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Medication takeovers: Covert druggings and behavioral control in Alzheimer's

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  • Berry, Brandon
  • Apesoa-Varano, Ester Carolina

Abstract

Older adults consume the most prescription medication in the U.S. For those who develop Alzheimer's disease, risk of medication misuse increases with the progression of the disease. Family members commonly intervene to lessen risks by taking over the management and administering of a medication regimen. Despite the potential for grave harm around the misuse of powerful drugs, few studies provide insight into the household social context of medication use for this disease. Drawing on 60 in-depth interviews conducted in four waves over 2.5 years, this study investigates how family members administered prescription and over-the-counter medications to elders with Alzheimer's. The findings detail how family members initially created and enacted the role of proxy-administrator to avoid self-administration errors and then expanded the role to manage disruptive behaviors. During this process, family members perceived themselves as working in partnership with doctors, especially in the effort to craft a regimen that controlled the affected individual's mood and sleep/wake cycle. The paper concludes by discussing the implications that family members used medications to improve conformity to a preferred household social order. The study offers conceptual advances in understanding 1) the process of proxy-administration in Alzheimer's care and 2) the role of proxy-administrators in the medicalization of deviant behavior.

Suggested Citation

  • Berry, Brandon & Apesoa-Varano, Ester Carolina, 2017. "Medication takeovers: Covert druggings and behavioral control in Alzheimer's," Social Science & Medicine, Elsevier, vol. 188(C), pages 51-59.
  • Handle: RePEc:eee:socmed:v:188:y:2017:i:c:p:51-59
    DOI: 10.1016/j.socscimed.2017.07.003
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    References listed on IDEAS

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    1. Berry, Brandon & Apesoa-Varano, Ester Carolina & Gomez, Yarin, 2015. "How family members manage risk around functional decline: The autonomy management process in households facing dementia," Social Science & Medicine, Elsevier, vol. 130(C), pages 107-114.
    2. Rogers, Anne & Day, Jennifer C. & Williams, Brian & Randall, Fiona & Wood, Pamela & Healy, David & Bentall, Richard P., 1998. "The meaning and management of neuroleptic medication: a study of patients with a diagnosis of schizophrenia," Social Science & Medicine, Elsevier, vol. 47(9), pages 1313-1323, November.
    3. Conrad, Peter, 1985. "The meaning of medications: Another look at compliance," Social Science & Medicine, Elsevier, vol. 20(1), pages 29-37, January.
    4. Pound, Pandora & Britten, Nicky & Morgan, Myfanwy & Yardley, Lucy & Pope, Catherine & Daker-White, Gavin & Campbell, Rona, 2005. "Resisting medicines: a synthesis of qualitative studies of medicine taking," Social Science & Medicine, Elsevier, vol. 61(1), pages 133-155, July.
    5. Donovan, Jenny L. & Blake, David R., 1992. "Patient non-compliance: Deviance or reasoned decision-making?," Social Science & Medicine, Elsevier, vol. 34(5), pages 507-513, March.
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    Cited by:

    1. Apesoa-Varano, Ester Carolina, 2020. "“I know best:” women caring for kin with dementia," Social Science & Medicine, Elsevier, vol. 256(C).

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