One of the best ways to help your aging parent stay independent is to help him or her manage medications. Not following the doctor’s recommendations is a common cause of preventable problems. It is a common cause of falls and hospitalizations. It can also be the difference between generally good health, or a significant decline.
There are many ways that people end up “mismanaging” their meds. Your family member may forget to take his or her pills. He or she may not take them due to concerns about costs. Or, your relative may take too many, take them at the wrong time or in the wrong combination. Although medications can be helpful, they can also have difficult side effects. And medication regimens can be complicated.
Below are some insights to assist you in helping your relative manage medications effectively:
Fill in this form and one of our caring staff will get back to you.
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.
What reasons seem the most likely in your relative’s situation?
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. There are special, national services you can sign up for, where, 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.
Which of these strategies seems like the easiest one for your loved one to try?
There are many reasons why your loved one’s medicines might change. A stay in the hospital is one of the more common reasons. But sometimes a new drug comes on the market that the doctor thinks would be better. Or the pharmacist may have found one that has fewer side effects, or is a more affordable option.
It can be confusing when routines change. But not taking all the medicines, or not taking them when they need to be taken, can result in your loved one getting worse.
Be sure you understand:
Which new medicines have been added (what they are for, the strength of the medicine and how often it should be taken).
Which medicines have been dropped.
Which medicines remain but have been modified in some way. For instance, they now should be taken at a different strength or at a different time.
And don’t forget over-the-counter and non-pill types of medicines. In addition to prescription medicines, you should ask about changes in over-the-counter preparations. The pattern of taking vitamins, herbs, and simple pain relievers may also need to be changed. Plus, don’t forget that some drugs now come in the form of a patch. Others are syrups. And still others are delivered through an ointment or cream. Be sure you include these in your thoughts as you confirm the new medication schedule.
Especially after a hospitalization, your loved one may need help keeping track of the new medications, until the new regimen becomes a habit. Here are other ways you can help to be sure that your loved one continues toward a strong recovery:
Before leaving the hospital, make sure you understand the new medication schedule: what’s new, what’s been dropped and what’s been modified.
Be sure to get a good supply of any new medicines. If you don’t purchase this at the hospital pharmacy, stop by your pharmacy on the way home. Pick up a solid supply so there is no gap in dosage when your loved one gets home.
When you get home, compare the new medication schedule with the old one. Is there anything missing that surprises you? Quite often the hospital didn’t know about a medicine your loved one was taking when he or she was admitted. Just because it is not on the hospital discharge list does not mean the medicine should be stopped. If there are medicines your loved one was taking before, call the doctor. It may be that it simply was forgotten in the hubbub of the admission process and needs to be restarted now that your relative is home. If you are not sure, try calling the pharmacy and ask for a medication list. (Ideally your relative gets all medicines from one place.) The pharmacist can also help you compare the old list with the new. They have a lot of experience with this!
Set out a good week’s worth of medicine ahead of time. Use a pillbox that has a tray for each day. Preferably there’s even a tray for morning pills. One for mid-day. And one for evening or night. You may need to fill the pillbox until your loved one is fully recovered and has mastered all the changes.
There is a much smaller chance for errors if you reduce distractions when filling the pillbox. The television, conversations or trying to do other things at the same time simply increases the chance of error. Medication errors are one of the most common causes of hospitalization, and re-hospitalization. You can avoid that by giving the pillbox your undivided attention when you fill it once a week.
Write out the new medication schedule and post it by the pillbox. Put the date on it. Ideally, you would also keep a copy for yourself and have your loved one carry a copy in his or her wallet. Be careful, though. Medications change often. If they do, you will want to update all the written lists. Or, you might consider an online medication tool. That way you only have to update the list in one place and anyone with the password can access the most current list from anyplace where there is an Internet computer.
What medicines changed? How does that disrupt your relative’s routine? What might you do to help create a new routine?
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 misuse and side effects.
To safeguard your loved one and minimize the hassle of medication management, check out free web-based and smartphone apps. Each one has its advantages and disadvantages. For example:
Caring Village offers a medication list and refill tracker as part of their free set of online tools for family caregivers. You can create a medication list with dosages, images of the pills, and even the ability to upload a photo of the pill bottle.
Advantages. This information is accessible from a computer from anywhere, by anyone you have given the password to. Good for your loved one if he/she is not smartphone savvy.
Disadvantages. The printout is primarily a list of the medications—good for doctor visits—but not a schedule of what to take when. The pill images and pill bottle photos do not come through on the printout.
MyMedSchedule Plus is a mobile app downloadable from the Apple Store or Google Play. It allows you to carry all medication information in your phone. Among its features, you can:
Create an at-a-glance chart of medications to be 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.
Charts include a summary list, a list by time of day (great for filling pill boxes), and a checklist for keeping track of which pills are taken when each day.
