Medicine ABC’S for Caregivers

The following is an overview of the basics every caregiver should know about medications. Reviewing them and ensuring they are followed can save a life.

Medication Basics for Caregivers

•    Keep a record of all medications taken.

Make a list of all the medicines that the person you are caring for takes. Include prescription and nonprescription medicines. (Personal medicine record books, sometimes called “medication passports” are available at no cost at some pharmacies.)

Write the name of each medicine, the doctor who prescribed it, what it is for, the amount taken, the possible side effects, and the times of day it is taken.

The person you are caring for should keep a copy of the list in the medicine cabinet and in his or her wallet or pocketbook. You should keep a copy, too. This record should be reviewed with the doctor at every visit and whenever a doctor prescribes a new medicine by phone.
•    Ask about drug allergy bracelets and necklaces.

Drug allergy bracelets can be bought in many pharmacies. These are small metal bracelets that can be worn over the wrist or hung on a necklace. For example, a bracelet might say “Allergic to penicillin.” Custom medical identification bracelets or necklaces are also available by mail for a fee. Some pharmacies have the application forms.

Customized bracelets can tell medical personnel, such as ambulance workers, about a person’s medical condition, allergies, medicines, and special needs, such as blood type and if the person has a living will. In some instances this information will be provided to health care workers when they call a telephone number imprinted on the bracelet.

•    Ask the doctor or the doctor’s staff to review all medicines and explain the reason for each medicine at least once a year.

As new medical problems occur, new medicines may be prescribed and it is important for the doctor to know what medicines the person you are caring for is already taking. Also, new information about side effects may become available about these drugs. Therefore, it is important that medicines be reviewed regularly.

•    Use only one pharmacy, if possible This way, the pharmacy will have all of your prescription medicines and drug allergy information on a computer. This will be helpful when the pharmacist checks for drug interactions as new prescriptions are filled.

Tell the pharmacist the medical problems that the older person has. Medicines taken for one problem may make another problem worse, and the pharmacist may notice this if it has escaped the doctor’s attention.

•    Labels can be hard to read and difficult to understand. Ask the pharmacist to explain the information on the label including expiration date, number of refills (if any), and directions for use. If the information is not clear, ask for an explanation.

For example, if a label says “Take three times a day,” what does that mean?
Does that mean every eight hours?
Does the patient need to be awakened promptly to take the medicine?
Should the medicine be taken with meals or an hour before meals?
What should you do if a dose is skipped?
Can it be taken with other medicines?

•    If there are no children in the home, refuse child safety caps on bottles

Child safety caps have helped prevent child poisonings, but they can be difficult for an older person to open. If it is too much of a struggle to open the bottle, an older person may not take the medicine. If children sometimes visit, keep medicines locked up or on a shelf they cannot reach or work on some other solution that both helps an older person get his or her medicines easily but also keeps the medicine away from children.

•    Store medicines in a cool, dry place

Although many people keep their medicines in the bathroom, its high moisture content makes it a poor place to keep them. Many tablets and capsules lose their strength if exposed to moisture or strong heat or light. The bedroom is usually a better location. Store medicines in the refrigerator only if told to do so by the pharmacist or if they are labeled “Refrigerate.” If you do not know how to store the medicine, ask a pharmacist.

•    Keep medicines in their original containers

Mixing different pills in one bottle can be confusing and even dangerous. Since many medicines look alike, this can confuse the patient, caregivers, or people who may be called on to help in an emergency.

•    Do not keep medicines at an older person’s bedside

An older person can wake up in the middle of the night and take an additional dose of medicine without realizing it.

•    Have the older person sit up or stand when taking pills, and use a half cup of water to wash them down.

Use water-not milk or other drinks-to help wash down a medicine. Some medicines are less effective when taken with milk. Water will help prevent the medicine from sticking in the throat and causing irritation. If the person you are caring for has difficulty swallowing, ask your pharmacist if the medicine is available in liquid form, or ask if it is all right to crush the tablet and mix it with applesauce or other soft food. Some tablets or capsules should not be crushed or chewed.

•    Use a pillbox.

You can buy a pillbox with many sections at your pharmacy. Some pillboxes have compartment sections for seven consecutive days and for times of day the medicine must be taken: early morning, noon, evening, and bedtime. Mediset(tm) is a popular brand of this type of pillbox.

There are also pillboxes with alarms to notify the user when the next dose should be taken. (These are useful for medicines that require precise timing, such as medicines for Parkinson’s disease.)

For medicines that cannot be placed in a pillbox-such as liquids, cream, and patches-a reminder note placed on the refrigerator may be helpful. Keeping medicines on the kitchen table with a note saying when to use them may also be helpful.

•    Use reminders.

A checklist or marking on a calendar may be helpful to show when medicine should be taken and when it was last taken. Alarm clocks can be helpful or you may have to remind the person you are caring for when to take medicines.

•   Ask about other ways to take medicines.

Most people have trouble remembering to take a medicine three or four times a day. If the person you care for has trouble taking the prescribed medicine, or has trouble remembering to take the medicine, tell the doctor or pharmacist. He or she may know of a similar medicine that is easier to take, or one that needs to be taken only once a day.

Some medicines are available in the form of patches that are placed on the skin and need to be changed only every few days; however, they are usually more expensive than the same medicine in pill form.

•    Throw away old medicines.

Check the expiration days on medicine bottles, and throw medicines away if the date has passed. It is usually a good rule of thumb to discard medicines after a year.

It is natural to want to hold onto unused medicines (“just in case”), but stockpiles of medicines can be confusing and even dangerous. Some pharmacists highlight the expiration date with a yellow marker; you can do the same thing at home.

Highlighting the expiration date on nitroglycerin tablets is especially important for they may keep their strength for only six months once opened.

Some communities have laws about how drugs can be disposed of. For example, in these communities it is illegal to flush medicines down the toilet. Ask your pharmacist if it is OK to flush medicine down the toilet or if you can return the expired medicines to the pharmacy for disposal.