With the variety of chronic ailments that can come with age, it is no surprise that senior patients/clients use more over-the-counter and prescribed medications than any other age group.
Taking multiple medications for different conditions can pose a significant health threat for seniors, with medication mismanagement cited as a major cause of hospital admissions, readmissions, and nursing home placement. These, in turn, contribute to higher healthcare costs.
Recent surveys reveal that:
- Seniors use more medicines – over the counter, prescription, and supplements – than any other age group in the US
- 75% of 50–64-year-olds use prescription drugs, filling an average of 13 prescription medications annually
- 87% of 65–79-year-olds fill an average of 20 prescription medications annually
- 80% of those taking medications report making mistakes in medication adherence, including forgetting to take them
- 55% of seniors don’t take their medication according to their doctor’s instructions.
For many seniors, remaining independent and living at home may depend on their ability to manage a complicated medication regimen or receive the appropriate help and support to do so. Making sure senior clients take their medications as prescribed, on time, and in the correct doses is an essential component of the home care management process.
As a caregiver, you may be responsible for ordering, picking up, and administering medication, in addition to providing transportation to appointments and dealing with scheduling, billing, and insurance issues. You might also be required to assist with other medical processes such as physical therapy, injections, feeding tubes, and so on.
So, what can you do to support your senior patients/clients further to ensure they manage their medications successfully? First, it is necessary to be aware of the challenges they face.
Top 8 Medication Challenges for Seniors
1. Forgetting to take medications
For many seniors who suffer from chronic conditions or cognitive impairment (such as dementia) that require multiple prescriptions, remembering to take their medications can prove challenging. Additionally, frequent changes in prescriptions and dosages can lead to further confusion.
2. Resistance to taking medications
There are many reasons for seniors resisting or refusing to take their prescribed medications. Common reasons include:
- Confusion: Dementia or Alzheimer’s patients, in particular, may not be able to process the concept of taking medication or understand what is going on at all.
- Adverse effects/interactions: Most drugs have side effects, and in cases where these cause significant discomfort, seniors may resist taking their medication because they feel worse. Drug interactions with other medicines, foods, or drinks are another common problem that can put seniors off adhering to a medication plan.
- Difficulty swallowing: Many pills can be hard to swallow, especially for seniors who have had a previous stroke or suffer from dental issues.
- Unpleasant taste: A lot of medications have an unpleasant taste. It is common for seniors to be fussy about what goes into their mouths, especially if they associate certain medicines with a bitter taste/after taste.
- Fear of becoming addicted
- Mistrust: Some seniors do not trust their health care providers or their motivations for prescribing certain medications.
3. Inadequate health literacy
Research shows that up to two-thirds of US adults over 60 years of age have poor literacy skills. Family caregivers can also lack adequate health literacy skills to manage medications well. Additionally, family caregivers report receiving little or no training in managing medications, despite frequent visits to the emergency department and overnight hospital stays.
4. Confusing one medication for another
It is common for prescription medications to have names that are similar, hard to remember, or easy to get mixed up. Seniors, especially those with memory problems, can confuse pill bottles and pills when they appear similar. Additionally, poor vision in some seniors can add to this challenge.
5. Taking more medication than prescribed
Accidental overdoses are the number one cause of medication fatalities in seniors, particularly those with memory problems who cannot remember if or when they took their last dose and thus take multiple doses without realizing.
6. Not taking medication according to doctor’s instructions
Understanding and remembering instructions for taking their medications is another big challenge, particularly for seniors taking multiple medications for different conditions. The FDA reported that nearly 20% of medication errors are due to seniors taking them incorrectly, such as swallowing rather than taking sublingually (under the tongue) or taking with/without food.
Studies report a considerable inconsistency between medications prescribed and medications taken by seniors. For example, one study reported that at two days post-hospital discharge:
- 64% of patients were taking at least one drug that was not ordered
- 73% were not using at least one medication as prescribed
- 32% were not taking all the medicines issued at discharge.
