How to Manage Mutliple Medications
Does the cabinet where your parent (or you) keeps pills, ointments, and inhalers look like a mini-pharmacy? Many people in need of long-term care (older people and those with chronic conditions) take a lot of medications. It's hard to keep them organized and follow the doctor's orders exactly, and vitamins, herbals, and supplements may have been added to the collection.
Beyond asking a doctor whether all these drugs are really necessary, there are some things you can do to bring some order to the process and make it easier to know what to take, when, and how, and when to renew prescriptions.
Make a list
The first step is to make a comprehensive list of all the medications, including over-the-counter drugs like aspirin and laxatives. You can write these out in a notebook or use one of several online forms. Here are two examples:
It is important to update your list every time there is a change, and to take this list with you to every doctor's appointment or Emergency Department visit. It will save a lot of time and reduce the possibility of error.
Common problems and solutions
"I don't understand the instructions." Doctors still use a lot of Latin terms. For example, "bid" means "twice a day," "tid" means three times a day, and "po" means by mouth. The instructions on the bottle or package may be too small to read and too complicated to understand. If you see terms you don't understand or have questions, ask the doctor or pharmacist what they mean. For example, what exactly does "as needed" mean? What should I do if I miss a dose? On your medication list, write down the timing and any other instructions.
"This drug isn't the one the doctor ordered." Some insurance plans substitute generic drugs for brand-name prescriptions. Usually there is no difference but if there is a reason the doctor prescribed a specific brand, ask the pharmacist how to obtain permission to get the drug as prescribed.
"I can't open the bottle." Ask the pharmacist for special easy-to-open caps.
"I don't know how to use the inhaler." There are special ways to use an inhaler so that the medication goes into your lungs, not into the air. Ask the doctor or pharmacist to demonstrate.
"I forget when to take which pills." There are special pill boxes that have sections to put pills for mealtimes and bedtimes. Some even beep when it is time to take the pill. There are also automatic pill boxes that can be set to open at specific times.
"I don't like the taste." Perhaps the medication comes in a different form that is easier to take. Or there may be an alternative drug that you can try.
"I forget to renew the prescriptions." You can ask the pharmacy for an automatic reminder, or you can try a mail-order service, which may be able to supply a larger amount. You can also check the pill bottles to see how many refills remain, and make a reminder list.
"I feel better so I stopped taking the medication." Not a good idea. You should take the medication for the full time the doctor prescribed. An antibiotic to fight infection has to be taken over a number of days or you won't get the full benefit.
Get to know your pharmacist
Your best ally, in addition to your doctor, is your pharmacist. He is a skilled professional who can help you find the best ways to make sure you take your medications as prescribed. If possible, use the same pharmacy for all your prescriptions. That helps the pharmacist alert you to potential drug interactions. If you use a mail-order service, there will be pharmacists on call to answer your questions.
Disposing of unused medications
Medications are powerful agents that can harm a person for whom they are not intended and cause environmental damage as well. Ask your pharmacist about how to dispose of unused or expired drugs. Some can be flushed down the toilet, but you should do this only when advised that this is safe. You can also check the advice from the Food and Drug Administration.