when you are too far to help elderly manage the meds

[badatmath]

I got a message today that a relative is on over 100 pills per week all of which are round and white and he keeps mixing them up. Has pill boxes. 2K miles away so not like I can sort them. I suggested he ask pharmacists for solutions but . . . any other ideas?

I have a sneaking suspicion if I had to take that many pills I just wouldn't do it. . .

Not really understanding what the color of the pills matters as they are in containers right but . . . since I don't have that problem I can't quite imagine.

 

[badatmath]

I did find CVS has a 30 day pill pack service but can't imagine him moving all the RX there really.

 

[ivinsfan]

Do some online looking and find a pharmacy that will sort andpackage the pills by dose. Perhaps help relative signup and make sure the RXs transfer.

 

[Montecfo]

We found with DMIL that once pill confusion set in, it did not improve despite more sophisticated processes and reminders. Memory issues are a marker for learning ability.

We had to go to hiring a service to administer the pills 3x per day.

Was expensive but effective. It is not a solution she would ever have chosen for herself since she "had been taking them for 30 years".

 

[OldShooter]

DW gets her pills from Amazon prepackaged in dated and morning and evening dose envelopes. It works well.

 

[badatmath]

Hmm. Amazon is probably beyond what relative could handle. And he is in a small town (population well under 3K I think)

 

[Murf2]

We live in a similar sized town and the local pharmacy offers a pill pack service. You might give them a try.

While 100 pills per week sounds daunting, that could be “only” 7-8 prescriptions. A lot of older patients could benefit from a review of medications from time to time also. Might just be able to lose a few.

Good luck!
Murf

 

[marko]

My brother uses the CVS Simple Dose pill pack. Great service and easy to use. He take 9 different meds a day at different times. It's all spelled out with day, date, time, and what each pill looks like.

 

[savory]

We found with DMIL that once pill confusion set in, it did not improve despite more sophisticated processes and reminders. Memory issues are a marker for learning ability.

We had to go to hiring a service to administer the pills 3x per day.

Was expensive but effective. It is not a solution she would ever have chosen for herself since she "had been taking them for 30 years".

Perhaps, it’s simply a sorting issue but my experience reflects the experience shared by Montecfo. Understanding cognitive abilities would be my first step for developing a solution.

 

[Aerides]

Is anyone else close by? If not, and you care enough, time for a trip. Spend a week, do what you can to get them organized, and find local resources that can check in and help out.

 

[MarieIG]

It would be best to have someone close by assist. Maybe find someone nearby with common sense whom you can trust and pay them a minimal stipend for their efforts? A young retiree?

I monitored DF's meds, but I lived across the street. I organized his meds, and eventually handed them to him with his drink. I also checked the bottles and the appearance of the pills when I got them from the pharmacy, and if the pill looked different looked up the appearance from the prescription (color/ markings, etc..), the generic and called the pharmacy to confirm.

I caught at least two errors. One while DF was in the hospital (I went daily while he was admitted and checked his chart) - on a blood thinner by a factor of ten. I had to argue with the nurse who denied that there was an error, but when I would not stop, she eventually called the doctor and the issue was corrected . . .

Different colored pills simply make them easier to distinguish. If you are dealing with organizing a large amount of pills, sometimes you get distracted and wonder - did I put this pill in the dispenser? (Think about counting out $1000 in singles and someone comes by and asks you a question.) If you have really great eye site, you can distinguish the markings on the medication . . .

 

[ncbill]

I would still be asking if the OP's relative really needs 100 pills a week.

ONE doctor should be co-ordinating all those meds.

 

[athena53]

I would still be asking if the OP's relative really needs 100 pills a week.

ONE doctor should be co-ordinating all those meds.

I agree. My late husband's mother was on a ton of meds when he took over her care and he brought them all to her new PCP. I think he cut out half of them, including Premarin. We couldn't figure out why a doc would prescribe that for a woman in her 80s.

The author of "Elderhood", a doctor, found that the reason one nice old couple had bloodwork that zigzagged all over the place from one visit to the next was that they didn't want to deal with all those prescription bottles so they dumped all the pills in a bowl and just took a few every day.

I'm glad there are pill pack services. DH started getting confused in his last few months and I finally started parceling them out on schedule and watching him take them.

 

[harllee]

My mother is in a Continuing Care Community and they have a service whereby an employee comes to mother's apartment each day to administer her pills. Expensive but worth it.