7. High medication costs
Being able to afford multiple prescriptions is another big concern among seniors. Those on low- or fixed incomes may not be able to afford all the medications they need. As a result, some will reduce the prescribed doses or go without necessary medications for long periods.
8. Living alone
Many seniors live alone. Several studies have shown that those who live independently are less likely to manage their medication regimens successfully. It is common for seniors to feel lonely, become depressed, and fall out of important routines (like their medication schedules) if they lack regular engagement with others.
Caregivers can prove invaluable in supporting seniors with proper medication management and providing them with valuable socialization.
To help your senior patients/clients avoid these common medication challenges, we’ve put together a list of our top 10 tips:
10 Tips for Medication Management With Your Senior Clients
1. Do your research
Seniors typically receive prescriptions from different healthcare professionals, making it challenging to keep track of medicines and identify any drug interactions, side effects, and harmful or ineffective doses.
It is helpful to learn about your senior clients’ health conditions and medications by talking with healthcare providers, reading trustworthy websites, attending relevant training, etc. The more information and knowledge you have, the better placed you will be to manage their care plan and medication regimes – and identify any potential problems.
Read the medication labels thoroughly to understand dosages, frequency, etc., and learn about interactions and side effects. Reading medication labels is vital for prescription drugs, over-the-counter medications, and any supplements or herbal remedies.
As a caregiver, you are likely to be the key person that knows your patient/client’s particular needs and challenges – and will notice any changes in their health or behavior over time. By being well-informed, you can be their champion, ensuring they receive the very best care.
If you have any concerns, speak with your client’s doctor, health provider, or pharmacist.
Trust your instincts, and don’t be afraid to ask for additional advice if you feel something is off.
2. Minimize the number of doctors and pharmacies
If relevant in your caregiver role, try to reduce the number of providers and pharmacists, making it easier to coordinate care, maintain communication, and prevent confusion. Where possible, try to use only one pharmacy for medications, which will add an extra layer of safety around appropriate dosage and adverse interactions.
By using one pharmacist, you can ensure they have the complete list of prescriptions that your patient/client is taking, keep track of refills, monitor the use of medications, and check for any drug effects and interactions.
Another benefit of using one pharmacist is caring for seniors who need multiple medications on a budget. Generic prescription drugs can be obtained in many cases, which feature the same active ingredients as brand-name counterparts but are usually considerably cheaper. There are also financial assistance programs for prescription medications, with many pharmacies offering a discount program or manufacturer discount programs and state prescription assistance programs. These can all help to reduce drug costs significantly.
3. Make sure everything is written down
It is essential to create and continuously update medication lists for your senior patients/clients. This is useful for you and your client and their family members, healthcare providers, and the pharmacy.
These lists should include:
- the name of each medication (generic and brand), including OTCs, supplements, and any herbal remedies
- who prescribed each drug and the pharmacy that supplies it (and their contact details)
- what the medicine is for and the symptoms it should treat
- how to take the medication – dosage and frequency, and any special directions (e.g., how many times a day/week, time of day it should be taken, what it should/should not be taken with)
- likely side effects, interactions, and allergic reactions to be aware of
- warnings, including who is at increased risks of side effects and when to stop using
- if/when refills are needed
- storage instructions.
Several apps are available to help create medication lists, but experts recommend that seniors have a paper version they can keep and take to doctor’s appointments.
The list must be regularly reviewed and kept up-to-date, for example, when your client is prescribed something new, if a medicine is stopped or if a dosage/frequency changes.
4. Keep all medications organized and stored properly
It is essential to make sure medications are stored safely in their original bottles/tubes, clearly labeled, and kept out of the reach of children. A clear plastic storage container is ideal and ensures that everything stays together in one location.
By keeping medications together and well organized, you can see what is being taken, when refills will be needed, and when to dispose of expired medications. If your senior client has multiple prescriptions, use a separate container for backup medications and those only used occasionally to avoid confusion.
5. Set up a medication management organizer
Setting up a medication management organizer for seniors taking multiple doses of different medications throughout the day is beneficial. There are numerous tools and devices you can utilize. These can also help your senior clients maintain independence, as once the medication is organized in daily batches, they just need to remember to take them.
