Medication management for caregivers

Tips for caregivers of aging parents and elderly adults

Caring for and aging parent or elderly loved one can be challenging when it comes to managing healthcare and medicine routines. If you are a family member caring for an aging relative, it’s easy to become overwhelmed not know where to start, or lose track of priorities. Knowing the facts about medicines and older adults will help you become a better and more informed caregiver. Many adult children who are caregivers for frail parents have primary responsibility for administering medicines. Yet even active older adults who care for themselves may need help in taking medicines safely and appropriately. Here are some ideas for helping parents and older adults to make good use of their medicines, regardless of their age and health.

If you are not sure if the older adult in your life needs support with medicine or other healthcare issues? Ask! Don’t assume that medicine management is under control. The majority of older Americans take multiple medicines each day, and with the help of their medications they can live longer, healthier lives. Yet because older people often take more medicines than other age groups, they also have a greater potential for adverse reactions to their medicines.

Checklist of questions to help figure out if the older adults in your life may need help managing their medicines 

  • Is he or she older than 75?
  • Does she or he have more than one medical condition?
  • Does he or she use more than one medicine?
  • Does she or he have any problems seeing, hearing, strength, or getting around the house?
  • Does she or he have memory problems?
  • Is this person no longer able to drive himself/herself or walk safely to a location where medicines are available?

If you’ve answered “yes,” to any of these questions the older adult in your life may need some support from another person such as a family member or caregiver to take their medicines on schedule.

So where do you start?

Start with a team approach. Whenever possible, work together with your parents or the person in your care to establish healthcare goals and develop plans to accomplish them. Involve other members of the family, such as siblings. These conversations should include a discussion about how to manage their medicines.

Talk to your parents about their medicines. Find out: 

  1. What medicines they take and for what conditions.
  2. How often they take the medicines and how they take them.
  3. If they feel the medicine is helping.
  4. If they have fallen more often, been more groggy or sleepy, or been less hungry since taking the medicine.
  5. If they have any problems in taking them, such as forgetting a dose, being unable to tell the pills or capsules apart, having annoying side effects from the medicine.
  6. If they feel they have enough information or instructions for taking the medicine.

Use this checklist as a starting place to help older parents and older adults use medicines safely, to maximize the benefit of the medicines they take and to reduce the risk of side effects and drug interactions: 

  1. Know what medicines are being taken. Recommend that your parents go to one pharmacy that can maintain records of all their prescription medicines. Such records can help avoid a drug interaction or remind your parent to renew a needed prescription.
  2. Start and maintain a medicine list at home with the name of each medicine and other important details. This is important to have on hand for doctor appointments or urgent care/emergency room visits.
  3. Go to medical appointments with the person in your care, if possible, to offer support.  Share any concerns or problems with his/her medicine. Be sure to take notes that you can review later.
  4. Encourage the older adult to share any concerns or questions with his or her healthcare providers. Encourage them to write down in advance of their medical appointments any questions or concerns they have about their condition or medication, and to take notes on what the doctor says. At each healthcare visit, encourage them to ask questions. (See NCPIE’s 10 Questions to Ask About the Medicines You Take)
  5. Read and review all medicine labels with the person in your care to understand potential side effects or drug interactions.
  6. Ask if he or she can read, understand, and follow dosing instructions.
  7. Ask if he or she needs help with developing a medicine schedule.
  8. Read the medicine labels to check if drug interactions are possible between any of the medicines the patient is taking, if more than one medicine is used.
  9. Ask the older adult to show you how he or she takes his or her medicine. Try to determine if any intervention or instruction is needed to change a pattern that isn’t safe or accurate.
  10. Discuss the importance of not making decisions about medicines alone, without a healthcare professional’s guidance. Suddenly stopping some medicines can be very dangerous, for example
  11. If your parents have vision problems or difficulty with written English, suggest color-coding each prescription bottle and putting the same colors on a chart that gives directions for using each different medicine they take. Suggest that they ask the pharmacist for large print labels. If fine motor skills or arthritis is an issue, ask your parents’ pharmacist to dispense their medications with non-child proof caps (remembering, however, that it is essential to store all medicines up and away and out of sight if young grandchildren are around.)

Watch for side effects or adverse reactions that could be confused with signs of aging

Many times people mistake undesirable effects of medicine for the “natural” effects of aging. Consider the possibility that any of the following may be caused by medication:

  • Agitation or anxiety
  • Confusion or memory loss
  • Fatigue
  • Decreased sexual drive
  • Depression
  • Weakness
  • Fainting or black outs

Sometimes older parents are reluctant to tell their children if they are having problems such as dizziness, which may be related to their medicines. Dizziness can lead to falls. Be sure to observe if your parents have bruises or discolorations on their body. This could be a sign of falling due to an adverse medicine reaction.

If you suspect an adverse drug reaction, talk to your parent about consulting his or her healthcare provider. Bring it to the provider’s attention yourself, if necessary. Talk to your parents about the importance of seeing their physician every 3 to 6 months for a check-up when they are on long- term therapy. Suggest that they ask the physician if their medicines are still necessary.

Work with your parents to find outside help when needed

Many services are available that can be useful in assisting older adults with their medicines. Suggest that your parent talk (or reach out yourself) to the local Area Agency on Aging, Visiting Nurses Association, or the American Society of Consultant Pharmacists to find out about:

  • A formal, in-home evaluation by health professionals of medication status and needs.
  • Regular telephone contacts by volunteers (who could help remind about and monitor medicine-taking and reinforce positive habits).
  • Periodic home visits by health professionals to monitor progress, give advice, or teach skills related to medicine use.
  • Classes in the community that teach older adults to coordinate their own care and manage their medicines wisely.

Be helpful, but don’t take responsibility for your parents’ medicine use if you don’t need to

As long as your parents are not confused or forgetful, it is healthy for them to stay in charge of their own lives. They may welcome your interest and assistance if you let them know that your role is supportive. Look for natural ways to bring up medicine issues and be diplomatic.  Just like supporting a loved one who might be trying to lose weight or give up smoking, it is important not to criticize their use of medicines. A positive, supportive approach works best.