As we age it is common to have an increased need for daily medications. It is typical for seniors over 65 to be taking 5 to 6 different medications per day. Almost 20% of elders (65 years or older) take 10 or more medications.(1) For seniors, the management of medications can be a challenge. Remembering to take medications, which ones, and when is often too overwhelming for them to handle on their own.
In addition to seniors, it is reported that nearly 75% of all Americans do not take their medications as prescribed. Improper medication management at home causes approximately 125,000 deaths per year, and 10% of all hospital admissions are medication related. For those over 65 the number escalates, 30% of hospital admissions are directly related to non-adherence of prescribed medication. Many seniors have family members who help with their medication regimen. This often includes filling medication reminder devices or pill dispensers. These dispensers can range from highly sophisticated electronic devises to simple Sunday through Saturday plastic holders. Filling them is one thing, knowing when to take the medications, and remembering to take them is another.
What can be done to help with this problem? At Abundant Blessings Homecare, Inc. we have seen the problems with medication management in many different situations. We have adopted a plan of action we would like to share and recommend. This plan is listed below.
1. Best practice is accountability. To have a caregiver with you to prompt and remind you to take your medications at the appropriate time and to document is ideal. This person can be a family member or a private duty homecare aid. The key is to have someone there anytime medications are to be taken.
2. Utilization of automated medication dispensers. There are many manufacturers offering programmable dispensers which will alarm (both visual and/or audible) when it is time to take medications. One even alerts a call center which in turn calls the client and/or up to three people if the medications are not removed from the dispenser after a set amount of time lapse. The limitation to these dispensers is that they need to be filled weekly. We have reviewed many dispensers of this type and are now selling at a discount and recommending various models from MedReady, Inc. which can be seen and purchased at our website. http://www.abundantblessingshomecare.com/medication-dispenser/
3. For any situation which leaves seniors living a distance from family, or when there is no one to fill medication dispensers on a weekly basis, we recommend bubble packs or blister packs. These are available from many pharmacies in the area. They consist of clear little pouches containing each day's pills, sorted according to the day of the week and time of day they should be taken. Bubble Packs are filled and
sealed by the pharmacy and all medications which are to be taken at any given time are together in one pouch. Bubble packs help eliminate confusion as to when and what pills to take. No one needs to fill a weekly dispenser; the bubble pack acts as a prefilled dispenser. A caregiver may still be needed to remind and prompt. Studies indicate that One 14-month study indicated that patients' medication compliance had risen from 61% to 96%.
4. If none of these suggestions are taken, we would recommend at minimum utilizing basic weekly Sunday through Saturday medication dispensers. These can be obtained at any pharmacy. They are very simple to use, yet help tremendously with medication compliance.
One last consideration is regarding safety and theft prevention. Often seniors have many service people working in and around their homes, from Home Health Care Nurses, Physical Therapists and Home Care Aids, to landscapers and cleaning companies. Our policy with our Clients is that any medications not in use or in a dispenser must be locked up. In some situations, even family members may be tempted to steal certain medications. Locking them up prevents theft, deters misuse and eliminate any pointing of blame when medications are missing. If you would like to talk to us about help with your or your loved ones medication management we are available 24/7. Anyone who is considering altering their medication management, or that of a loved one, should consult with their physician first. As health care reform progresses, the goal is that clinicians will share medication management responsibilities following the patient-centered medical home model of care.(2)
(1) Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases. JAMA. 2005;294:716-724.
(2) Feldstein AC, Smith DH, Perrin N, et al. Improved therapeutic monitoring with several interventions. Arch Intern Med. 2006;166:1848-1854.