foster parent handout
TRANSCRIPT
Foster Parent Tips for Medication Management and Health Care
byJeffrey Cheng RN BscN
CASA
Tips for Caregivers• Connect to a consistent Pediatrician• Having a consistent family physician will
also be beneficial in rural areas
Tips for Caregivers• Try to rule out any variables that may be
stressing the child before thinking of changing medication or dosage
Physiological Variables:Lack of sleepSensory triggers: noise, over stimulation, food textures and tastes
Tips for CaregiversPhysiological Variables:
HungerFood Intake is especially important if the child is on ADHD medication that can suppress appetite•Collaborate with school board to ensure that snacks are available to child when they get hungry•Tweak snack times at home as well
Tips for CaregiversEmotional Variables: Child reacting to changes in caregivers, placement
Child coming back from overnight short term stays with bio parents
Contextual Variables:Is there adequate priming/transitioning between activities?Structured vs unstructured daily routine: – predictability and structure reduces child stress
Tips for CaregiversCommunication Style Variables• Body language, intonation• Using short, concrete sentences• Allowing more processing time for child to answer or
follow cues/direction• Caregiver competency of how to interact effectively
with kids facing specific mental health challenges (ie. Autism)• Accommodation of challenges with cognitive and
receptive language delays
Tips for CaregiversWritten care plans
Consistency of plan should be across all environments that a child participates within– Collaborative multi-disciplinary approach
that may involve teachers, teaching aide, behavioral specialist, OT, mental health professionals, caregivers, youth workers, caseworker
– Involve the child if possible.• A version of the care plan should be written for
them in a way they can easily follow and understand.
Tips for CaregiversWhat can be outlined in a care plan?• Medication admin times• actions, body language, or gesturing that may
precede disruptive behaviors• Behavioral interventions (ex. spatial
boundaries, specific social skills)• Sensory concerns that may overstimulate or
engage a child in activity
Tips for CaregiversWhat can be outlined in a care plan?• De-escalation tactics that have been historically
successful »Taking child out of class for a walk if they begin to
wind up» Sensory object to soothe or use when feeling
frustrated or overwhelmed»Alternative step down activities in class if having a
challenging day• Whether the child works better with males
vs females
Tips for Caregivers• The use of a care plan can help the team stay
consistent in managing a child across environments and interventions.– Can help reduce splitting and confusion that a
child may otherwise experience and contribute to their frustration and acting out behaviors
– The resulting display of disruptive behaviors may then be dealt with the prescribing of additional medication
Tips for Caregivers
Psychotropic Medication Safety Planning• Should be in place between child, caseworker,
mental health professionals, school board, caregivers for activation of suicidal ideations or self harming gestures– Planning should take place prior to
commencement of any psychotropic medication– If possible, involve child/teen in planning
Tips for CaregiversAWOLS and Party Favors
• Coordinate a treatment plan to deal with AWOLS, and illicit substance/alcohol ingestion– Be proactive and have a plan in place before such
an event occurs– Make sure to speak with prescribing physician to
get direction– Involve the child and treatment team (SW, school,
prescribing doctor, youth worker etc.)
Tips for CaregiversAWOLS and Party Favors
• Drugcocktails.ca– Resource to look up interactions between street drug and
psychotropic medication– Can be accessed by caregivers and youth
• Concerta and marijuana– Can make heart beat too fast
• Risperdal and alcohol– can worsen the uncontrolled movements (also called 'EPS') that risperidone sometimes
causes. – risperidone can make people sleepy, dizzy and confused, especially at first as your body
gets used to it. Alcohol can make this worse.
Tips for CaregiversStay Organized
• Keep a list of most current active medications with frequency of admin and dosage– Communicate all changes in medications to the
caseworker– Verify medications each time child is discharged from a
hospital or remand setting and communicate changes to caseworker
– Caseworker can then contact consultant to review medications
Tips for Caregivers
• Discuss drug monitoring practice with prescribing doctor– Monitoring is at the discretion of the attending
physician. – Clinics may have their own systems in place for
monitoring.– Don’t leave the clinic without securing a follow up
appointment date
Tips for Caregivers
• Keep a record of vital signs which can be communicated to the caseworker– Blood pressure, heart rate, height, weight, body
mass index (BMI), waist circumference– Weight is especially helpful for med reviews in
cases where medication dosing is weight based
Tips for Caregivers
• Look for a streamlined medication regimen– One medication per psychotropic class– If there is more than one medication within a
psychotropic class• Discuss with prescribing doctor and learn about the
rationale behind using more than one• Example: Using two antipsychotics. One to help reduce
disruptive behavior, the other to help sleep and calm at night
Caregiver Resources
• CASA Caregiver Villagehttp://www.caregivervillage.ca/
• Triple Phttp://www.triplep-parenting.net/alb-en/home
• NAMI Psychotropic Medicine Overviewhttps://www.nami.org/getattachment/Learn-More/Fact-Sheet-Library/Medications-Overview-Fact-Sheet.pdf
• My Health Alberta Medication Look Up page– https://myhealth.alberta.ca/health/medications/Pages/default.asp
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Caregiver Resources
• On the Pointhttp://www.excellenceforchildandyouth.ca/resource-hub/psychotropic-materials
• Kelty BC Mental Health – http://keltymentalhealth.ca/treatment/medications
• Drug Cocktails– www.drugcocktials.ca
Mental Health Resources for Youth• Head Meds–http://www.headmeds.org.uk/
• Mind Check–http://mindcheck.ca/
• On the Point–http://
www.excellenceforchildandyouth.ca/resource-hub/psychotropic-materials
Mental Health Resources for Youth• Young Minds
– http://www.youngminds.org.uk/for_children_young_people
• Mind Your Mind– http://mindyourmind.ca/
• Youth Smart– http://www.youthsmart.ca/
• Help4Me– http://www.help4me.ca/
• Drug Cocktails– www.drugcocktails.ca
