My mother has advanced Alzheimer's Disease along with several other chronic conditions that require medications. In addition to the eight prescribed medications that she takes every day, she also takes supplements. My father took care of organizing her meds until his own health challenges made that too difficult for him.   

My mother has 24/7 care from terrific aides provided by an agency, but they are not licensed to either set up or give her the medications. So, I have been going over to their home and organizing her meds so that the caregivers can place them in front of her at the appropriate times. It’s been a disaster! Between making sure she takes all of the medications at the right times and making sure she doesn’t run out, it's almost like a full-time job.

Any suggestions? Laura S., Miami FL.

Managing medications is one of the most challenging, and time-consuming tasks that older adults and their family caregivers face. It is also one of the first of many activities that is compromised when a loved one becomes cognitively impaired. For your particular situation, I recommend two ways to make this process easier for you. First, simplify your mother’s medications to those that really matter and then, once that is completed, set up a medication process that works for your mother.

Because this is such an important issue, with so much to explain, I’ll focus only on the first action to take in this column. For the second step, please visit my blog, where I take a deep dive on this issue and offer suggestions for products and phone APPS that could help.

For ways to simplify your mother’s medications to those that really matter, I contacted Marie Savard, MD for her expert advice.  A former ABC News Medical Contributor, Dr. Savard has spent most of her career taking care of elderly patients and is now devoting her time to inspiring others to simplify and manage a loved one’s medications. She has the following step-by-step advice for you and others who find themselves in the same situation;

“First, take an inventory of all the medications and supplements that your mother takes and create a comprehensive list,” said Dr. Savard. The list should include the following information:  medication or supplement name, the reason for taking it, the name of the prescribing physician, dosage, the time(s) it should be taken, the color of the pill and the renewal date. Try to determine how often your mother actually takes the medications.”

Then, Dr. Savard suggests reviewing this complete medication/supplement list with her primary care physician, and if at all possible, plan to accompany your mother on this visit; 

“Let your mother’s physician know your concern about managing her medications. Be sure to give him or her an update regarding which ones she might not be taking consistently or those whose side effects are worrisome. The goal is for her physician to simplify the list of medications she takes on a daily basis,” said Dr. Savard.  

"It’s important to review a medication list on a regular basis with a physician because a patient’s needs change and sometimes the necessary changes in medications don't follow, Dr. Savard explained. “For example, research shows that some dementia-related medications are no longer recommended or effective for those with more advanced disease. Furthermore, taking medications such as statins or aspirin to prevent heart disease may no longer make sense.”

Dr. Savard added that an appointment with your mother’s physician presents an opportunity to ask other questions such as what to do if medication doses get missed and if the pills can be crushed and mixed with food if she has trouble swallowing them. Some of these meds might even be available in liquid form.  And then there’s the concern about side effects;

 “Medications often have side effects,” Dr. Savard added. “For example, NSAIDS, such as ibuprofen, can lead to stomach irritation and indigestion and too often more medications are prescribed to control these side effects. A complete review of the medication might indicate that it’s best to stop the problem medication rather than add another pill to the list.”

I thank Dr. Savard for her guidance on this very important topic. For more information on this important topic I invite you to view her and follow her blog. In the meantime, I will continue with my response to Laura’s question about creating a sustainable daily routine for medicine management on my blog. I hope you will continue reading there.

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Category: Care Planning, Caregiving, Medical