Too many medications to manage

Mix of pills in the hands of a senior
Posted 11 June 2018 by Fallon Health

This is the first in a series of posts on medication management. The next post explains how to help your loved one manage medication.

By Mojgan Haji, Pharm.D., RPh, and Katherine Loomer, Pharm.D., BCACP

If your loved one is over 65, chances are good that if you take a look at their medications you’ll find at least five different prescriptions. Maybe more. Especially if you count up the over-the-counter (OTC) and herbal remedies.

Even in the best of circumstances, it’s easy to get confused and make errors when dealing with so many medications. Do I take that one with food? Is this one expired? Should I take two later since I forgot the morning pill? Uh oh … was that supposed to be stored in the refrigerator?

A person who has difficulty reading labels, following instructions or remembering things is more likely to make an error. And medication errors can have serious, lasting or even lethal consequences.

Should you be helping with medication?

If someone you care about is finding it difficult to manage medications, you may be able to make it easier, even if the person is reluctant to have your help at first.

There are certain signs you can look for, to see if you need to step in:

  • Is your loved one forgetful? Easily confused?

  • Are pill bottles or blister packs difficult to open?

  • Is your loved one able to read the labels?

  • Can your loved one tell you what prescribed medications are for and how to take them? And explain how to keep medications organized?

  • How are medications stored? They should be orderly. There should NOT be:

    • Expired drugs
    • Unopened pharmacy bags
    • Plastic bags with assortments of mixed medications
    • Numerous OTC medications and dietary supplements not recommended by a medical provider
    • Duplicate medications

  • Are health conditions under control?

    If conditions like diabetes, asthma, chronic obstructive pulmonary disease (COPD) and high blood pressure are not in check, it could be because your loved one isn’t taking medication as prescribed. If that’s the case, find out if there are specific barriers keeping them from taking their medications.

  • Are the same medications appearing in multiple forms?

    Acetaminophen (also known as Tylenol) appears in many multi-ingredient medications. Formulations for cold symptoms, migraines or pain, for example, often have acetaminophen as one of their ingredients. Taking them in combination with plain Tylenol tablets can be dangerous.

If medication is properly managed, your loved one has an opportunity for continued independence. We don’t recommend taking over medication management for someone who’s doing fine alone.

Tips for offering to help

If your loved one is struggling, you—or someone else close to the person—may need to step in to manage their medication. Maybe they need just a little bit of help to get back on track. Or you may need to oversee the situation very closely.

In either case, it’s important for your loved one to retain a sense of control, as much as possible, even if others manage a lot of their care. Here are a few suggestions for approaching the situation:

  • Try presenting your help as a way to take the task off your loved one’s plate, so they have room for other things that are more enjoyable.

  • Explain that having help can enhance their safety. If there were a mix-up between pills or your loved one forgot to take medication, it could be dangerous. Adverse reactions due to medication can result in falls, depression, confusion, hallucinations, malnutrition or other serious situations.

  • Alert the primary care provider to the situation, if you encounter a lot of resistance from your loved one even though it’s clear that they need help. Sometimes a suggestion is accepted more easily if it comes from a physician.

  • Find out if your loved one’s health plan offers a medication management program.

Some people feel overwhelmed by being on so many medications, and they’re relieved to have help in keeping them in order and taking them appropriately. Your loved one may feel that way, too, and be glad you brought up the topic.

Mojgan Haji and Katherine Loomer manage Fallon Health’s Safe Transitions, a medication therapy management program designed for members transitioning home after hospitalization.

How did YOU bring up the topic of managing medication with the person you care for? How did you know it was time to start helping with this task? Share your ideas in the comments section below.

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