Verified by 
Key points
- When medications are not taken correctly, strokes, seizures, bleeding, and other serious problems can occur.
- Is your loved one taking medications from bottles? Count them to assure they are being taken correctly.
- Pillboxes are usually a good option. There are many styles available.
- You, other family members, friends, neighbors, or professionals may need to administer the medications.
In my last two articles, we reviewed basic memory strategies and memory aids, two ways to improve memory and daily activities. Managing medications, however, is so critical to the health of your loved one that this piece is dedicated entirely to this topic.
Assure medications are taken correctly
There are many medications that can result in life-threatening problems if doses are missed or taken twice. If your loved one has been taking their medications on their own for years, it can be tempting to simply let them continue. Perhaps they keep their medication bottles on the nightstand and have been taking them every day before they go to bed. But how would you know if they miss a dose or if they take a dose twice? The reason that keeping medication bottles on a table and taking them at a certain time of day typically fails when one has even very mild dementia is that this system relies upon memory. One first must remember to take the medications and then one must remember that the medications have been taken (so that they are not taken again). Luckily, there are many good solutions.
Count the pills
If your loved one only has mild memory problems and you think that their old system of taking medications directly from their bottles is still working, you can easily check and make sure. Simply count and write down the number of pills in each bottle. Next, note how many pills should be taken each day from each bottle. Return a week later and count the pills again. Are the correct number of pills in each bottle? If so, then good; the old system is still working. If not, then a new system is needed—and needed today.
Have family, friends, or professionals administer medications
If you (or another family member or friend) are living in or near their house, one simple solution is for you to give them their medications. You can use whatever system you wish to make sure the medications are being taken correctly, but you may wish to use one of the systems described below. If there are no family members, friends, or neighbors who can help, a nurse can be hired to administer the medications, or other professionals can remind your loved one to take them.
Use a pillbox
There are numerous styles of pillboxes available today. Basic pillboxes have one compartment for each day of the week and come in one-week, two-week, and one-month options. There are also pillboxes with two compartments each day (for morning and evening pills) and some with three compartments (for morning, afternoon, and evening medications). They can have a variety of other options, including color-coded compartments, Braille lettering, built-in alarms, display screens, and even communication devices that alert family members when medications are taken. You may want to speak to your loved one’s doctor to find the right pillbox for them. Some providers may give you a free pillbox and some insurance companies will cover its cost.
Once you have a pillbox for your loved one, the next step is to determine how it will be used. Some individuals with very mild dementia may be able to fill their pillbox and use it to take their medications correctly by themselves. Most individuals with mild dementia, however, will need you to help them fill their pillbox, but then can take the pills on their own. In both of these cases, you should routinely check the pillbox to make sure it is being used correctly. In moderate dementia, you need to both fill the pillbox and supervise them taking their medications. Some families have found success in calling their loved ones on the phone and having them take their medications right then and there—while they are on the phone. In this moderate stage of dementia, the pillbox is mainly a tool to help you or another caregiver make sure that medications are being taken correctly.
Last, pharmacy-filled blister packs are becoming more common and are essentially pre-filled pillboxes. This option is ideal because no one has to take the time and trouble to fill a pillbox and you know the pills are in there correctly. Check to see if your pharmacy has this option available.
© Andrew E. Budson, MD, 2022, all rights reserved.
References
Budson AE, O’Connor MK. Six Steps to Managing Alzheimer’s Disease and Dementia: A Guide for Families, New York: Oxford University Press, 2022.
Budson AE, O’Connor MK. Seven Steps to Managing Your Memory: What’s Normal, What’s Not, and What to Do About It, New York: Oxford University Press, 2017.
Budson AE, Solomon PR. Memory Loss, Alzheimer’s Disease, & Dementia: A Practical Guide for Clinicians, 3rd Edition, Philadelphia: Elsevier Inc., 2022.
