What to know about IV Care for the Elderly
When it becomes necessary to introduce medication or nutrition into the patient’s body that cannot be administered orally, then it must be administered intravenously, commonly referred to as an IV.
IV Therapy Considerations:
The IV solution is prepared by the pharmacy. The solutions can be kept in the home but be sure to pay attention to the instructions for storage. Other considerations for administering an IV are:
- Adequate electricity and available outlets to run the IV pumps
- Proper refrigeration facilities for the medication
- A safe place to store needles and supplies for IV equipment
- Patient and caregiver understanding of any possible side effects or complications
- Manual dexterity if the patient is running the equipment solo
Your insurance may allow IV therapy outside of a hospital setting if it is administered by a licensed and certified agency, has doctor’s orders, and is for FDA-approved medications. Some IV uses such as hydration therapy may not have the benefit of insurance contributions.
Types of IV Care for the Elderly:
Nutritional Support:
This is total parenteral nutrition (TPN) and must be administered through tubing that can handle a large volume and density of fluid. The administration site may be accessed frequently depending on the length of time that the support is needed. The type of intravenous device and placement could be any of the following:
- Port a cath
- PIC Catheter
- Central venous Device
The doctor will instruct how to care for the IV site and a nurse may be needed for assistance.
Note: this type of device may also be warranted if the patient is being given frequent doses or very irritating medications on an outpatient basis.
Hydration Therapy:
Sometimes the fluid balance in seniors is not adequate. This is when a long or short term form of hydration therapy is necessary. This could be the result of severe or prolonged diarrhea or vomiting that leads to dehydration.
This type of therapy is administered through an IV catheter that is placed in the patient’s vein and may need to be changed every two days. There are some intravenous needles that can be left in longer so if the patient is out of the hospital, you may want to discuss the use of this type of equipment.
Chemotherapy:
Prior to administering chemo outside of a hospital setting, the doctor must administer the first dose in a supervised setting. This is a so any reactions to the medication or treatment can be safely assessed before sending the patient on their way.
Anti-Infectives:
When there is an infection present, antibiotics may be administered by an IV. This type of medication must first be administered in a supervised setting to gauge any negative response. However, antibiotics that have been successfully used in oral form in the past will likely be fine through an IV. But be aware that new medications which the patient is using, ones that were not present when they took the antibiotic previously, may cause a reaction that was not seen during earlier doses. Err on the side of caution.
Enteral Therapy:
This type of therapy includes feeding tubes into the nose, stomach or intestine. By the use of a pump, gravity, or gently pressure through a syringe, liquid nutrition can be administered. Since those on a feeding tube are generally not able to care for themselves, it’s important to have the assistance of a care provider. Some reasons for this type of IV include:
- Difficulty swallowing
- Persistent refusal of food taken by mouth
- Frequent choking
- Medical diagnosis which alters digestion of solid foods
Final Note about IV use in the Elderly
In every case for the use of the IV care for the elderly must be considered by all parties involved including the doctor, the patient, and the caregivers. When the caregiver, outside of a hospital setting, is not able or willing to monitor the IV usage then home care and other alternatives should be considered. Always check with your insurance provider to see what coverage is available so that you know your options and can get the best care necessary.
