With age comes new experiences, new challenges and new medications. And as your own healthcare needs or those of your senior loved one become more complex, so will the system you use to manage medications and other health information.
“Medication management is important for everyone, but especially seniors,” says Monica Moreno, the senior director of care and support at the Alzheimer’s Association. In addition to being prescribed more medications, seniors are also more likely than younger adults to experience mental or physical changes (such as memory problems or muscle weakness) that can further complicate medication administration. “Having a plan in place [for tracking medication] is important, as it can help to reduce the risk of error or harmful unintended consequences, such as taking the wrong medication or the wrong dose,” adds Moreno.
Given such high stakes, we spoke to Moreno and other experts to gather guidance on creating an effective medication schedule, as well as medication management tips for seniors.
The importance of effective medication management for seniors
Getting older or caring for a senior loved one comes with its own challenges, but one of the most significant issues seniors face is polypharmacy, which Michael J. Mandarino, a clinical psychiatric pharmacist, defines as “the use of multiple medications to treat one or more conditions.” And this is associated with complications like medication side effects and interactions, falls and hospitalizations (in more severe cases), he adds.
Polypharmacy can also lead to medication misuse. Studies show that misusing medications may result from “many medications, forgetfulness, lack of deprescribing, lack of communication, poor understanding, and limited awareness of inappropriate medications,” writes Christina Christopher, et al.in a study published in Aging Medicine.
The experts we spoke to highlighted this point in their own experience. ”Complex medication regimens can become overwhelming for patients and families to manage,” says. Mandarino. And this can result in seniors struggling to adhere to the correct timing and dosage of their various medications, he adds. The clinical impact of this is “hospitalization mortality and poor health outcomes in older adults,” according to the previously mentioned study in Aging Medicine.
This is particularly important to be aware of if a senior loved one is showing signs of — or as an official diagnosis of — Alzheimer’s or another kind of dementia. “In the early stage of the disease, caregivers may need to help the person living with dementia remember to take their medications,” says Moreno. “As the disease progresses, symptoms will grow severe enough to interfere with daily tasks, including the ability to take medications safely.”
Regardless of the presence or absence of dementia, a plethora of medications can be overwhelming and potentially dangerous to juggle. To circumvent the risks of misuse, it’s important to put systems in place to ensure medication is taken properly.
Join Care for free
Signs that the medication schedule is not working
According to Moreno, there are a few things to watch out for if you are caring for or concerned about a loved one’s ability to manage their medications.
- Finding untaken medications on the counter or the floor.
- Discovering that prescriptions are being refilled too soon or not often enough, which may indicate they are either taking more or less medication than prescribed.
- Changes in the person’s condition. For example, if the individual’s blood sugar levels are suddenly higher than normal.
- Too many or too few pills left in their organizer, which may also indicate they are under- or over-dosing on their prescribed medications.
5 medication management tips for seniors
Older adults tend to be prescribed more medications than younger people, says Mandarino. Studies show that this is a result of a higher prevalence of chronic health conditions, such as high blood pressure or diabetes. To help mitigate some of the risks that come with a complex medication regimen, here is some advice from the experts.
1. Establish clear communication among healthcare providers
When you or your senior loved one has multiple doctors as part of your care team — a primary care provider and potentially multiple specialists — it’s easy for important details to slip through the cracks. It’s very possible that different offices will not share the same computer systems, meaning that records won’t automatically transfer.
With that in mind, Mandarino recommends advocating for yourself as a patient by “[communicating] where you have care established to any new provider and [maintaining] a medication chart.” (More on that later.)
It’s also important to ask either your doctor or pharmacist to check for possible drug interactions and, when a new medication is prescribed, whether or not it’s OK to take with current medications, says Moreno.
Mandarino adds, “There is no such thing as a bad question. It is important to speak with healthcare professionals about your concerns, as things may be overlooked unintentionally.”
