Q: I have been helping my 80 y.o. mother with her medications, by putting them in the daily pill boxes, calling and making sure that she’s taken her pills for the day, etc. But I’m growing more and more concerned about whether she is taking her medications properly. Some days I will find a pill on the kitchen counter, or one on the floor. There are times that all the medications from the previous day are still in the box. Or I find that the pills for the next day have been taken.
Her memory isn’t the greatest, and I don’t think that some days she knows whether it is Monday, or Tuesday, so I wonder how she would know if she is suppose to take the Monday pills, or the Tuesday pills.
My mom lives by herself. I’m just wondering if there is a better way to ensure that she is taking her pills properly?
A: You are correct in being concerned about your mother’s compliance with her medications. The problem of medication errors among the elderly is widespread, with statistics showing that 30%-50% of hospital admissions of older adults are due to drug-related problems, or what is referred to as ” Adverse Drug Reactions” (ADRs).
Adverse drug reactions in older adults are most often caused by frequently missing pills due to the person forgetting to take their medication, or from the person forgetting that they did take their medication, and then taking additional. Therefore, both over-dosing and under-dosing is a problem.
The average older adult is on at least 8 different medications; with research showing that medication compliance decreases as the number of medications increases. This makes the chances of having an adverse drug reaction (ADR) from medications 7 times more likely in those 70-79, and is experienced more severely by the elderly, than younger adults.
Common results of ADRs in older adults are depression, constipation, falls, immobility, confusion, and hip fractures. Problems with adverse drug reactions (ADR) in hospitalized older adult patients have been associated with significantly prolonged lengths of stay, increased cost, and an increased risk of death.
Another interesting finding is that many older adults have no insurance coverage for prescription medications. The cost of medications has repeatedly been found as a reason for an older adult’s intentional failure to adhere to, or comply with their prescription. This suggests that an older adult’s inability to pay for a medication may be leading them to use less, buy less, or ask for samples, which in turn, may result in miss-dosing, or under-dosing.
So, what can you do to help ensure your mother is taking her medications correctly?
It has been my finding that the best system to use when assisting the memory impaired, or a medication-resistant person, is an electronic medication dispenser. These dispensers can hold up to 28 days of medications, and they are programmable and lockable. Such systems help prevent the chances of double-dosing, and come with additional features that include a red flashing light and a modem that will call emergency numbers if medications are not taken properly.
By using a medication dispensing system such as this, you not only will give yourself the peace of mind that your mother is taking the right medications, but you also help preserve her independence.
There are several manufactures of electronic medication dispensing systems, which can be easily found and ordered on-line. The Alzheimer’s Associations website http://www.alzstore.org has a listing of some, and then there is E-pill, at http://www.epill.com/pillbox.html.
Also, the use of external and/or internal cues can further assist your mother in taking her medications properly, such as:
– leaving pills in a prominent place
– planning medications to be taken around activities at the beginning of the day
– associating the taking of certain medications with daily activities such as taking medications with a meal, or taking the daily vitamin when brushing teeth in the morning.
– keep a copy of medications posted in a convenient place for easy review.
Some final recommendations to help you prevent the chance of an adverse drug reaction. Whether you’re assisting an older adult with their medications, or just wanting to ensure your own proper dosing, you should keep a copy of all medications with you, and have it reviewed and updated at each doctor visit.