Caregivers can be
overwhelmed with the number of medications that their loved
ones need to take on a daily basis. Medication errors are
too common, with administration of drugs accounting for 38
percent of errors. According to the ALARIS Center for
Medication Safety and Clinical Improvement, at least 7,000
deaths annually are blamed on medication errors.
There are many options on the market for organization
system. Deciding which one is right for your family needs to
be the driving force behind the system that you ultimately
choose. Most all of us are familiar with pill organizer
boxes with various slots for time of day and days of the
week. There are other options, though, that can be just as
effective when implemented consistently.
There are many issues to consider when setting up an
organization system for your loved one. Some of these
How old is the person who is
taking medication? Are they old enough to take their own
medication or do they need someone else to give it for them?
Are they capable of taking
their medication independent of your help? Perhaps your loved
one needs help in keeping track of which medications need to be
given at a particular time of day, but they may be capable of
choosing the correct medication from the shelf.
Do they have impaired
eyesight? Would it help to have larger print on the bottles?
Does your loved one
understand why they take each medication? (NOTE: Patients with
some level of dementia and even children may not be able to
comprehend the medications given.) It is important that persons
understand the reason behind the medication to the best of their
ability. As people age the answer, “because the doctor said so,”
may not be acceptable.
Will others who may assist
with caregiving be able to understand the system readily? If you
leave town or are a long-distance caregiver, the system needs to
be readily understandable to other friends, family, or even paid
caregivers who may be in the household while you are away.
Is the system flexible so
that changes in medications and dosing schedules can be
adjusted? It is not uncommon for doctors to change medications
when there are chronic conditions involved. Be sure to develop a
system that can adapt to these modifications and be implemented
without confusion to your loved one.
No matter what system is chosen,
proper storage of medications is essential. Keep medicines stored in
a cool, dry area away from moisture or heat. The kitchen cabinets
often serve as a favorite place to keep medicines. Be sure that the
cabinets chosen aren’t subject to the moisture or heat changes near
refrigerators, dishwasher steam, or even steam from the kitchen
sink. The holds true for bathroom cabinets as well.
Also, keep medications in their original container until they are
ready to be administered or placed into a pill organizer. It is okay
to make notes on the bottle with a black marker, such as a Sharpie®,
to make instructions more clear for your loved one or other
caregivers. When moving medicines into a pill organizer, make sure
not to take out more than one week’s worth.
The Canadian National Institute for the Blind recommends some of the
following methods when considering a system to organize medications:
Using a pill organizer with
one or more sections for each day. If your loved one is taking
multiple medications, it may be best to associate these with a
meal or event rather than a particular time of the day. You can
“re-label” the time slots with the event to make it more
There are electronic pill
organizers which can dispense medications on a set schedule.
Some of these only have beepers or other reminders to let
individuals know when medications need to be dispensed. Others
can dispense medications on a pre-programmed schedule. The only
caution with these is the programming and being certain that the
device helps in your particular environment. The elderly may or
may not be receptive to their use.
Organizing medication on one
shelf alphabetically or according to their frequency of use. If
you choose this method, be sure that your loved one can read the
labels on the bottle and that they are able to open the bottles
without help. Also, you may need to set reminders to let them
know when it is time to take each dose.
Using personal markers or
even colors on the top of the bottle so each medication can be
readily identified. Blind persons can even put Braille wording
on the top of the cap to make sure that each medication is taken
Changing pill bottle shapes
or sizes to differentiate between medications.
Also, putting rubber bands
on the bottle to indicate how many doses need to be taken each
day. Each time a dosage is taken, remove a rubber band and at
the end of the day, replace them.
While these suggestions may work
well for individuals who can give medications to themselves, there
are still others that may help individuals who are in the home
providing care one-on-one. These suggestions include:
Using a dry erase or
bulletin board to write the medicine schedule. You can color
code if needed. Dry erase boards need to be mounted to a wall
rather than carried around the house since they can be erased
easily, thus contributing to more medication errors. Poster
board can also be used for this same purpose. A simple grid with
medications down the side and dosing times across the time will
help keep you organized.
There are several online
communities that offer simple medication logs where patients and
caregivers can track the medications they need to take and when
they need to be taken. Insert the log into a three-ring binder
and keep it in a place where it is easily accessible. Find one
that works for your situation and use it on a regular basis.
Taking medications that center
on events such as breakfast, lunch, dinner, or bedtime may be easier
than trying to maintain an elaborate time schedule. There is less
room for error and it serves as a good reminder of when medications
may be needed. Plus, with the number of medications that need to be
taken with food, centering some drug administration at meal times
makes it more comfortable for the patient.
These are a few ideas that will help get caregivers thinking about
how to manage medications in the home. Certainly, there is no wrong
way to develop a system as long as it meets physician orders and
provides the necessary medications when they are needed. Being
comfortable with the solution is just as important as finding the
solution. To the extent possible, involve your family members in the
planning process. They may provide insight and suggestions that you
may have overlooked.
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