Medications, Part 2

Medication safety can never be overrated.   I have seen medication “organizing systems” that have left me wondering why bad things have not happened to the individuals involved!  Here are some additional tips that I hope will prevent potentially deadly mistakes:

• Read each medication bottle carefully before preparing to give or take any medication.
• Do not write over labels on the prescription bottle.
• Do not write the name of the medication on the bottle caps/lids, as the wrong cap may be accidentally replaced on the wrong bottle.
• Secure the lids on all medication bottles; request non-childproof lids from your pharmacy if opening the lids is difficult.
• Store medications securely in bottles; never allow them to lie loosely in the home where small children or confused individuals could mistakenly swallow them.
• Do not mix a variety of medications in one bottle.
• Keep each individual’s medications separate.
• Store discontinued medications securely in a separate area of the home.

                          

Ordinarily, I encourage caregivers to devise organizing systems that work best for them, but not when it comes to medication.  In this case, these standard safeguards must apply: 

• Never attempt to track whether an individual has been taking his/her medication by relying on the “bottle right side-up/bottle upside down” system, or by changing the location of medicine bottles on shelves or counters.  Both of these systems are too prone to chance, error, or indiscriminate handling to be safe and effective.
• Instead:  use a multi-day/multi-dose pill box (with separate compartments for AM/PM or breakfast/lunch/dinner/bedtime).  These boxes can be purchases at local drug or grocery stores, and some home care/hospice agencies or insurance  companies may provide them at no cost. The larger boxes are easier to open, easier to prepare and hold a larger number of pills.  Less commonly available but also very effective are auto-dispensing medication containers that sound a reminder alarm.

• When preparing medications, I recommend finding a quiet time without interruptions, creating a clutter-free work space, and having all medication bottles in front of you.  This will allow you to more carefully and systematically fill the pill boxes.
• If you have been keeping a comprehensive medication list, use it as a check system against the medication bottles.  Check each label carefully! 
• If changes have occurred during the week, make sure the pill container reflects those changes.  (Count pills per day, if necessary.)
• If you are having problems organizing and/or remembering to give the medications as prescribed ask the doctor for help; arrangements can be made for a home care agency to come to your home to assist you.  There are also senior services in many regions that can assist you. 

The goal of any medication system should be safety and simplicity.   Consider the possibility of another caregiver having to step in suddenly to administer medications on your behalf:  Would the new caregiver be confused?  Would he be able to follow the medication system you have established without interruption? 

Medications come in many forms:  pills, ointments, patches, liquids, suppositories and injectables. 

• Inform the doctor if the current form is not working for your loved one; for example, if they are having difficulty swallowing pills.
• Do not crush any medications without first checking with your doctor, home care/hospice or pharmacist.  Do not “hide” medication inside food (as you might with a pet) without checking with your doctor or pharmacist.
• If doses are missed, inform your doctor or nurse. Do not double-dose unless instructed to do so.
• If unable to take the medications as prescribed, notify your doctor or nurse.
• Notify the doctor or nurse if you begin to experience side effects.

What questions or concerns do you have?