A family caregiver’s medication management checklist
By ALICIA SCHWARTZ R.N. and Care Coordinator, VNSNY CHOICE Health Plans | 3/22/2018, 11:36 a.m.
Picture your elderly father living alone and seeing a doctor for several chronic conditions, and his latest checkup has you troubled. His high blood pressure has been creeping up again, chronic pain seems unmanageable and, concerned about keeping diabetes under control, the doctor has prescribed new medications. When you stop by for a visit with your dad, you encounter unopened prescriptions and over-the-counter medications, half-empty containers of outdated drugs and an assortment of loose pills you cannot even begin to decipher.
For many caring for an older loved one with several chronic conditions, this scenario might be heart-breaking and familiar. With more than 83 percent of people over the age of 65 taking prescription medications, the possibility of mismanagement—including overdose or under dose—is a growing concern for family caregivers. Although balancing several medications can prove difficult for anyone, risks for the elderly can be complicated by memory loss as well as vision and hearing impairments.
The average senior takes more than five different pills daily, not including over-the-counter drugs or supplements, which can leave them more vulnerable to adverse reactions. In fact, researchers at the Centers for Disease Control and Prevention found that senior citizens are twice as likely to visit the emergency room because of adverse drug reactions as their younger counterparts.
At VNSNY CHOICE Health Plans, my colleagues and I work closely with those in our care and their family caregivers to reconcile all medications after a doctor’s appointment or trip to a specialist. We use new electronic medical record systems that send reminders and alerts to keep patients on schedule. You can help your loved one manage medications safely, too. Here are a few guidelines to help navigate medication adherence with family members and their doctors or pharmacist:
- Make a list. Keep a personal record of all the meds your loved one is taking, including the name of the medication, the dosage instructions, the reason it was prescribed and the name and number of the doctor who prescribed it. Don’t forget to include over-the-counter meds and herbal supplements, too. If your loved one’s medication regimen is too complex to keep track of, ask your doctor if a service such as MedMinder, which sends caregiver alerts when a dosage is missed, might be something to try.
- Take all medications to all of your doctors. An estimated 100,000 older Americans are hospitalized for adverse drug reactions yearly, and three of the most commonly prescribed drugs— insulin, the blood thinner warfarin (aka Coumadin) and the heart drug digoxin—are most often the cause, according to a study by researchers at the CDC published in the New England Journal of Medicine. If you or your loved one is unsure about any prescriptions, put everything in a bag and take them to your doctor. Ask for help figuring out what you are taking and why, to avoid taking medications incorrectly. Being knowledgeable about your meds is the first step in preventing medication errors. Most importantly, don’t leave the doctor’s office without an updated list of all your meds. The doctor might have changed or discontinued a prescription, and it is easy to forget such changes by the time you get home. For added assurance, share the list with your pharmacist, who can help keep track of and adjust medications, too.
- Ask questions. Don’t be afraid to speak up. Every time a new med is recommended or prescribed, ask the physician and pharmacist these key questions: Why has this drug been prescribed? How does it work? How can I tell if the drug is working? What are the possible side effects? Is this drug safe to take with other prescriptions and over-the-counter drugs? I also recommend asking about the risk of taking medications with different foods and drinks. Something that seems innocent may cause an adverse reaction. Grapefruit juice, licorice, chocolate, alcohol and other food and beverages are known to increase side-effect risks with certain medications.
- Change dosage. Overwhelmed? Ask your prescribing physicians about possibly lowering the number of different pills taken throughout the day. Studies show that the more pills a person takes, the less likely they are to adhere to the schedule and dosage.
- Store smart. Don’t keep your meds in the bathroom or the kitchen. Many people are unaware that moisture and heat in these areas can affect medication potency. Knowing how to properly take and store your medications not only helps them work more effectively but also could save your life.
And remember, It’s OK to ask for help! According to the Family Caregiver Alliance, family caregivers spend an average of more than 24 hours per week solely providing care! It’s not a sign of weakness to ask for help. Speak with your doctor if managing medications is becoming a problem. In addition to the solutions mentioned here, you may be eligible for assistance from a licensed home care provider such as VNSNY or Partners in Care. Even a home health aide who comes once a week can provide helpful reminders for forgetful loved ones—and that can bring everyone peace of mind.