 

[Amethyst]

Vaginal estradiol is prescribed to help prevent UTIs in older women. A gynecologist should be consulted.

I agree. My late husband's mother was on a ton of meds when he took over her care and he brought them all to her new PCP. I think he cut out half of them, including Premarin. We couldn't figure out why a doc would prescribe that for a woman in her 80s.

The author of "Elderhood", a doctor, found that the reason one nice old couple had bloodwork that zigzagged all over the place from one visit to the next was that they didn't want to deal with all those prescription bottles so they dumped all the pills in a bowl and just took a few every day.

I'm glad there are pill pack services. DH started getting confused in his last few months and I finally started parceling them out on schedule and watching him take them.

 

[athena53]

Vaginal estradiol is prescribed to help prevent UTIs in older women. A gynecologist should be consulted.

I know- I'm using it myself (for another purpose as well ). She was getting the pills. DH's mother died years ago so nothing to do now. Maybe the doc prescribed the pills because he/she thought compliance would be better than applying the cream a few times a week.

 

[badatmath]

Yep his problem is different doctors prescribe the pills though he says he takes a list to each appointment. None seem to want to overrule the others and actually tell him to stop any. I have pointed out he needs to upgrade to assisted living or something but he refuses to consider it.

 

[pacergal]

Is there a way you could arrange a trip to visit?
--go to a medical appt with him/her and take the pill bottles, not just a list. Make sure doc reviews each med/why prescribed/?still necessary
--check out local pharmacies to see if they offer pill packs/dated/timed. If not, arrange via Amazon or on line pharmacy and help transfer prescriptions

You could also check local Senior Social Services to see what they could help with or recommend/refer. Perhaps once month at home nurse to set up daily/weekly pill containers. Purchase several and they could be set up for 4 weeks at a time.

 

[Sarah S]

Agree. Urgently needs a med review. Does he have a pcp? Any pcp worth the title should be able to find a way to cut these drastically.

 

[OldShooter]

Hmm. Amazon is probably beyond what relative could handle. And he is in a small town (population well under 3K I think)

If pill packs are available locally and competently (Bozos at Walgreen and CVS, I'm looking at you.) then that is probably the best choice. DW just had her scrips transferred to Amazon and her box of pill packs for the next month arrives early in the previous week. It's automatic and requires her attention only to open the boxes. I think she started this a couple of years ago and the experience has been good.

 

[badatmath]

Yep he has a pcp, pcp will not override the cardiologist, of which he actually has 2, for different heart issues. IDK if the kidney doctor has him on anything. I will have to ask. It is difficult to get straight answers because it mostly makes him mad.

 

[MichaelB]

We found with DMIL that once pill confusion set in, it did not improve despite more sophisticated processes and reminders. Memory issues are a marker for learning ability.

We had to go to hiring a service to administer the pills 3x per day.

Was expensive but effective. It is not a solution she would ever have chosen for herself since she "had been taking them for 30 years".

This matches my experience with DM as well.

Do some online looking and find a pharmacy that will sort andpackage the pills by dose. Perhaps help relative signup and make sure the RXs transfer.

I would still give this a try before looking for caregiver assistance. It will mean transferring all the prescriptions to a pharmacy that assembles and packages by dose, but it’s easier and less expensive, and if it works, more reliable than hiring someone to administer the pharmaceuticals.

Any option OP chooses needs regular inspection.

 

[OldShooter]

Yep he has a pcp, pcp will not override the cardiologist, of which he actually has 2, for different heart issues. IDK if the kidney doctor has him on anything. I will have to ask. It is difficult to get straight answers because it mostly makes him mad.

I recall one time being advised to have a PhD pharmacist review my meds. If you can find such an animal that may be the best choice. I never followed through but the health care system we use shows several "PharmD" on staff and offers a program called "RxCheckup."

 

[Morgan22]

Maybe look into PACE programs in his state? My elderly mother recently began using her state's PACE program and it's working well so far. Everything goes through her PCP. The PCP has done a thorough review of all meds and cut them down a bit. She also now receives everything in prepacked daily bundles like others on this thread talk about. From what she tells me her PCP sounds very attentive to her needs and my mother seems happy with the program.

 

[badatmath]

It says PACE coming June 2024 for his state but still very helpful to hear of such a place.