Email charts so you can print out a full-size, wallet-size, or even large-print version for easy reference.
Update information quickly and 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 or by text.
Refill reminders are available by email or text message.
Keep everyone informed. You can readily share information by emailing or texting printable schedules to others. Before Dad goes to visit your sister this summer, bring her quickly up to speed.
Advantages. Many different formats with very useful views (for filling pill boxes, talking to the doctor, etc.)
Disadvantages. If the person you care for does not have a smartphone, they will be dependent on you to keep them supplied with current, printed out schedules.
Our family worked with Marsha Raines of Aging Well Rochester at a crucial moment when our mother was experiencing a decline in her physical capacities after living on her own for most of her adult life. Marsha was our guiding light throughout the process: explaining, with compassion, the various options for Mom; guiding us through the application process for both rehab and long-term care; and ultimately, settling Mom in at her wonderful new home where she is safe, comfortable and happy. I wholeheartedly recommend Aging Well Rochester!
Was connect with Marsha from Aging Well Rochester while searching for assistance with understanding the system and what is needed for elder parent. Marsha provided me with information, guidance, and took the time to explain differences between assisted living, independent living, and what questions to ask while interviewing for a new home for my mother. Valuable information. Marsha continues to follow up to assist if needed. Very pleased and so glad found Aging Well at a crazy time.
Coming to grips with a parent's decline and figuring out how to meet their needs can be a terribly stressful ordeal. Marsha and her team made it vastly less so. Marsha's calm demeaner, wisdom and professionalism were invaluable during the 8 months during which my father's needs were rapidly changing. She has a wealth of knowledge about resources available in the community and was able to bring them to bear quickly. I will be eternally grateful for the emotional support she provided during the entire journey.
At a time when you don't know what you don't know, Marcia knows! She asks the right questions, narrows the choices, and provides direction. She definitely helped us feel more confident as we moved forward, and she was thoughtful enough to follow up to be sure we were making progress. Highly recommend.
Marsha and staff were exceptional in their guidance though the difficult and unfamiliar journey of finding quality care for our aging parents. For over three years, they were able to anticipate needs, advocate for our parents, and provide support for them through various crises. We are so thankful for their expertise and compassion through all the changes. We highly recommend Aging Well Rochester to anyone seeking help with aging loved ones.
I just want to thank Aging Well Rochester for their assistance to complete an urgent PRI for my stepmother and also one for my father in case we needed it. The nurse went above & beyond to do that for us as we fortunately found a bed quickly for my stepmother. All went well & she is now receiving wonderful care at St. John's Home. Thank you Marsha and your staff - you made a difficult situation much easier.
Marsha Raines was incredible--responsive, caring and very knowledgeable. She helped me navigate options and provided excellent counsel. I highly recommend Aging Well to you if you are facing a difficult and emotional situation with a loved one who needs ongoing medical/rehabilitation placement and services. Marsha exceeded my expectations. Christine L.
Our initial consultation with Marsha Raines was very informative as it provided our family with a starting point concerning a long term care plan for our aging father. Her knowledge, experience and compassion allowed her to assess where each of us were in dealing with the emotional stress of the situation and provide recommendations to get us moving in the right direct with a long term care plan. Marsha helped us narrow our focus to ask the right questions regarding our next steps in care for our father. Thank you Marsha!
We were exceptionally fortunate to have Marsha Raines of Aging Well Rochester assist us in placing my wife in an appropriate facility. She guided me through all the paperwork, answered every question I had and resolved every impediment that we found in the process!Thanks so much Marsha!
We received great service from Marsha. Highly recommend. Navigating rehab and long-term care can be daunting. Marsha breaks down the ins and outs and helps bring the family to consensus on the best next steps.
Our family reached out to Aging Well Rochester for an understanding of the options and to seek clarity as to next steps for our elderly father regarding his future care. Marsha provided our family with the assistance, guidance and resources necessary to make a decision that was best for our father. Marsha's response to e-mails and phone calls was always in a timely manner and we truly appreciated all of her knowledge and expertise and would not hesitate to recommend Aging Well Rochester!!
Marsha understands the world of aging and the decisions that need to be made. She has both the education and experience to navigate a complex system to secure the best care as well as the expertise to guide throughout the process. My wife and I are grateful for her depth of knowledge, experience, skill, and compassion. We plan to use her as a resource for years to come!
Marsha Raines and her team have been a gift to my family. I'm on the West Coast, and her local knowledge has been extremely valuable in locating care options and knowing what to look for. Her direct style does not shy away from talking about tough issues, and in fact, makes it easier to devise a care plan. Marsha is a gem.
I truly appreciate the advice Marsha has to share. She has a great way of putting things into perspective and knows her stuff! Thank you for the advice, help, and input while trying to figure out the next steps with my parents.
