when you are too far to help elderly manage the meds

I did oddly enough find a potential pharm D not too far from him. Looking at that.
 
Tough situation to manage from a distance. All the pharmacists graduating in the last couple of decades have been PharmD (which is not a PhD) Pill Packs could help but in person assistance might be needed. Fewer prescriptions would be better but if the primary care won't deal with it there isn't any easy way out.
 
How close is this relative you don't have to be specific...if its a close relative the term you got a message is confusing.Did the relative talk to you directly? Is it really over a hundred or just a whole bunch. Any large pharmacy chain will usually have a phone app where it lists all meds and the prescribing doc. If your family member gives permission you can remote monitor by your phone. Then you have one ask... not many questions and less likely to cause anger. You could research the meds a little to educated yourself on what might be going on. As a caution if your relative takes betablockers or the like missing doses can cause huge problems...good luck
 
100 pills a week is pretty rough. But it could be worse, my father-in-law (79 years old) takes 27 pills a day, so 189 a week. It does get pretty complicated, but he does not have any mental impairments yet. He does have a system, but even then mistakes can happen. I wonder if I should suggest one of these pharmacy programs that have been mentioned.
 
A friend of his stopped by and sent me a msg he had confessed to her about the meds and she passed it on. She lives probably 100 miles form him so would not be daily help. And he does take 115/week according to the msg anyway.

I had relatively recently read an article about a the pharmD (which I thought meant specialty consultant or something but apparently doesn't) and as I understood it you make an appointment with such people, pay them a chunk of money and they go through your meds and provide suggestions to your doctors where there might be overlap or issues. I had saved the article not imagining I would need it as this decline has been rather quick. It was from Prevention 2008 and says nothing of pill packs (maybe that was not a thing yet?)

It is a bit wordy if you don't like to read, but mostly says it is pretty easy to get overdosed by different doctors consequently the patients get harmed from side effects.

https://siricarpenter.com/wp-content/uploads/2009/11/polypharmacy.pdf
 
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Pharmacies have software that looks for interactions and conflicts maybe someone in the business could give more insight in this thread. Using a single pharmacy is desirable. I used to get notes from pharmacy benefit managers from time to time on the lines of medication x is associated with more side effects in old folks. On the other hand if there are value judgments, trade offs and multiple prescribers it could be a challenge to get changes implemented as noted your article where a patient was fired by a physician for bringing the consultant pharmacist's report.
 
RetMD21 said:
... it could be a challenge to get changes implemented as noted your article where a patient was fired by a physician for bringing the consultant pharmacist's report.
Click to expand...
I would consider being fired like that as a solid gold gift! The last thing I want to have is an arrogant doctor who thinks he knows everything. That is a truly dangerous situation.
 
OP is your goal to reduce the number of pills or simply to facilitate proper dose taking of the medicines in question?



Because of the distance involved the dose control would be easier to implement. You seem pretty resistant to the idea of dose packaged meds which is really the only easy fairly quick solution here.
 
ivinsfan said:
OP is your goal to reduce the number of pills or simply to facilitate proper dose taking of the medicines in question?

Because of the distance involved the dose control would be easier to implement. You seem pretty resistant to the idea of dose packaged meds which is really the only easy fairly quick solution here.
Click to expand...

Both.

I guess I don't understand how I can make him use a prepackaged program that he is not interested in. (I brought that up yesterday) and that he is convinced (without checking) that his insurance would not pay for. As it is his medicine is "too expensive" and he will use difference pharmacies and discounts for the best deal. His insurance is not medicare d and he will not switch to it if that matters. I have no actual authority to do anything on his behalf that I know of.

I have learned a lot from this thread though. The problem won't be solved overnight.
 
