Medication Management: Top Tips for Family Caregivers

0 Comments

Discovering that your loved one hasn’t been taking their medications properly is cause for a scare. Although a senior may downplay the severity of forgetting to take their medications or accidentally double-dosing, even minor changes in their drug regimen can yield dangerous or even deadly results. As your loved one gets older, their ability to appropriately manage their medications may slowly decline. This could be due to a change in their mental status or physical condition, or it could be brought on by a growing number of medications and increasingly complex dosing schedules. Regardless of the reason, mismanagement directly affects your loved one’s safety and is a red flag that they need some assistance.

Implementing a medication routine isn’t always met with enthusiasm, so caregivers often have to get creative with the ways they ensure their loved ones take all prescriptions, over-the-counter medications, and supplements as directed. Members of the Caregiver Forum share their tips and tricks on how verbal encouragement, fancy pill boxes, and your loved one’s favorite treats can alleviate the struggles of the infamous “pill war.”

Verbal Encouragement and Redirection

“Every time I give my mom her medications, I tell her what a great sport she is. Somehow that seems to work. As she is taking them, I talk to her about something really good coming up after she takes the pills, such as eating a muffin, which is her favorite.” –suddenlysally7

“A technique that I see staff use regularly with my dad and others in his memory care unit is, when the patients say they don’t need or want their medication, the staff just ‘forget’ about it and go away. They come back after a couple minutes and start a conversation about something the patient can discuss, like their life as a child or a trip they remember enjoying—anything that will get them remembering and talking about something. Then, while they are sharing and talking, the staff member will just hand them the pills and a drink without saying anything. They often just go along with taking them, because their mind is already focused on something else. If it seems as though they are going to focus on the pills, the staff member just asks another question about what the patient was just discussing. You may have to walk away and come back a few times for this to work. It’s called diversion. For those with dementia, it works really well to calm agitation and defuse anger. By the time you come back again or get them focused on something else, they have totally forgotten what had them upset.” –joannes

“If they are not cognitively impaired, you might consider telling your loved one that they don’t have to take medication if they don’t want to. This will give them back some of the power they have lost.” –ferris1

“My wife has been bedridden for almost 4 years with dementia. There are moments when she refuses to be cooperative. At those times, I simply change the subject. Two minutes later she has forgotten the problem and then I try again, repeating the procedure as necessary. So far that technique has worked. If necessary, I would prioritize certain medicines. Some are much more important than others.” –Dirk

“My mother, who is 76 years old and has depression, refuses to take her medications. We now tell her to please take her ‘vitamins’ because we need her to be healthy. If they are called medications, she won’t take the pills, so we started framing it in a way that she accepts.” –Jigsmoreno57

“I have had pretty good success with my mom by doing a few things. I have a daily pill dispenser so that none of the pills are in their original containers for Mom to see. Therefore they are all ‘vitamins’ to keep her healthy, because I want to keep her around as long as I can! I take mine at the same time she takes hers, even though mine really are just vitamins. I have Mom take the most important ones first, meaning the actual medication, followed by true vitamins or other meds that aren’t as important.” –RobinF

“A matter-of-fact approach may help. If you are anticipating your loved one will be uncooperative, you may be projecting doubt and they are picking up on it. Maybe start a conversation about what you both are going to do after they take their medication. Perhaps the term ‘redirect’ is pertinent here. It seems we must make adjustments often to cope with the little darlings.” –ChristinaW

“My mom is 91 and has been in the nursing home a couple of times in the last two years and in a rehab hospital. She refused her medications, mainly because the staff would come up to her with a cup of pills and want her to down them all at once. She is now very suspicious about any medication they try to make her take. I wrote a large sign and hung it up in my mom’s room that if she refused her medication they were to call me from her room on my cell phone and I would talk to her. I would tell her that her regular doctor that she really likes wants her to take this medicine and he is going to be very upset if she doesn’t. That usually does the trick.” –GayleinJaxFL

