It starts out simply enough — your parent or grandparent might take a statin to help manage their cholesterol levels, or a calcium channel blocker to lower their blood pressure. But then they may need another drug to help control side effects from the blood pressure medication.
Over time, they may need additional medications to treat other health conditions such as low thyroid levels or diabetes, and they may also take vitamins or specialized supplements.
Some pills need to be taken once a day; for others, it’s twice. Some need to be taken on an empty stomach while others work best with food or a full glass of water. Managing all these different medications and their schedules is enough to make your loved one want to give up altogether. But that would be a mistake.
Dr. Jaclyn Robinson, a geriatrician with Banner Alzheimer’s Institute in Tucson, said, “It’s important for seniors to keep their medications organized and take them as scheduled, so they minimize interactions between drugs and reduce side effects.”
A range of issues can make it difficult for seniors to take the medications they are prescribed:
• They need to remember to take medication at the right time.
• Their doctor may change their dose or frequency.
• Special instructions could be confusing to follow.
• Pills can look alike.
• Medication names can be difficult to remember or pronounce.
• Medications can have unpleasant side effects.
• They don’t like taking so many pills.
• Taking pills can make them feel full, so they don’t want to eat.
• They don’t see results from medications that don’t take effect right away.
• Help your loved one with these seven techniques so you can ensure they are taking all of their medication as directed.
Use medication boxes or pill organizers
Boxes or organizers can help seniors take the right medication on the right day and at the right time. Robinson recommends filling pill boxes every two to four weeks. That way, seniors can better manage their daily routines, reduce the stress associated with organizing their medication, avoid confusion and build confidence, knowing they are taking their medication as directed.
Setting alarms and reminders can also help keep seniors stay on schedule with their medication.
Keep track of all of the medications
Make sure your loved one has a list of all the medications they are taking and update the list after every doctor’s appointment, ER visit or hospital discharge. Have your loved one review the list with their primary care provider, since other providers might not share records or changes with their PCP.
Dedicate a space to medication management
Having a space devoted to medication, such as part of the kitchen counter, is ideal. Along with the medications or pill boxes, keep a journal or log where you can check off which medications were taken and when.
“That way, patients and family members can be confident they took the right medication at the right time,” Robinson said.
Have doctors’ names and phone numbers available in this area as well.
“If there is any confusion or question about medications, it is better to call the office to clarify and avoid any errors,” Dr. Robinson said.
Watch out for “prescribing cascade”
Providers aim to prescribe medications in their patients’ best interest. But sometimes, a medication may cause a certain side effect, so another medication is added to treat that side effect. Then that medication may create another side effect which requires another medication, and so on. That’s called a prescribing cascade.
Your loved one can ask their doctor if there are newer versions of medications that have fewer side effects to help combat this problem.
Recognize that dosages might change with age
Your loved one may have taken the same medication for years. But the aging process affects how the kidneys and liver metabolize medications. So over time, a lower dose of certain medications might be effective.
Monitor other medications and products
Ask your loved one what nonprescribed products they are taking.
“Older adults are vulnerable to advertisements and claims about certain supplements that frankly may not have any scientific evidence proving they work,” Robinson said. And even products that work could still cause side effects or interactions with other drugs. Make sure your loved one talks to their provider about the following:
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Benadryl
• Dramamine
• Sleep aids such as ZzzQuil, or Tylenol PM
• Vitamins and minerals
• Supplements
• CBD or THC
• Tobacco or alcohol use — alcohol can cause liver problems and can interact with certain medications
Check in with your loved one about what matters most
Your loved one has their own health care goals and priorities about what makes a difference in their quality of life. Talk to them about what’s important. That way you can talk to health care providers about options for treating conditions less aggressively, with less medication to manage.
Special challenges for people with dementia
People who have memory issues might forget what medications they take, repeat doses, forget to take doses or forget why they need to take their medications. In addition, people with moderate to advanced dementia may get upset about taking their medications and may resist help.
“It is important for people with dementia to have a good care partner or close support system,” Robinson said. “People with dementia may get upset or frustrated more easily, so you have to come up with creative ways to ensure they take their medications as directed.”
The bottom line
As your loved ones get older, they are likely to need more prescriptions to help treat their various health conditions. It can be a struggle for them to keep track of all of their medications and to take them as prescribed. You can help them put strategies in place that make it easier and help them stay healthy.