The Worms Might Win
For some of Maple City Health Care Center’s patients, taking the right medicine at the right time is a matter of life and death.
For Santiago, taking the right medicine is crucial because of an advanced stage of diabetes, but taking the right medicine also difficult because he is legally blind.
At Maple City Health Care Center, Santiago has a team of care providers. The team includes a physician, a nurse practitioner, a nurse health coach, a nurse care coordinator, a behavioral health provider, a nutritionist, and three medical assistants.
After having missed appointments for an extended period of time and after seeing other physicians, Santiago arrived at Maple City Health Care Center for a diabetes check.
James, the physician on Santiago’s team, asked Santiago about his medications. James was especially interested in prescriptions that other physicians might have made. Santiago confessed that he was confused about what medications he was supposed to be taking.
Because members of Santiago’s care team work together in the same room, James could speak immediately with Arely, the nurse care coordinator on Santiago’s team.
Arely called Santiago’s pharmacy and discovered that Santiago’s prescriptions included four very important medicines – one medicine to be taken three times a day, one medicine two times a day, and two medicines once a day.
James reviewed the list of medications and noticed that two of the medications were contraindicated and that two other medicines duplicated each other. James changed Santiago’s prescription from four medications to two. While the change simplified Santiago’s task, he still struggled to tell one pill from the other.
Arely worked with Santiago and soon understood the specific challenges. Santiago couldn’t see the labels on the bottles or the color of the pills. He couldn’t read Braille. The only way that Santiago had of identifying the pills was by feeling them, but the pills for the two medications were both circular in shape and were both about the same size.
Arely talked with Santiago about whether a pill dispenser might help. Santiago liked the idea, but he expected that finding transportation to a store to buy one was going to be a challenge. Mariana, the medical assistant on Santiago’s team, made a quick trip to a drug store and brought back a double-tiered, one-week pill dispenser.
Arely filled the dispenser and taught Santiago how to identify and open each compartment. Arely and Santiago decided that if he brings the container with him for his regular appointment, someone on his care team will fill the container with the right meds.
Santiago arrived that day at Maple City Health Care Center unable to feel his meds. He left feeling confident in his new plan to ensure a healthier future.