Medicines

M is for Medicines

Often older people in need of care have been prescribed many medicines. You might not be confident that the person you care for understands their medicines and is good at taking the right dose at the right time. You can ask the local pharmacist, or a pharmacist based at the GP practice, to do a structured medication review. ‘Polypharmacy’ is the word used to describe the situation when someone is taking too many medicines. The combined side-effects of these medications are sometimes put down to ageing. But the tiredness, constipation, loss of appetite, confusion, falls and many other symptoms may actually be the result of the pills that are being taken for some other reason. The pharmacist knows about how medicines can affect older people differently from younger people. 

A rule of thumb is that an old person should not usually be taking any more than five different drugs. Remember that they may also be self-medicating with over-the-counter medicines that they have picked up from the pharmacy or supermarket in addition.

De-prescribing

‘De-prescribing’ is the word used for going through that list of medicines and making sure anything that’s not needed is stopped, and anything which is reacting badly with another medicine is replaced. Sometimes people have been prescribed medicine for a symptom and they keep taking it even though it didn’t make any difference, or the symptom has gone away on its own. 

Pill organisers, also called dosette boxes or blister packs, help stop medicines being mixed up. These are boxes with a different compartment for each time of the day and each day of the week. They can be loaded by the carer or the person you are caring for, or come ready-packed from the pharmacy. This helps prevent common errors such as accidentally taking the medicine twice. If the person starts to forget to take medicine, you could ask for a care worker to give a prompt or get an automatic pill dispenser. Sometimes the pill dispenser has an alert that can warn you on your smartphone that the person has not taken their medication at the right time. There is more about this sort of kit on the AskSARA website (see Useful Contacts and Resources in the One Stop Guide).

 If the person is refusing to take their medicine, ask for advice from the pharmacist. For example, if they are having problems swallowing pills there might be an alternative syrup. Don’t crush medicines without taking advice. Hiding their medicine disguised in food is a serious course of action because you are making someone do something without their consent. Ask the doctor if this medicine is essential for life before considering an action like that and make sure she knows that you are doing it. And because you already have enough to do, ask the pharmacy if they do a delivery service.

There is much more about medicines in  Carers and Caring: The One-Stop Guide: How to care for older relatives and friends - with tips for managing finances and accessing the right support  available from all good bookshops in May 2022

Three hints:

1.     Get a pharmacy review

2.     Use a pill dispenser

3.     Ask for delivery services