“Occasionally my mom will get annoyed at the number of pills and say ‘what would happen if I just stopped taking these?’ I tell her that she would suffer from low potassium and magnesium and slip into a coma and die. Then I tell her it is an option but not a great one. Then she shoots me a dirty look and takes the pills. I give her a similar line when she asks what would happen if she stopped going to see the doctor. No doctor, no pills, same result.” –DownSouth

Timing is Everything

“My mom has memory issues. Even though Dad would set the pills in front of her, she may or may not take them. Since they moved into an assisted living facility, she gets her pills at the same time every day. She’s improved so much that it is amazing! She’ll never get her memory back, but her health is better, and she’s more sociable. I’m convinced the regularity of the pills is one of the reasons she’s doing so much better!” –my2parents

“If your loved one is refusing their medication, particularly in the morning, it could be that they find the medicine more tolerable on a full stomach by the end of the day. I can’t take vitamin D or vitamin B-12 in the morning because it upsets my stomach, even if I take the pill right after breakfast. But in the afternoon or later in the evening, I have no problem.” –freqflyer

“With some diseases, like Parkinson's disease, it is crucial that they get their medicine on a schedule. It is better to overlap by a half hour or so than to miss a dose by a half hour. You get really good at figuring out the timing." –kathyt1

Storage & Organization

“To help me stay organized, I typed up double-sided daily medication chart sheets. Each one has the date on the top, the pill names are listed along the top row, and meals (breakfast, lunch and dinner) are listed down the side. I placed a big check mark in the appropriate grid square and Mom would circle it after she took it.” –MsMadge

“One of my siblings or I will call Mother every morning to tell her to take her morning pills. We use the same method for her evening eye drops and bedtime insulin. Most times that works. I also taped a calendar to the table near the pill box and tell her to ‘X’ out the day after we speak at night. This has helped, too.” –pgscott

“My father-in-law spent his last years with us, and I would get a bunch of small manila envelopes, label them AM or PM, and give him one day’s worth of medication at a time. It was much less intimidating than a pillbox! You can make a morning card and a night card and list the meds and what they’re for. Put them in a sealed envelope clipped to the card and leave night and morning envelopes with no other ones in reach.” –partsmom

“My mother-in-law refuses to use the pill box setup and I have bought and returned 5 different ones. So, I gave her a white basket for morning pills, a black basket for evening pills, and a yellow basket for twice a day pills. I also bought her a shot glass with ‘Oma's Meds’ custom inscribed on it. She has a routine after breakfast and after dinner to fill the shot glass with her medication and take them with a big glass of water. She has dementia, but she is regimented. Her prescriptions are always visible.” –Lovestinks

“Start with the pill cases that you can buy at CVS. Buy two, one for night and one for day in two different colors. They have slots for each day of the week.” –Llamalover47

“I would load a seven-day pill box for my mom each week. That way all she had to do was pop a compartment for morning, noon, afternoon, and evening.”–pamstegma

“Once a week I separate my dad’s medications into easy-open zip lock bags labeled Monday morning, Monday afternoon, Monday night and so on. I keep the bottles in a special bag with me, which prevents any chance of overdose or ‘self-help.’ He likes not having to worry about refilling each one at the pharmacy. That’s all my job and it’s worth it to know that he is taking all that he is supposed to.” –sagebush99

“When my mom simply had ‘mild cognitive decline,’ I was able to get her three pill boxes, yellow for morning, green for noon and blue for evening. I set her pills up in them once a week and she wrote down on a sheet of paper when she took each set of pills.” –BarbBrooklyn

“Some pharmacies are now offering an Rx bottle with a clock on top. That is one way to know when the elder has gotten into it.” –Llamalover47

“If your loved one is forgetting to take their prescriptions, the best method I'm aware of is the companies that deliver blister packs or other types of containers, with all meds organized and combined for the correct times— breakfast, before dinner, bedtime etc. It’s not terribly expensive.” –Windyridge