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Op you hit the nail on the head...it doesn't sound like your relative is willing to accept any help..silly us for thinking he was doing anything but complaining. You mentioned the easiest solution the prepackaged option and he blew it off. You obviously can't make him do it...your hands are pretty much tied at this point. Frustrating for you
 
ivinsfan said:
Op you hit the nail on the head...it doesn't sound like your relative is willing to accept any help..silly us for thinking he was doing anything but complaining. You mentioned the easiest solution the prepackaged option and he blew it off. You obviously can't make him do it...your hands are pretty much tied at this point. Frustrating for you
Click to expand...

It is but I still might be able to make use of this information in the future as it is not really anything I ever gave any thought to. And maybe with some time to adjust to the idea he will not resist so much.
 
badatmath said:
Both.

I guess I don't understand how I can make him use a prepackaged program that he is not interested in. (I brought that up yesterday) and that he is convinced (without checking) that his insurance would not pay for. .
Click to expand...

Oddly enough pharmacies seem to pill pack for free but it doesn't matter if he isn't interested. It would be nice if his primary care dr looked into his cognitive issues but that likely won't happen if he doesn't bring it up
 
*update* Relative in question landed in the hospital for emer heart problem. Guess that accounts for his confusion maybe.
 
badatmath said:
*update* Relative in question landed in the hospital for emer heart problem. Guess that accounts for his confusion maybe.
Click to expand...


Or it could be the result of mixed up heart meds..let's hope this med and med identifying issue gets addressed in the hospital..who is listed as his ICE contact, they might talk to the hospital social worker for some help.
 
Well I am the emergency contact but the hospital is the biggest mess I ever saw and tell me nothing. They certainly show no interest in the patient either. Maybe tomorrow with holiday over they will be back to more staff.
 
I know from managing my friend’s pills while he had Parkinson’s disease that it’s a big job. First his came in blister packs but he couldn’t open them. So I got them in bottles and filled the dispenser for a month. They had pictures of the sun for morning and moon for night. He was on 16 medications.

That’s when I realized that he couldn’t manage his own medication. I would check to see what he had taken. That’s one of the reasons he had to move to an assisted living apartment from independent living. You can’t do any of this from a distance.
 
It doesn’t sound like that many pills to me, but I just counted and I’m on 20/day so 140/week of the daily meds, not including the “as needed” prescriptions of which I have dozens. This is down from over 210/week which were taken over six time periods per day, and with many of the same “as needed” meds on the side. And I’m only 58 ��. Health issues can be very complicated! I couldn’t manage the 210+ without help. I have to use two large pillboxes currently, and I still sometimes mess up. My health care providers review all meds every visit.
 
I hired a service to give Mom her pills. Once she got confused no amount of containers, me loading the containers, or reminders helped. The one I hired was called Right At Home, but there are lots of services.
 
KarenF said:
I hired a service to give Mom her pills. Once she got confused no amount of containers, me loading the containers, or reminders helped.
Click to expand...
+1. My mom with dementia had a dear friend who pre-loaded her monthly pill dispenser with a timer and alarm (the lid for the compartment with the current dose automatically popped open when ready). My mom rarely heard or recognized the alarm, and was still over and under-dosing as she could never remember if she had taken her pills. And she kept calling the pharmacist and getting extra refills as she could not remember that her friend was setting up her meds.
 
I had to ask for a "meds review" every 6 months the last 2 years of his life. He had many specialists who just added meds, never took away. A PCP nurse or a pharmacist can review all meds and see if he still needs them. We check with the specialists to confirm.
 
I think the pill packs are a great idea, but if has memory issues pill packs alone won't insure compliance. My late MIL was on Synthroid for years before she was prescribed BP meds after a stroke; She could never remember she was on BP meds or that she had a stroke. My ex would call her everyday to make sure she took them. My suggestion for you would be to get the pill packs, but call everyday to make sure they take them. Speak with their PCP. They may be able to time the meds or use extended release versions so you only need to call once or twice a day.
 
First is to get the relative to dr to get meds straightened out. No one needs to be on that many pills. I am in anesthesia we see it a lot that patients are on too many pills for same thing. After that if no relative or neighbor can help, how about council on aging type organization to offer ideas. Good luck it is a big unsafe problem
 
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