Medication Management – Keeping it Simple

Taking medication the way it was prescribed seems like such a simple task.  Then why is it such a problem for the elderly?  Consider the fact the most elderly take multiple medications, often more than once a day, prescribed by various doctors, for a number of medical conditions.  Add supplements into the mix and you can start to imagine the number of pills an elderly adult must juggle.  There are several ways that can make medication management safe and easy.  

1. Make sure your doctor and your pharmacy know your drug allergies.
2. Set up your the medications in a weekly pill box.  This serve as a reminder for each day’s medication
3. Discuss your medication with your physician. Take all of your medication (even the supplements and over-the-counter drugs) to your physician at each visit. This allows them to review all the medications and make adjustments as needed.  
4. Have all your prescriptions filled at the same pharmacy. This will allow the pharmacist to check for drug interactions and appropriate dosing.
5. Medications have more than one name – the brand names and the generic name.  This means the same medication may have several different names and types of packaging.  If the pharmacist gives you a pill that looks different than the one you are used to, ask for an explanation.
6. Always take your medication as prescribed by your doctor.  Make sure you know what to do if you miss a dose.
7. Talk to your doctor about the possible side effects of your medication so you know what to look for.
8. Always check with your pharmacist before taking over the counter or herbal medications.
9. Keep an updated list of your medications, dosage and frequency in your wallet.  That way if you go to the urgent care or the emergency room, you will be able to provide them with a current medication list.  Write your drug allergies on this list in red ink.

If you are setting up pills for a person with dementia:

1. Keep the extra medication locked up or off-site.
2. Set up medications in a weekly pill box, but keep it out of site and take out one dose at a time.
3. Watch the person take their medication.  It is common for people with dementia to spit their medication out or hide it.

If you have a loved one with memory loss, it may be beneficial to consult a Geriatric Care Manager to assist in developing a plan for medication management.  The Care Manager can help you determine the best plan for medication management, including devices that dose the medication throughout the day.  With a little planning, medication management can become an easy routine and your chances of a problem will significantly decrease.

How to Introduce a Caregiver

As our parents age, we are often faced with the reality that they are no longer able to safely care for themselves.  This may be due to a physical imparity or a cognitive deficit.  Unfortunately, many times our parents do not recognize their own deficits and believe they can care for themselves without assistance.

So what do you do when Mom or Dad needs help and they are resistant to the idea?  What if they flat out refuse any help?  These situations can be difficult for everyone involved.  One option is to introduce a Geriatric Care Manager into the mix.  The Care Manager can look at the situation objectively, without the emotion and history of a family member and make recommendations that are in the best interest of the client.  They can also make recommendations for a specific strategy of introducing caregiving services, if that is determined to be necessary.

Once the decision has been made to introduce caregivers into the home, it should be done gradually.  Four hours a day, 3-4 days a week is often a good place to start.  Once your parents adjust to this situation, the number of hours and the number of days per week can be increased gradually until you have the caregiver in place as much as you need.  Be patient.  It can be hard for your parents to adjust to a new person their home, especially if they don’t believe they need any assistance in the first place.

Enjoying the Holidays with Memory Loss

A person with memory loss needs structure, routine and a calm environment.  These things are sometimes absent during the holidays.  If you have a loved one with memory loss, there are ways to make the holidays enjoyable for everyone.  Experts at the University of California, San Diego, offer the following tips:

• If an older family member tires easily or is vulnerable to over-stimulation, limit the activities or length of time that person is included in the festivities.
• Consider planning a nap time or providing a "quiet room" where an older person can take a break from the noise and confusion.
• If there's a get-together at the home of someone with memory impairment or behavioral problems, don't rearrange the furniture. This could cause confusion and anxiety.
• If the family function is somewhere else, remove slippery throw rugs and other items that could be hazards or barriers to people who have difficulty walking.
• Avoid comments that might embarrass someone with short-term memory problems.
• Involve everyone in holiday meal preparation, assigning tasks to include the youngest and oldest family members.
• Make sure that older people adhere to their regular schedule of medications during the holiday hustle and bustle.
• Reach out to older relatives and friends who are alone. Loneliness in older people is associated with major depression and with suicidal thoughts and impulses.

If you have a loved one with memory loss, it may be beneficial to consult a Geriatric Care Manager to assist in developing a plan for the holidays.  This preventative plan can help keep the holidays from becoming more stressful for everyone, especially the person with memory loss.