Securing Medication

“Ideally you should get a box that is securely attached to or built into the wall, with keys. Any locksmith can help you with the right size box. Only you will have the key. Combinations can be orally shared or even forgotten.” –pamstegma

“Sometimes you can simply find a cabinet in the home and put a lock on it. That will not keep out burglars if they are looking for drugs and know where they are, but it’ll discourage a newly hired home care person that you may not trust yet.” –Ibeenscammed

“Use an old metal file cabinet with a lock on the top. If needed, get a welder to attach a padlock to the side and a TSA lock should suffice. We also put a padlock on the crisper drawer in the fridge for medication that needed to be refrigerated.” –ruthieruth

“My one elderly friend just used a simple lock box that was made out of some kind of heavy metal. He lived in an apartment complex, so he kept all of his medicine locked up because he thought people were stealing his meds when he was actually just dropping them all over the floor. A simple lockbox is really a good thing. Whatever kind of container you choose, make sure to keep it out of sight and in a safe place where no one can find it. Another good idea is to take it a step further and not keep any pills in the medicine cabinet. That way everyone stays safe and no one gets tempted, especially snoopers. I was just thinking of another type of box you can also get at Walmart in the beauty section. They have some very nice boxes with latches, and some of them are clear. The laundry supplies aisle is another section to look in for solutions.” –Dontask4handout

“I went to Walmart and got a floating lock box in the boating section. It is large enough to hold all the medication and is bright orange, which would be hard to overlook if we had to evacuate due to bad weather.” –Sheriffbadbunny

“I hide all prescription and over the counter medications in a cardboard box and put it in my closet. My husband never goes in my closet and probably wouldn’t know how to open it because it has a hidden sliding door. Put all medication up and out of the reach of your loved one.” –ferris1

“If you are coming over to your loved one's house to fill weekly pill containers, the bottles could be kept with you offsite. Where I live, there is also an option to have pills in blister packs delivered weekly from the pharmacy.” –cwillie

“You could hide meds in a garment bag with compartments and hang it in a closet where winter clothes are stored. A flat under-bed plastic container in a guest room could work, and so could the upper unused kitchen cabinets above the fridge. A locking filing cabinet is my first choice. Just make sure your loved one is not watching where you hide them when you are refilling for the week.” –Mulata88

“Hiding” Medications in Food or Drink

“Try crushing the pills and mixing with something sweet, like jelly. That’s the technique I use with Mom. It’s mostly successful.” –Bayou52

“There is a fine line between crushing medications and putting them in food to make it easier for someone to swallow them and hiding them in food so the patient is fooled into taking them. When someone refuses to eat, drink, and take meds and they have been considered appropriate for hospice, there is little point in worrying about routine medication if the patient refuses. Medication for pain and anxiety should of course be continued, though.” –Veronica91

“My mom used to refuse to take her pills while in the hospital when crushed and placed into applesauce. Mom just didn’t like the taste of applesauce. I told the nurse that Mom liked chocolate, so the nurse went and got a very small serving of chocolate ice cream and put the crushed pill in there. Mom loved it.” –freqflyer

“Crush the medication up in milk, coffee, or whatever your loved one likes to drink, and then give it to them.” –ferris1

“I suggest crushing medications and putting them in food, but not all medicines can be crushed or broken because some are time released. Check with your pharmacist!” –lifeexperiences

“We sometimes forget our elders find it difficult to swallow tablets, since some medications are quiet big. Crush the medication and give them to your loved one with their drink. I did this for my mother, after I checked with our pharmacist, who said it would be perfectly OK.” –Johnjoe

“I crush my mom’s medications and mix them with vanilla ice cream drizzled with chocolate sauce. A sundae before breakfast and one after dinner means no more fights about taking meds.” –Mellie1951

“I always smashed up Mother’s medicine and then put it in a small bit of applesauce. My mother couldn’t swallow pills. She had her mind, but she would have never taken her medicine if I didn’t give it to her every time.” –luckylu

“I remember when I was little my mom gave us our pills with jam. You could try that.” –Gershun