The most commonly used organizer is an automatic daily pill dispenser (available at most drug stores/pharmacies), with separate compartments for each day’s medications. Many have additional compartments within each day so that seniors can quickly identify which pills they need to take in the morning, afternoon, or evening.
If you are caring for seniors with more advanced dementia who can’t safely manage their medications, it is still beneficial to set up a dispenser – which you (or a family member) can supervise. This saves time and ensures the right medications are taken as instructed, regardless of who is overseeing the process.
6. Pre-sort 1-2 weeks of medication at a time and stick to a routine
Staying organized with a fixed routine is essential for good medication management. Sticking to a pattern can be very beneficial for getting senior patients/clients to cooperate, especially those struggling with dementia. A regular schedule can significantly reduce resistance to taking medication.
Organizing medication for 1-2 weeks in advance saves time, reduces errors also helps you to know well in advance when your senior patient/client will run out of each medication.
7. Set medication alarms/reminders with a tracking system
Many seniors have difficulties remembering to take their meds or struggle to keep track of whether they have taken them on certain days. A medication reminder system and tracking log can help with this issue, ensuring they know when to take their medication and if they’ve taken the right meds at the correct times.
It is possible to create tracking systems with pen and paper, for example, a simple chart that you or your senior client can mark with an X when each dose has been taken.
You can set up automated reminders for seniors with memory problems, including alarms, such as medical alarm watches or bracelets, or mobile reminders. Some of these tools can relay reminder information verbally, based on personalized recordings.
SMARTcare software includes automated reminders via the SMARTcare mobile app.
You can use automatic dispensers and computerized pill boxes that call a designated number if pills have not been taken on time for extra safety.
8. Monitor and observe reactions
You can prevent major health risks by regularly talking with your senior clients about their medications and monitoring any health or behavioral changes when increasing/decreasing dosage, adding a new prescription, or beginning a different combination of drugs.
As seniors often require multiple medicines, there is an increased danger of drug interactions and potential side effects. In addition, many age-related changes – such as weight loss, decreased body fluid, reduced liver and kidney function, and increased fatty tissue – can alter the way drugs are absorbed, broken down, and removed by the body. Increased sensitivity to medicines is also more common in older adults.
If your senior patient/client begins to show signs of being unable to manage their medications (for example, increased confusion), do not allow them sole management of their medications. You will need to closely monitor the situation for signs of medication mismanagement, such as pill hoarding, premature refills, medicines left over that have not been taken completely, or refills that have not been collected on time.
9. Make it as easy as possible for your senior client
Getting older and dealing with multiple health issues is stressful for your senior clients, so making their medication management as easy as possible is essential. In addition to the tips above, try to create a calm environment around taking medications and help your seniors cultivate a relaxed, positive mindset.
There may be specific issues around taking medication that you can easily resolve. For example, for those with failing eyesight, many pharmacies offer labels with large print or even a talking medication system that includes micro-chipped labels and readers that scan individual pill bottles and recite crucial information aloud. Similarly, if a senior client has trouble swallowing a particular medication, ask their doctor or pharmacist if it is available in smaller pills or a liquid solution that is easier to swallow.
Be creative in finding workarounds to your senior clients’ specific problems or frustrations and make the process as simple and easy as possible.
10. Offer rewards
Where you are dealing with senior clients who are particularly resistant to taking their medications, it can help to offer rewards so that they begin to associate the process with something positive.
The best motivations will be things you know your senior client values, whether a chocolate treat, a walk around the park, a Facetime call with a friend/grandchild, or a game of cards.
Managing medications is often a significant part of providing excellent care to your senior clients. A clear, systematic approach is required to effectively manage medications in these patients/clients, recognizing their individual needs and specific goals.
Remember, effective medical management requires teamwork. We hope these tips help to empower you, your senior patients/clients, and their families to better manage medication regimes, get the very best results from care plans, and avoid the common risks involved in taking multiple medications.
To find out more about how SMARTcare software can help you, your clients, and their families, give us a call today.