegate nursing care. An EN is not authorised to delegate any nursing care task to any other staff member.
Members who have concerns about medication practices in their workplace should contact their local QNU workplace representative or QNU Connect on
3099 3210 for assistance.
Legal requirements of carers (AINs/carers however titled)In the QNU’s view the Health Drugs and Poisons Regulation 1996 requires that carers:
Legal requirements of ENs/RNsIn the QNU’s view the Health Drugs and Poisons Regulation 1996 requires that:
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