I hired Marsha Raines to help me find the best Nursing Home for my husband. She was professional, quick to answer any questions I had, told me all I needed to do, and quick find him the right place. She was extremely helpful and compassionate with this difficult undertaking . I highly recommend anyone searching for a home for their loved one call Marsha before doing anything else!
Marsha level of expertise in this field has been tremendous. She explained the changes that occurred in the nursing homes industry. She took the time to research nursing homes for me and this afforded me time to focus on my mother's medical needs. I found Marsha to be resourceful and committed to helping me through this difficult time. I would highly recommend her service to you.
We moved our mom to a memory care residence, and in just a few short weeks we realized that it was not the right place for her. Distraught that we had made a horrible mistake, we needed help. I contacted Marsha and she met with our family to help sort things out. She took our concerns seriously, consulted with other industry professionals to assess our mom, and found us a better place for her. Just two weeks later we were able to move mom to a wonderful residence that cares for her properly and gives us all peace of mind. We are so grateful for Marsha and her ability to navigate the challenging world of eldercare on our behalf.
My husband, Bradley, needed to be moved to an adult home due to my inability to continue caring for his needs. I had no idea where to turn until Marsha Raines name was given to me. It is very difficult to navigate this process while you are under stress and her kindness and actions got the process started making it much less painful. I highly recommend her for her insurance knowledge which was extremely helpful to me.Mary Ellen Hindson, Rochester, NY
Marsha Raines assisted our family through the most trying time of our lives with Mom. She was extremely knowledgeable about placement, finances local care available and placement. She was personally involved in contacting the care facility to assist in mom getting placement.Her recommendation of the Presbyterian Home was spot on. All grants recommended came through and we were able to continue her care until she passed away.Thank you Aging Well. I would recommend her services highly.
My parents needed more assistance than I could give working full-time in another state in 2015. They were facing medical issues and needed to move out of their beloved home of 60 years. Since then, Marsha and her team have been instrumental in supporting my parents, and me, through good times and bad. They arranged movers, set up and attended doctor appointments, arranged for aides and companions to assist my parents in living safely and independently, and checked in on them to be sure they were comfortable and happy. Marsha has been an incredible resource to me, providing information and advice when needed in a direct yet sincere manner. I feel relieved to know that Marsha is there to help when I can’t be, keeping me informed, and checking in when needed. She is an incredible resource and advocate for the elderly and their families.
I contacted Marsha two weeks ago. I quickly learned that a PRI, exam to determine the level of care was needed to go into a nursing home. I was given 10 local agencies that could do it. I chose "Aging Well". Marsha was so personable on the phone, getting all the fact. She was able to arrange the exam in 5 days. The nurse showed up on time and my aunt chatted away. Two days later I got an urgent call from my aunt begging me to find her a new place immediately, she had a horrible weekend and wanted out. So, I called Marsha back that same day and asked her to take our case on and help get my aunt placed ASAP. She was pleased to help. She sent me the 3 applications to the facilities my aunt wanted by the end of the day. She kept in close contact with me the next couple of days with words of encouragement while I scrambled to get the information. I submitted the first one. Marsha personally went into the facility and spoke to the intact person giving her more details of my aunt. 5 days later, I moved my aunt into the facility she wanted. Here is a photo of her reaction. Marsha is focused, very knowledgeable, explains the process well, upbeat and is very encouraging. I would work with her again in a heart beat. She is the best.
I have worked with Marsha for 5 years now and have been consistently impressed with her diligence and dedication to providing top notch innovative and caring service. She creatively reaches out to others in the community to put together programs that will provide her clients with the high quality care they need and deserve. She is an extremely responsive and creative care manager!
I have been working with Marsha since 2008 planning for the aging process and various transitions for my parents.She has always been incredibly helpful, knowledgable and available. Over the years she has grown the organization, but still maintains that level of support. Her manner is caring and supportive yet direct, a quality that I have found very comforting and helpful during stressful transitions. I can't recommend highly enough.
Aging well Rochester did an AMAZING job of helping my family deal with my experience and Hospitalization with Covid 19. Marsha worked with my children and family and the hospital staff to make sure that I would receive the care needed upon my return home. I can't thank them enough for making this experience as easy as it could be.
Living more than 500 miles away from Rochester, visiting my mother as often as we would like was a challenge. Luckily I found Marsha Raines and her colleagues at Aging Well Rochester. Their visits to my mom were so frequent and warm that the staff at the nursing home thought they were family! Actually that's how we think of them. In addition to the care and support for my mother, the feedback and advice Marsha and her colleagues provided us was always timely and helpful. I consider the day I found Marsha to be one of my luckiest. I can't imagine the last few years without Aging Well Rochester! Thank you for enriching my mother's life and ours.