Additional Medication Safety for Your Elderly Parents and Clients
Medication storage is sometimes a heated debate for those taking more than one or two pills a day. Technology now offers some wonderful alternatives to having a bunch of pill bottles sitting around with confusing instructions. If your parents or clients are taking just one or two medications, can open bottles easily, and have retained most of their cognitive functioning then putting the pill bottles in a convenient location and letting them dose themselves is the most likely plan.
On the other hand, if there are any cognitive deficits, multiple medications, or physical restrictions which prevent ease in opening the bottles then alternatives need to be explored. I have outlined a number of options below.
1) Pillboxes offer many alternatives. There are boxes that can allow up to four different schedules throughout the day. The days of the week are labeled and the timing for each dose can be written on the compartment according to the directions on the prescription. If there are no cognitive difficulties your parents, or client, may be able to fill their own box each week. It is suggested that the box be filled on a scheduled day each week. Routine leads to fewer mistakes.
If there are cognitive deficits then filling the box should be overseen, or handled, by a family member, nurse, or trusted friend. In some instances the local pharmacy will fill the box each week if there is no other responsible person available to fill it.
2) Medication dispensing units come in various shapes, sizes, and complexities. Some have an internal clock and can dispense pills up to six times a day. These devices can hold doses for multiple weeks and the pills are dispensed in a plastic cup that is expelled from the machine at the appointed time with an alarm, or buzzer, that alerts the patient that it is time to take their medication.
These units are tied by phone to a monitoring company which will make a phone call to a designated person if a dose is missed or if there is a malfunction in the machine. Home health agencies often promote the use of these machines. In some states their use is covered by insurance or Medicaid.
Regardless of what method your parents, or clients, use as a reminder or dispenser-of-pills make sure it is utilized correctly and filled by someone who fully understands the instructions issued by the doctor and pharmacist for dosage, route, timing, and frequency.
Injectable medications present a different set of challenges. It is imperative that the patient drawing up the medication be able to see clearly enough to see the units or milliliters on the syringe. Some medications can be drawn up ahead of time so the patient can self-inject. In other instances, that is not possible so there must be someone available for assistance if the patient is incapable of drawing up themselves.
In addition, some individuals do not care to self-inject. This needs to be assessed carefully because if they will not inject then they will obviously not receive the medication which the doctor has ordered and complications will develop.If your parent, or client, will not self-inject be sure that someone is available to deliver the doses of their medications as ordered. For some, this is the first step in leading to a change of location to an assisted living facility or other setting where staff can administer the medication as ordered.
Be sure the medical provider ordering injectable medications is aware of any resistance your parent, or client, may have to utilizing this method of delivery. Explore with the medical provider possible alternatives to injectables. If no alternatives are available then have the medical provider explicitly explain to your parent, or client, the importance of the medication and any possible problems that may develop if the medication is not taken as ordered. The importance, emphasized by the medical provider, is more likely to make an impression on your parent or client, and elicit their compliance, coming from someone other than you.
Another important aspect of injectable medications is the method of storage. If the bottle is dark this is a good indication that the medication needs to be kept away from the light. Some medications need to be stored in the refrigerator while others do not. Be sure to check with the pharmacy staff on specific storage instructions. They are there to answer questions and assist you in any way possible to be sure medications are taken as directed and in a safe manner.
All medications should be stored in a place where they are not accessed by small children or anyone who may mis-use or abuse them. Child-proof caps may be undesirable for senior citizens, but they are necessary if there are children in the home or who visit frequently. Be alert to the safety of others as well as the intended recipient of the medication.
In today’s world pain medications such as hydrocodone, Oxycontin, and morphine(and many others) are desirable as illicit street drugs. There have been reports of individuals posing as door-to-door sales people gaining access to a home in the guise of selling a product, then asking to use the restroom, and the unsuspecting homeowner later discovering their pain medicine has been taken from the medicine cabinet or bathroom drawers.The thieves are usually long gone and the medications are not recovered.
Advise your parents, or clients, to keep medications in a secure location and to use caution when allowing anyone they do not know access to their home. Review common safety factors on a regular basis with your parents, or clients. Prevention is the best defense.
Comments, questions, and additional stories on this topic are encouraged and welcome in the comments below.