July 28th, 2011 at 9:09 am
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Did you take your pill? Medication concerns and older adults

by Kathryn Kilpatrick, M.A. CCC/SLP

Dealing with aging and health issues of elders and loved ones can be difficult. From discussions about taking away the car keys to bringing in additional help, having the elder live with a family member to mom or dad moving into an assisted living facility, these conversations are fraught with emotion and challenges. Yet, before these major conversations take place, another issue should be resolved: ensuring the elder is properly taking his or her medication.

For example, a family member–who normally is not in town–was setting up her dad’s medications, she noticed one of the pills looked different. When she made a phone call to check on it, she was told it was a generic version. That was not the case. The dosage was ten times the amount prescribed and the gentleman was experiencing hallucinations. He told his neighbor he was having serious problems. If it weren’t for the actions of his neighbor and daughter, he could have died.

Issues with medication changes

Some of the medication lists for my patients take a full page or more. Understandably, the potential exists for problems to arise when changes are made to these medication lists. In the event of a serious illness, a hospitalization or a stay in rehab, new medications are often prescribed during the treatment period. Nurses or nursing assistants are typically responsible for dispersing those medications. Yet, upon return home, the elder may have some difficulty with the changes to their medication regimen.

If the person seems to be doing fairly well, family members often assume that person can handle the medication changes appropriately. However, that is often not the case. It may be necessary to modify the routine, provide new lists, or increase supervision to observe if change needs to be made to the system.

A recent client had been very independent until he had a mild stroke. But, it wasn’t dealing with the stroke that made him nervous, it was his new medications and the change in routine. He had everything set up on a tray with strict orders that no one should move them. We suggested using a pill box and he agreed. Now the hesitancy and double checking is less of a concern. We also suggested he assist the home health nurse or his sister when they set up his medications so he could still be part of the process.

Is mom forgetting to take her medication?

Sometimes a person forgets to take the medication properly, such as with or without food, or before or after a meal. Many patients comment they cannot remember if they took the meds or not. For example, one woman would fall asleep after dinner, wake up and was not sure what day it was so she often did not take the pills. In another case, a daughter called and reminded her dad to take his medication, but by the time he hung up the phone he forgot to take them.

Intervention is essential if an elder continually forgets to take his or her medication. At this point, it is important to figure out what a person can handle and then work with someone who can follow up on the recommendations and supervise the pill taking.

One daughter drove two hours each weekend to set up her parent’s medications. I noted during a therapy session that there were some in the pill box for a previous day and a few had fallen on the floor. Neither one of them had noticed. I contacted the daughter with my concerns and suggested prepackaged medications. With minimal reminder phone calls, that system seemed to work the best, at least for now.

Take some extra time to observe exactly what is going on with older adults when they set up and take their medications, especially after a hospitalization or when there are changes. If possible, make sure that someone goes with the older adult for doctor’s appointments, or calls the doctor’s office to verify medication changes or updates.

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