Developing an Organized Medication System at Home

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 include:

• 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: People 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 permanent marker 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 user-friendly.
• 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 accurately.
• 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.