Q: How do I know if the nursing home where my mother lives is giving her the proper doses of her medication?

A: One of the easier ways to check use of medication is to check how frequently medications are refilled. Pharmacies can only bill prescriptions within the frequency as established by the patient's health or prescription drug plan. Usually the frequency is a 26-30 day interval that allows the facility staff to reorder medications early to prepare for weekends or holidays. However, refills are about every 30 days. Refills dates for each medication can be checked on statements or you can request a refill history report from the dispensing pharmacy.

Nursing staff is required to document each dose of medication after it is given. For medication used as needed, you can compare the refill history with the number of doses noted as given during a block of time. Another good evaluation of medication use with "as needed" pain medication, is how the patient is responding, how well pain is controlled with an "as needed" pain med or how well constipation is corrected with the "as needed" use of a laxative. Additionally, blood levels from lab reports can also reflect medication use, but other factors may alter blood levels.

Whenever you have a question about how any medication is used, you are encouraged to address you questions and/or concerns with the facility's nursing director. The facility's patient care committee is also a good place to speak to staff about medication use. Facilities in many states have advocacy groups that can also assist with your questions about medications or other concerns you may have.