Diabetic diets are provided routinely, but not low-fat ones. Since the family must pay for laboratory assays for patients without adequate insurance coverage, the cost attached to a drug assay becomes a major impediment to therapeutic drug monitoring. Another area of concern lies in the training and education level of personnel working in assisted living facilities. In Tennessee, licensed nurses are required to administer medications. Since assisted living residents are able to leave the facility and purchase nonprescription or prescription medications without staff's knowledge, the role of the pharmacist becomes more important-and more difficult.
Medication errors are another source of potential problems.
The medication pass does not occur in assisted living as it does in a nursing home because staff is more limited and the residents may be in any part of the building at any time. Thus, medications are set up and then the staff member must search for the resident to administer them. Serious problems can also occur in drug storage. I have found many expired medications, both in the medicine area of the nursing station and in the residents' rooms. Finally, the family's substantial role in care has been problematic.