2. Understand medication options
If, for whatever reason, a current medication system is not working, Mandarino advises seniors or family caregivers to speak to their doctor to see if there is any room to optimize how medications are prescribed. For instance, some medications may be available in liquid form, or may be injected instead of taken in capsule form. Mandarino adds that if “dexterity is an issue,” patients can even “elect at the retail pharmacy level to have medications dispensed in containers that are not child-resistant.”
Medications may also be available in a variety of dosages, says Mandarino, or as an extended-release formulation, which means it can be taken once a day versus multiple times throughout the day.
“There are many solutions to how medications can be prescribed,” Mandarino says. “If there are any perceived barriers, it is important to communicate them, so a reasonable solution can be developed.”
“There are many solutions to how medications can be prescribed. If there are any perceived barriers, it is important to communicate them, so a reasonable solution can be developed.”
— Michael J. Mandarino, a clinical psychiatric pharmacist
3. Leverage your pharmacist’s knowledge
Whether your go-to pharmacist is located in a retail pharmacy setting (or a drug store) or in your doctor’s office, Mandarino advises utilizing them as “one of the most accessible healthcare providers.”
If you have questions about your or your senior loved one’s prescriptions, or a particular medication is causing side effects, Mandarino recommends getting clarification from a pharmacist, rather than turning to the internet. With a plethora of incorrect information readily available online, a pharmacist can cut through the noise and provide an accurate medication assessment, he adds.
4. Create a personalized medication chart
With multiple medications to keep track of, Mandarino recommends “[creating] a medication chart and [sharing] it with providers at any transitions of care (at the doctor’s office, at a specialty provider appointment, in the emergency room, etc.).” And make sure to keep it updated to ensure that providers are aware of your current medication regimen.
The chart (like this one from the Centers for Disease Control and Prevention [CDC]) should include the following, according to our experts:
- All prescription and non-prescription medications, as well as instructions for use (dosage and frequency).
- What each prescribed medication treats.
- Who prescribed the medication.
- Any medication allergies.
- Emergency contacts.
5. Utilize medication reminders and tools
In this day and age, there are a plethora of options for keeping track of medications, such as smartphone apps and automated pill dispensers. However, if old-school is more your style, Mandarino suggests trying a behavioral strategy as a reminder for taking medications: For example, leaving medications near a toothbrush or by the coffee machine (something you know will be used consistently).
You can also keep it simple and utilize a pill box organizer, says Moreno.
For medication regimens that are complex and/or difficult to manage, Mandarino adds that some pharmacies may be able to supply medications in blister packs, organized either by medication or per time of day of medication administration. This may “help streamline the medication administration process when numerous medications are required for treatment,” he says.
Additional tips for safe medication management
Every senior’s medical (and subsequently, medication) needs are different, and some older adults might have special circumstances that require additional attention or monitoring. With that in mind, the experts shared their advice on a couple unique situations that may affect medication management.
Take extra precautions when dementia is involved
If Alzheimer’s or another form of dementia is diagnosed, caregivers will eventually “need to place medications in a locked drawer or cabinet to avoid accidental overdose or throw out medications that are no longer being used or have expired,” points out Moreno.
Talk to your doctor about deprescribing
“Deprescribing is the process of slowly reducing or removing medications in which there is not a favorable balance between benefits and risks of continued treatment,” explains Mandarino who recommends regularly checking in with a healthcare professional to determine if deprescribing is warranted.
He continues, “There are many instances where medications may be prescribed for acute or temporary conditions, and the medications may be continued for longer durations than required without questioning the need for use.” However, do not stop taking any medications without first speaking with your or your loved one’s provider, he adds.
The bottom line on medication management for seniors
When a multitude of medications are prescribed to a senior, it can become overwhelming to manage doses, timing and drug interactions. And it necessitates extraordinary organization and attention to detail. That said, Moreno encourages both seniors and their caregivers to familiarize themselves with the purpose and proper usage of their prescribed medications.
Additionally, getting more organized can make a world of difference for you or your senior loved one’s well-being. As she concludes, “Implementing a medication management plan for prescription and over-the-counter medications can help ensure the effective management of an illness or disease” and improve quality of life.
