Caring for the Elderly: Tips About Medications

A Bit of Background

The small physical problems that we begin experiencing in adulthood have a tendency to expand and become more problematic as we age. That stiffness turns to pain and even reduced mobility. The failure to stop smoking has resulted in some difficulty with breathing and maintaining a more active lifestyle. So on and so forth. Of course as we get older, there are other things that may come along which are even less expected. High cholesterol, osteoporosis, heart disease, and other problems may show up and begin to gradually exert more control over our lives.

As these issues come to the surface, many older individuals find that medications become an important part of life. At some point, they can become overwhelming in fact. So many medications to remember and such a large volume to ingest.

I'm not a physician, nor am I a pharmacist or nurse. I can offer no advice regarding medications and their usefulness, interactions, or anything else. I also don't feel qualified to discuss alternatives to the pharmaceuticals that are prescribed by most physicians. However, I am someone who is involved in caring for elderly parents and wanted to offer some suggestions regarding steps that can be taken to improve the chances that such an individual will be able to comply with a medication schedule and be as safe as possible with them. These suggestions are based only on my personal experience with my aging father and mother and are not medical advice.

Difficulty Ingesting Oral Medications

Pill size can be a problem for some people. There are of course a number of options if an elderly individual encounters pills that are simply too large for them to swallow. Pill splitters are one option that's inexpensive and simple to use. Of course, it's important to split the pill in a manner that indeed makes it small enough that it won't get lodged in the throat. Taking them with enough liquids can help with this as well. It is possible to split a very large pill such that it's left with a sharp edge which makes it more painful if indeed it does get stuck. Pill crushers or pulverizers are another option which can eliminate this problem.

Some pills are available in other forms and if you're caring for an elderly individual who is having difficulty, you can inquire with the physician or pharmacist about this. Some may be available in smaller, coated capsules which make ingestion easier, but even more useful is a liquid form when possible. Sometimes the medication itself can be switched and administered by an entirely different route as you can see below.

Going a Different Route with Medications

My father had difficulty swallowing large pills, crushing was useful for him. My mother on the otherhand could swallow a pill the size of a walnut and never complain. However, she simply had difficulty ingesting the large volume of medications she had to take on most days. Finding a way to get her to consistently take all of her medications and to avoid becoming too full to eat anything, required us to check with the physician about other routes for taking the necessary drugs.

Because of her low nutritional intake, my mother needed supplemental B12. Luckily, one of her options was to get this via a once a month shot versus continuing to take it in pill form each day. In fact, her body seemed to make better use of the supplement when taken this way versus in pill form.

Some of her other medications were also able to be delivered by alternate routes. Instead of a daily pill, she switched one of her medications to a patch and another was administered as a once a year IV infusion. This switch not only reduced the number of oral medications she had to ingest but also reduced the number of medications she had to remember to take.

Her arthritis medication was shifted to one which could be delivered by nasal spray although it was still a daily dose. A word of caution here however: if the medication will be self administered you need to be sure that the individual can dispense a nasal spray properly so that they get the full intended dose. It can be difficult to operate the dispenser if there is tremor or other weakness.

Remembering to Take Medications

If you're caring for an elderly individual who is living independently and will be self administering their medications, being able to consistently remember them is critical. No medication is effective if the therapeutic level of it is not achieved and maintained. This means that it must be taken in the prescribed dosage, on the prescribed schedule; not just when it's remembered.

When my father was alive, we simply made a chart and my mother and he recorded on it each time he took a given pill. My mother was his reminder. Now, years later my mother is alone, and there is no one else there to act as her back up memory.

There are a number of products on the market that can help organize pills, act as a reminder, and even dispense pills so that there's no confusion about whether or not a pill scheduled for earlier in the day was taken. They range from simple containers to electronic devices that include an auditory reminder and visual alarm. They're even capable of dispensing up to 25 to 30 pills in a single day. Many of these require filling as infrequently as every two weeks, allowing a friend or relative to refresh it periodically if necessary.

Knowing Your Medications

Another thing I have learned is the importance of knowing all of the medications being taken and their dosage. My mother now keeps an updated list of all of her medications in her purse. Anytime we visit the doctor, they need know of any changes. This is particularly critical if more than one physician prescribes drugs for the individual. Obviously, this information would also be important in an emergency.

Of course medical alert bracelets and wallet cards can be a good idea for many individuals. These are often used for diabetics and patients on Coumadin, a "blood thinner". There are also medical alert signs that can be found online to put on your front door to alert any rescuers. A complete list of medications and so forth can the be kept on the refrigerator or medicine cabinet for their reference. Medical alert systems are also available which not only summon help in an emergency, but often also keep a record of medications and medical information which can be used by rescuers.

Know the Danger Signs and Watch for Them

If you're caring for an elderly loved one, the only other medication tip I can give is to be sure you read up on any drugs they're taking. Acquaint yourself with the precautions, side effects, and any mention of drug interactions. Asking the physician about this is important, but talking to the pharamacist is sometimes easier, as getting time to talk to the physician when you aren't at an appointment can be difficult.

