Question: We’ve had recurring problems handling my mother’s prescription medication. She takes about 10 prescriptions every day, and often she takes the medications in error, i.e., too many, not enough, etc. Last week we had to rush her to the ER because of an unintentional overdose of these prescription medications. What would you recommend we do to resolve this potentially dangerous problem?
Answer: There are a number of different solutions, depending on her medication routine, what is causing the difficulties, etc. When we do a geriatric care assessment, this is often one of the areas explored and it is not unusual to find problems, which as you well know can be very adverse. We tailor recommendations to the solutions that fit for the individual.
A couple of resources I can share that might work. First, you’re probably aware of simple pill boxes, where medications are laid out as to when to be taken. A family member or a R.N. from a home care company can do this. If your Mom can handle taking the medications from the pillboxes correctly, this can work. Some clients need additional reminders, and maybe it is feasible for someone in the family to call and help with this. Some pharmacies and services also package pills in easy-to-use dosages (one of our local pharmacies delivers them right to the client, packed in easy to tear off packets with all the pills for a specified time).
For other clients, especially with cognitive deficits, a more extensive solution may be needed. There are some wonderful technologies, such as electronic pill dispensers that are pre-loaded and dispense the meds. at the scheduled time. They typically sound a reminder and have different settings to help avoid missed dosages turning in to overdoses. Additionally, some of the emergency response systems (fall buttons) have options for medication reminders. Some clients may need more hands-on, personal assistance. A home care aide trained in medication assistance can be there to serve as a personal reminder. You may want to talk to a home care agency about your Mom’s specific needs and see if a reasonable plan can be worked out…with 10 prescriptions, timing may be tough so it may require some creativity or a combination of options.
I always like to go back to the basics too. I would suggest bringing this up with your Mom’s doctor (or doctors?) and asking if there are any ways to streamline the medication routine. When pills are prescribed over time (and sometimes by different specialists), the doctor doesn’t have a really good picture of how complex this can be, and obviously at this point there have been adverse effects which make this a priority. Can any of the pills be eliminated? Can some of them be taken at the same time, or a larger dosage be taken less frequently? If a review hasn’t been done recently, it is probably a good idea anyway with such a large # of medications. There are consultant pharmacists who specialize in medication reviews.
Shannon Martin, M.S.W., CMC
Aging Wisely, LLC
Clearwater, Florida 33756