A Caregiver’s Guide to Medication Management

Managing medications

Medication management becomes increasingly important with the addition of each new medication. Clinical research shows that each year in the United States, more than a third of all adults over the age of 65 have at least one unwanted reaction that results from a medication. These unwanted reactions are often called medication-related problems.

Older adults are more prone to medication-related problems because their bodies process and react to medications much differently than younger adults. Their kidneys and liver do not remove medications as easily as they once did. Changes in fat and muscle distribution also occur. All of these factors can result in increased side effects and medication-related problems in older adults.

Medication-related problems include:

Confusion
Depression
Insomnia
Falls
Drowsiness
Incontinence
Muscle weakness
Dizziness

Research has shown a majority of caregivers help their loved ones manage medications. It is essential that family members and caregivers help their loved ones keep track of their medications and ensure they are taking the right dose, at the right time, for the right condition. Older adults and their caregivers should inquire about the purpose of each medication being taken and discuss if the benefits outweigh the risks with their doctor(s). Medication should be evaluated for appropriateness in the elderly with the patient’s goals of care under consideration.

Tips to make medication management easier:

Make a list

The easiest way to keep track of your loved one’s medications is to maintain a medication list or record. Write the name of the medication, strength or dose, directions, and any other important information. The list should include all over-the-counter or non-prescription medications such as vitamins, herbal medications, and aspirin. According to the Centers for Disease Control and Prevention, adverse drug events cause more than 18 million emergency room (ER) visits per year, and older patients are twice as likely to visit the ER because of adverse drug events.

Confirm that all of your loved one’s doctors are aware of all the medications that he or she is taking, as this could prevent potential drug interactions and side effects.

Place a copy of the medication list in an easily accessible place (e.g., on the refrigerator or a cabinet) and give copies of this list to loved ones. Medications can be changed frequently, particularly when a patient leaves the hospital, nursing, or rehabilitation facility. Make certain the medication list is updated regularly.

Use pill boxes

Simple pill boxes are one of the most effective ways of organizing treatments. These boxes have labeled compartments for each day of the week, and even several rows of compartments for medication taken at different times throughout the day. If filling the pill box is too much for your loved one, try to fill it yourself or have a trusted neighbor or relative help keep the medicine organized.

Develop a Medication Routine

Having a medication routine is important to taking medications at the right time. Help your loved one establish a routine, such as taking medications with breakfast, after brushing teeth, or at bedtime.

Use one pharmacy

Using one pharmacy for all prescriptions can help prevent drug interactions and make getting refills easy. Most pharmacies offer automatic refills, along with phone or text message reminders. Your pharmacist can also become an important resource; don't be afraid to ask your pharmacist questions about your loved one’s medication, refills, or over-the-counter treatments.

Synchronize refills of medications

Ask your local pharmacist to have your loved one’s long-term medications refilled on the same day. You will make a single trip to the pharmacy to pick up prescriptions each month, making it convenient to stay on track with your loved one’s long-term medications. The majority of patients who have synchronized their medications found it very helpful in managing their refills and improving their overall medication adherence.

Talk to your loved one’s doctor or pharmacist – information is power

Nearly 90 million people -- half of all U.S. adults -- have difficulty understanding and acting on health information, according to the National Council on Patient Information and Education. This is especially true of the elderly: almost 40 percent of them are unable to read a prescription label, and 76 percent are unable to understand information given to them.

Some questions to ask your loved one’s doctor or pharmacist:

Why is this medication prescribed?
How does this medication help my loved one’s condition?
How can my loved one expect to feel while on this medication?
Is this medication the most appropriate for my loved one’s condition?
Is this medication appropriate for my loved one’s age?
What side effects can this medication cause?
What less-expensive medications are available?

Bring all of your loved one’s medications, including over-the-counter medications, vitamins, and supplements to the doctor’s office and ask to review each one.

Maintain communication with your loved one

Statistics show 40 to 75 percent of older adults do not take their medications correctly. Information and education are essential to taking one’s medications correctly. Make sure you know which medications are meant to be taken daily and which medications are taken only as needed. Often times, a simple query or investigation is enough to identify potential problems, such as extra pills due to missed doses, and unfilled prescription refills.

If you notice that your loved one is falling behind in paying bills, unable to drive safely, unable to shop for themselves, or is having difficulty preparing meals, this is usually a signal he or she may be having trouble managing medications as well.

Reduce the number of medications if possible

Medication adherence decreases as the need to use the medication increases to greater than twice daily. Risk of non-adherence increases even more for those who take more than five medications daily. Ask your loved one’s prescribing providers if it is possible to minimize the number of different pills he or she is taking, or at least limit the number of medicines taken twice a day or more frequently. Ask your pharmacist to contact the prescribing providers to discuss options to reduce the quantity of pills that your loved one is taking.

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