Any time a new medication is started, it's wise to monitor how the individual is responding. Are they having headaches, stomach upset, heart palpitations, loss of appetite, or anything else? It's important to keep tabs on things for a while. Of course, it's also possible that things can go fine for quite some time and only much later have problems arise when things seem to get out of balance. Medications can exceed their therapeutic level over time and need to be changed. Keep the doctor appraised! For elderly individuals who live far away, regular checks by the physician or a nurse are a good idea. Once a year visits aren't frequent enough in my experience.

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Comments 13 comments

Nancy's Niche profile image

Nancy's Niche 7 years ago from USA

Very informative with important points made. My children just went through a tough time when their father decided he refused all medications and any further treatment. Everything he tried made him feel worse and the loss of his independence was just too much. So, they moved him to a hospice center. He actually held on much longer than the doctors had predicted. He was determined to leave this earth on his terms and with dignity.

“The ultimate lesson all of us have to learn is unconditional love, which includes not only others but ourselves as well.” Dr. Elisabeth Kübler-Ross


irenemaria profile image

irenemaria 7 years ago from Sweden

This is comforting to read. The worst situation is probably when YOU have to make all the descicions. When the loved sick one cannot.


Frieda Babbley profile image

Frieda Babbley 7 years ago from Saint Louis, MO

Important hub you have here, mulberry1! My father lives miles away from me, but he had some heart conditions. I have him give me all the details of his medicines and talk to his pharmicist and look everything I can on line. I keep up to date with everything and help to keep him informed. When first given medications, they're usually informed while under the fog of what they've just been through, so I make sure he gets all the info he needs along the way. Still I wish he were closer. But since he's not, this is the best I can do.


lakeerieartists profile image

lakeerieartists 7 years ago from Cleveland, OH

My mother in law takes numerous medications each day and has a pill case to help, but she often forgets to take them and no one seems to be monitoring this well. This is excellent advice.


Peggy 7 years ago

We have found a way to help my mother-in-law take her medication. I bought small manilla envelopes (designed for coins). Each envelope has a label which says the date, day of the week, time meds should be taken, and how many pills are in the envelope. I prepare these. For example: the label will say "Friday, September 4, wake up, 1 pill" (on one envelope); Friday, September 4, morning,(on the next envelope) 8 pills; Friday, September 4, bedtime, 4 pills (on the last envelope). In this way, she cannot be confused whether or not she took her meds. It's been a great success.


mulberry1 profile image

mulberry1 7 years ago Author

Glad it's working for you. Anything to separate them out and label them as you say is helpful!


Nell Rose profile image

Nell Rose 6 years ago from England

Hi, mulberry. A great hub. I wish we had known about all these different ways when my mum and dad were alive. My brother and I had to look after them for many years as my mother was over forty when she had me. The tablet dispensers and charts, where great but we always had to remember when we filled them. I think after a few years of doing this, we, and you are probably more qualified than the doctors! It was traumatic, but I wouldn't have changed it for the world. Love was the best medicine. Thanks Nell


PegCole17 profile image

PegCole17 6 years ago from Dallas, Texas

Mulberry1, How comforting to find someone else who shares in this responsibility. Your tips for monitoring medications are so incredibly important. I sometimes believe I'm more informed than some of the medical personnel we meet. Not in a medical sense, but in the knowledge of reactions to medicines, frequency, dosage and so on for my own parents. I switched my Mom's primary care Dr. after she was prescribed a new cholestral medication following a non-fasting blood test. Once retested with fasting beforehand, her readings were in the normal range. The side effects of the medication would have been worse than adding yet another pill to her day.

We must continue to question the authority of those who only see their patients every few months. We see them every day.

My heart goes out to you on the loss of your Dad, my deepest condolences. I lost my Dad in 2005 to non-Hodgkins Lymphoma. His last few days in the hospital were a nightmare. I found myself reminding the staff to wash their hands and wear masks before approaching him! I felt like such a jerk, but not only was it posted on the door to his room, it was for his protection. One time he was left lying in the hallway for over 20 minutes awaiting an xray. He should have been wearing a mask and someone had forgotten to put it on him.

Without an advocate, patients are at the mercy of anyone and face potential serious risk.

Good advice here for caregivers.


oldbooklover 6 years ago

When an elderly person has become fragile, it is possible that the medications which are genuinely useful for stronger people will now be counterproductive for him/her.

Dr John Sloan, www.sunshiners.ca, has the facts. As a former family caregiver, I urge anyone in this position to check out this website and Dr Sloan’s book “A Bitter Pill.”


PaperNotes profile image

PaperNotes 6 years ago

Taking care of the elderly is sometimes similar to taking care of small children.. at times both are difficult to persuade in taking medications.


Ara 5 years ago

You should never crush or split pills unless your doctor or pharmacist says it's okay.

Some pills are made to dissolve at a certain rate and give you a certain dosage per hour. If you crush the pill, the dosage per hour changes and it could be lethal or ineffective.


mulberry1 profile image

mulberry1 5 years ago Author

Ara, yes I understand. I wouldn't recommend any change without consulting a physician or pharmacist. (that's why I emphasized I can't give medical advice etc. at the beginning) But this article should give people talking points and things to think about to discuss with their health professionals.


gottaloveit2 profile image

gottaloveit2 23 months ago

Excellent advice on medications for the elderly. I was my Mom's caregiver for the last 5 years of her life. You've nailed this topic!

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