#ManicMonday: Managing Grandma’s Medications

As we get older, sometimes we require medication to help with health issues. Medication can be intimidating, especially if you are not used to taking it yourself.  I even have trouble remembering to take prescriptions when the doctor gives it to me. Unfortunately, when you are responsible for another person, especially one that has serious issues like a heart condition or chronic pain, forgetting about medicine is not an option. 

I was trained as a certified medication aide as a direct support professional in my college days, so I was quite knowledgeable about administering medication. We were taught about deciphering the language on prescription labels, properly disposing of medicine, securing controlled drugs, being aware of side effects, documenting each pill on the Medication Administration Record (MAR), transcribing Physician’s Orders onto the MAR, and recording missed dosages and errors properly.

When I was a DSP, the medications were delivered to the house. Most times in that kind of environment, medications come in neatly packaged in bubble packs, and you punch them out according to the date into a little cup or envelope.  So the physical act of preparing meds was a breeze. My grandma frequently says, “You’re done with that already?”

But when you take care of a family member, you have to oversee the whole process of administering the medicine yourself. Sometimes, you have to physically take the prescription to the pharmacy. You have to go get the medicine yourself. If you want to keep track of when you take it, you have to make one yourself or Google it. Pharmacies don’t generate MARs for everyday people. When you run out, you have to refill the prescription. Add the extra layers of emotions and stress that arise from the daily trials of caregiving and all the other things you have going on, and medication becomes another thing that must be managed.

Fortunately for us right now, my grandma only takes has three prescription medications, but she does take several supplements, so it requires that I stay on top of the inventory. But becoming a master of managing this part of her life didn’t come with its lessons. Here are some tips I have after having helped Grandma take care of her medicine over the past couple of years.

 

Tip #1: Make managing medicine a part of your routine.

For some, this means monitoring medication everyday. For us, it means prepping the medicine every week on Saturday.

Before anything else can happen on Saturday mornings, I pull out her pill minders, pill bottles, and list of medications and set them out on the kitchen counter and set up her medicine for the week.  This allows me to keep track of how many of each pill are left, so that we can go to the store and buy more or call the pharmacy and refill them before the weekend runs out.

 

Tip #2: Know your pharmacy’s hours.

My grandma was a customer of Price Chopper Pharmacy for the longest time, strictly out of loyalty to a pharmacist who isn’t even employed there anymore and out of habit, because she lived right around the corner. Price Chopper’s pharmacy is closed on Sundays. People need medicine on Sunday. Hospitals don’t shut down on Sunday. So we had to fire her old pharmacy and get with the twenty-first century (and that is literally what I told her!).

We transferred her medications to Hy-Vee. If you find a really sweet pharmacy, they will transfer the prescriptions for you if you provide the bottles or prescriptions.

 

Tip #3: Join the twenty-first century and sign up for Repeat Refill 

When I first started taking care of my grandma, she went from calling and refilling her prescriptions every time they ran out to being completely dependent on me to take care of them. As a retired lady, she had more time on her hands to be on top of things like this. Since I work full time and juggle multiple obligations, I cannot call and physically go get each medicine as they run out.

Her pastor likes to say, “Automation trumps determination every time.” He is absolutely right. I don’t have to worry about anything running out anymore. The pharmacy calls me when the pills are ready, and I go get them.

If you shop at Hy-Vee, you can learn more about it at: https://www.hy-vee.com/helpful-ideas/repeat-refills.aspx. However, most places like CVS and Target also have a service like this now.

 

Tip #4: Use a pill minder to keep the guesswork out of taking medications. 

When you get older, clearly seeing and comprehending medicine labels can be challenging and confusing. Even distinguishing pills from each other can be a feat. It is easier for everyone involved and there is less room for error if you take the time to set up the pills in advance.

Follow a written list of medications each time so you don’t forget any pills. If your loved one can help you fill the pill minder, do it together. Whether you do it with them or you are completely responsible for prepping medications, you can have peace of mind they are all there (unless of course, they drop it and you find it on the floor weeks or months later while cleaning).

You can buy pill minders at the Dollar Tree or any department store.

 

Tip #5: If you must cut pills, cut them all at once.

One of my grandma’s medications requires that the pills be cut in half, because they don’t manufacture pills in a smaller dosage. At first, I was like, “Cut pills? How do I do that? They didn’t teach me this in Medication training!” I used a common kitchen knife at first, but the pills would break into little pieces. When I complained to my mom about it, I’m pretty sure she told me to get a pill cutter at the Dollar Tree. What an amazing invention!

At first, I would only cut the pills I needed for the week. Then I noticed, it took me more time to stop and do that and I was rushing through the rest of the pills. Now, when I get the fresh bottle of pills, I cut them all at once. It takes a couple more minutes on the front end, but now, when I am setting them up for the week, I can just take out what she needs and pop them right in the pill minder and ultimately saves time in the long run.

 

Tip #6: Use an app to remind your loved one it’s time to take their medicine. 

When we first got my grandma a smart phone, one of the first things I installed was a medicine tracker app.

She was taking Tramadol around the clock as a scheduled medicine, when it was a PRN medication. (Insider hint: PRN means “as needed.) She was taking it at 8am, 12pm, 4pm, 8pm, and even got up in the middle of the night to take it. When she complained about being sleepy and sometimes confused during the day, one of her healthcare professionals recommended trying to take less of it.

We used a medication reminder app to alert Grandma it was time to take her when we decided to change the times she took it. At first, we tried every eight hours, so we set a reminder at 4pm. It turns out that spreading the medicine out that far didn’t help her manage her pain, so we decided to do a dosage at 8am, 2pm, and 8pm. With all these changes, it was a little confusing, so the app really came in handy. You can go back and check the history of when the person took the medicine, as well, so you can see any missed doses or patterns.

We used the Round Health App, but you can search medicine reminder in the App store or Google Play and see which app works best for your family.

 

Tip #7: Keep a log of medication taken.

Medication can have a huge impact on a person’s health and making sure it is administered correctly can prevent unwanted symptoms and even unexpected hospitalizations. As a person’s support and medical needs increase, documenting the administration of their medicine becomes incredibly important.

I use Grandma’s daily organizer to track her medicine. She doesn’t take a lot of medications, so it is relatively simple to keep track of taking them right now, especially since I prepare them for her in advance. Having a space for the times she takes her medicine is good enough for now. It is helpful to her on days she wakes up early or late to visually see what time she takes it so she can write an adjusted time (ie: if she wakes up at 10, she should take her Tramadol at 4pm, instead of 2pm). 

If you use a medication reminder app, you can just use this as your log. I personally like having both to fall back on, just in case she forgets to mark it on her sheet, or she ignores the notification on her phone.

 

Do you have any other tips that make managing medication easier? We need all the advice we can get. Feel free to share them in the comments!

 

Extra Credit: I will give you 50 bonus points if you can tell me what this apparatus is.