Q: Mom gets confused as to what day it is and which pills she should take. It’s leading to many disagreements between us. How can I make sure mom takes her medication as prescribed, and also ease the tension between us?

A: This is an all too frequent problem among elders that must be very carefully addressed in steps.

First consider organization. There are various planners to assist in the timing of doses. Some planners are simple 4 weeks of the 7 days with each day divided into 1, 2, 3, or 4 slots or areas. Medications can easily set into each of the small compartments to assure when it is taken. Some of the down sides are:

  • All planners are not secure, seniors can "rearrange doses" unknown to family and then we are back to were we are started.
  • Some planners allow each day to be removed and carried in pocket or purse.
  • The morning or evening doses can get reversed.
  • Some seniors have complicated dose schedules and these medications should be in a separate planner.

Next, the senior needs to be a "self doser." If a senior does not take their medications on their own, then investigate a prompting system. It can be a simple phone call from you, another family member or volunteer, an electronic prompt, or a personal visit.

The planner needs to be set-up properly and timely. If more that one person sets up the planner, then everyone needs to agree on what each label means and when it is to be given.

Medications need to be reordered in time to completely set up each planner.

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Finally, and what I consider the most important, I always encourage a comprehensive review of the medications that are being used and how they may be contributing to confusion. There are Senior Care Pharmacists that specialize in such reviews. There is an under appreciation of the accumulation of similar side effects from multiple medications. This ‘build-up' of similar side effects is often excused as normal aging, but may be resulting in cognitive changes.

Organizing and prompting medication use is highly desirable but only if the dose is correct and the medication is taken the correct way.

It is important to consider that managing medications is one of the instrumental activities of daily living. Insrumental ADL's provide an effective measure of a seniors ability to live alone. If you have determined the individual is capable of taking correct dosages of medications at the right times if their medications are organized in separate dosages in advance, independent living may still be possible. If the ability to independently manage medications declines, it is time to consider increasing supportive services.