“You can get a pill crusher and mix medicine in applesauce or any other soft food your loved one will eat. It may seem kind of odd to put pills in applesauce at first if you’re not used to it. I had to do this with an antibiotic that tasted very bitter when taken with water. I didn’t crush it, but I mixed it with applesauce or even barbecue sauce. Any soft food will do as long as the person will eat it. Another thing you can do if you have a blender is make the patient a smoothie. Just drop the pill in the mix and let the blender do the rest. Another thing I thought of is possibly putting the pill down into a glass of soda and letting the pop dissolve it for you.” –Dontask4handout

“I used to buy my mom Ensure pudding in chocolate, vanilla, or strawberry flavors. Unfortunately, I had to buy it online because no local store was selling it. I would crush the pills up and put them in there.” –Lizdevine

“Yogurt with fruit in it worked well for us. I think it helped that it was not completely smooth and was already lumpy. My mom would spit medication-laden applesauce and pudding back out before I could even get the next spoonful ready.” –Rosebush

“Many medications don’t actually need to be crushed. It’s a misconception. If they are given with a soft food, such as pudding or yogurt, the pills will slide down the esophagus just fine. Only when pills are huge do they need to be crushed, and, even then, if they are cut up into small enough pieces, they can be swallowed with soft food. Crushing many medications makes them impossible to swallow because they are bitter.” –TooYoungForThis

“Teepa Snow recommends using jam. It is very sweet, and a not-quite-smooth texture can hide pills better than blended products like applesauce or puddings.” –cwillie

“Do not crush any oral medication that is labeled as:

  • Delayed Release
  • Enteric-coated (EC)
  • Extended release
  • Effervescent tablet (EVT)
  • Mucous membrane irritant (MMI)
  • Orally disintegrating tablets (ODT)
  • Slow-release (SR)
  • Sublingual forms of drugs
  • Sustained-release

Do not crush any oral medication that ends in the following letters:

  • CD
  • CR
  • ER
  • LA
  • SR
  • XL
  • XR
  • XT.”

–NYDaughterInLaw

“My dad started questioning what his pills were and it became a battle. I got creative and ended the battle. He’s been taking them for a few years without knowing, either in a milkshake or hidden in peanut butter in a sandwich. No more battle!” –LoriMb

“What worked best when my husband needed his pills crushed to swallow them was dissolving them in a very small amount of grape soda. That seemed to overpower the taste of the pills best and the carbonation helped dissolve them. The small amount let him get it over with quickly. Then he had a chaser of just the pop. This was for helping him swallow them. He was willing and understood what I was doing and experimented with me with several different approaches. This was not to hide them; that is a different issue.” –jeannegibbs

“Not ALL meds can be crushed. If your loved one’s medication can be, make a smoothie and blend it with fruit to see if that helps. Yogurt is also a choice, but try the ones without too much sugar.” –ferris1

Talk with Your Doctor or Pharmacist

“See if there are specific medicines that your loved one is refusing. Are they huge? Could they be refusing because of side effects? My mom has one pill that is big and she hates taking it. I found out that it we can get it in a smaller dose, but this will require more pills. Discuss the issue with your loved one's doctor and pharmacist to see if there is a better way to dispense or change medications.” –MaryLou88

“I would have a good pharmacist look at all the medication your loved one is taking and see if they are all necessary and/or possibly interacting with each other. The medication could have side effects that are worse than the condition they’re for.” –partsmom

“When my mom was having problems getting the bigger pills down, we talked to the doctor and stopped those medications.” –Rosebush

“There may be flavor options for liquid medicines. Pharmacists can use a product called FLAVORx to make them taste better.” –SeniorService

“Speak to your pharmacist. They know how different drugs are packaged, alternatives, generics, liquids, if pills can be crushed, dosages, etc. Physicians do not always know these things.” –Dinkiedink

