Managing Medications

Why Mom may not be taking her pills

Did your parent teach you to "do what the doctor says"? If he or she is not following doctor's orders for medications now, you're probably feeling confused. And concerned.

It's common for patients not to take pills as directed. Some reasons include:

• "It's too costly." One quarter of new prescriptions are never filled because of cost. Make sure the drug is on the insurance plan formulary. Or ask about generics. Find a discount pharmacy, or consider mail order.
• "I feel fine." Many illnesses lack noticeable symptoms. High blood pressure and high cholesterol, for example. These prescriptions often go unfilled. Many people don't finish their antibiotics for similar reasons: the symptoms went away. Ask the doctor or pharmacist to review with your loved one why a medication is necessary.
• "It made things worse." Consult with the doctor or pharmacist. Reducing the dose or changing from morning to evening may fix the problem. Or taking a different medication may be advised.
• "It was too complicated." Some drugs require multiple doses in a day. Others are restrictive ("30 minutes before eating"). Ask the doctor or pharmacist about alternatives.
• "I can't get the bottle open" or "I can't read the label." Arthritic hands and poor eyesight can make it difficult to follow directions. Ask the pharmacist for large type on the label and a NON-child-proof container.
• "Why bother?" Hopelessness and depression are common reasons why people don’t take their medications. If you suspect depression, ask the doctor to do an evaluation.
• "It won't do anything." Perhaps your loved one has an entirely different interpretation of what is wrong. Consider using the motivational interviewing techniques described in our article, "Your changing role: Partner-in-care." The discoveries you make in the conversation can help you increase the likelihood that he or she will follow the doctor's orders.
• "I forgot." Simple memory lapses are a fact of aging. The next article discusses ways you can help your parent to remember.

Tips for remembering

It seems that the older we get, the more pills we take. Remembering to take them, and to take them on time, can challenge even the sharpest mind.

If your loved one has occasional memory lapses, getting into a good routine for taking medications might be all that's necessary to stick with the doctor's recommendations. Some suggestions:

• Keep pills in sight. Good places might include the kitchen table or counter, or a bureau top. Keep them away from direct sunlight by a window or a steamy room, such as a bathroom.
• Link with other habits. Work with your loved one to associate pill-taking time with other routines, such as morning coffee or brushing teeth.
• Use a pill box. Pill boxes organize daily doses for a week. The simplest have seven compartments. Others have two or three compartments per day for am/pm doses.
• Add an alarm. Consider a pill box or a wristwatch with an alarm. Or program your loved one's cell phone to ring a specific tone when it's time to take a pill.

More active support may be necessary if your loved one has ongoing memory issues. Among the options available:

• Automated pill dispenser. These dispensers sound an alarm and open a dispensing drawer when it is time to take a pill. Some can notify you if a dose is skipped. Check the federal government's database of available products.
• Telephone reminder. For a monthly fee, your loved one receives timed, daily phone calls and an automated message to take his or her medications. Some services will notify you if the phone is not answered.
• Email or text message. MyMedSchedule is a no-cost, online service that provides email or text reminders. Or check online for smart phone medication apps.
• Personal medical alert. Many home-based medical alert systems include an optional medication reminder service.

Online tool for managing medications

Older adults with chronic disease commonly take at least five medications daily. That's a lot to keep track of! And it's one reason seniors are at high risk of medication overuse, underuse, and side effects.

To safeguard your loved one and minimize the hassle of medication management, check out the free Web-based tool at MyMedSchedule.com. Among its features, you can:

Create an at-a-glance chart of medications taken daily.

• You enter the medication, dosage, and time(s) it should be taken. The program adds generic and trademark names and a color photo of the pill.
• Print the composite chart in English or Spanish in full size, wallet size, or even large print for easy reference.
• Learn usage guidelines for each selected medication.

Update information quickly, easily. When a prescription changes, make the change in the existing schedule and print a fresh copy. No more rewriting of lists!

Receive a reminder to take a medication. It's easy to help Mom stay on track—from across town or across country. Have reminders automatically sent by email to your computer or by text message to your cell phone. Ask for refill reminders, too.

Access information anywhere, anytime. You can access your loved one's medication schedule anywhere via computer. It works on some smartphones, too. No extra software is required.

Keep everyone informed. Online or in your pocket, you can readily share information. Before Dad goes to visit your sister this summer, bring her quickly up to speed. When you're meeting a new doctor—whether in the ER or in the office—the schedule presents comprehensive information at a glance. What a convenience for travel this summer!