“You can get all drugs in liquid form. My wife’s nine pills cost $350/month copay. The same drugs in liquid form cost $270/month. (These are not just pills crushed up, though.) Ask your doctor for prescriptions for liquid drugs and find a local pharmacy that can provide them. They give you a little syringe to measure the dosage. Some of them may need to be refrigerated. Giving drugs five times a day was a nightmare for me and my wife, but now it’s enjoyable.” –warren631

“Sometimes the senior's instincts are correct. Check it all out on the internet to make sure your loved one even needs each medication. Last night we finally got a list of our mom’s medications and learned she is taking 28 of them! Some are for issues she no longer has. Others are duplicates. We are very glad we listened to her complaints and refusals. Doctors seem to solve everything by writing yet another prescription.” –January

“Has anyone considered the fact that when someone doesn’t want to take a certain medication it is because they hate the side effects from that medication? All medications have fillers, and depending on the fillers being used, one could be hypersensitive to them, which could cause a variety of different side effects.” –freqflyer

“Your loved one is the owner of their body and it’s their choice what to put into it. No one else owns it or is the authority on it. If your loved one is thinking clearly and refusing to take the medication, then maybe you want to ask them why. Maybe the pills give them nasty side effects, or perhaps they feel they are unnecessary. Maybe your loved one would like to hear about alternatives to pharmaceuticals. Many elderly people are on a cocktail of pills. Maybe your loved one found out the truth about the effects of these pills and has legitimate concerns. Ask!” –Ibeenscammed

“Work with the doctor to get your loved one's prescriptions down to the ‘vital few.’ The doctor can place a ‘discontinue’ order for those meds that are no longer necessary to take.” –JavaJoy

Medication Reminders

“We had the home helper remind my mom to take her medication. The helper who was there in the daytime would watch mom actually take her morning medication and then I would call around 9 each night and stay connected until she took her evening meds.” –anonymous11306

“You can buy an alarmed medication dispenser that is locked, so your loved one can’t over or under dose with the medicine. It holds up to 2 weeks of medication at a time. I got one for my father and I refill it every other Sunday and have never had a problem with him taking more medication that necessary again. I got mine on Amazon for around $40.” –Tracy1968

“My Dad had a pill box and morning caregivers who would make sure he took his morning meds. The caregivers would leave notes around Dad's home as a reminder to take the evening pills, even leaving the pills in a cup on the kitchen table.” –freqflyer

“Someone did tell me about a product on the market to help remind a loved one to take medication. It is some kind of electronic dispenser. It is supposed to make a noise or announcement when it is time for medication and open the right compartment. If the pills aren’t taken in a certain time, it shuts down so they can’t take it too much later. There’s even one that hooks to their phone. If the pills aren’t taken, it is programed to call you. Do a Google search for ‘automatic pill dispenser’ or ‘electronic pill dispenser’ and lots of choices will come up.” –JulieWI

“You can get a medication dispenser that dispenses pills at appropriate times. If the medication is not taken, it will call and let someone know of the missed dose.” –tacy022

“My mom and step-father used a medication dispenser with an alarm for several years. They really liked it!” –momdoesntknowme

“There is technology called telemedicine that dispenses medication at the time your loved one is to take it and vocally reminds people to take their medications. The machine can also send a text to you or a caregiver when the medicine is not taken from the dispenser tray. Of course, if they are really being rebellious and not forgetful, they will pick it up from the tray and not take it.” –IKORWPA

“The alarmed pill box is a lifesaver for loved ones who still have their wits about them. Otherwise, it’s a good tool for caregivers.” –deefer12

“Philips Lifeline has a great dispenser, but it’s pricy. You can put up to 10 days of medication in it. You set up the time for it to dispense, and a voice comes on to tell the patient it is time for meds. The patient hits the button and the pills come out in a plastic dispenser. It will announce a couple of times if meds are not taken and then you will get a call. It also locks so they can’t fool with contents.” –JoAnn29

You May Also Like

Free AgingCare Guides

Get the latest care advice and articles delivered to your inbox!

0 Comments