Reviewed by Dr Patrick Ruane
How are your parent’s managing their medications? Are they taking them the way they are supposed to? Do you know what they are all for?
Many older people have more than one health condition and need to take multiple medicines – often in different formats (pills, drops, inhalers, injections) – at different times of day.
Some older people start to find managing all their different medications challenging, whether that’s remembering to take them, knowing how to take them in the right way, or remembering what they are taking them for.
This can lead to several complications including taking the wrong dose – either too much or too little – continuing medications that are no longer needed, not taking them as prescribed, or missing them altogether.
By proactively helping your parents manage their medications as they age, you can prevent harmful mistakes and ensure they get the full health benefits of their treatments.
Here are some practical ways to make monitoring and managing their medications easier:
Create a detailed medication list
Start by keeping a comprehensive list of all the medications your parent is taking, including:
- Prescription drugs (those prescribed by healthcare professionals)
- Over-the-counter (OTC) medications (things like painkillers or antacids that don’t require a prescription)
- Any vitamins or supplements
As well as their NHS GP, remember that other healthcare providers, such as private consultants, physiotherapists, or nurse prescribers, may have prescribed additional medications for your parent. It’s crucial to gather all this information in one place to avoid any confusion or missed doses.
In the list, make sure you include the medication names, dosages, when and how often they are supposed to take them, and the reason they take them. Include any special instructions, such as whether or not any should be taken with food.
Print the list and place a copy in an easily accessible place, such as on the fridge, so that you, your parent or anyone caring for them can quickly reference it when needed.
Keep the list on your phone as well (either by taking a photo, or keeping it in a ‘Notes’ or ‘documents’ app). A list on your phone is a very handy reference during health consultations or emergency admissions to hospital.
Taking photos of medication bottles, packaging, and instructions can also help ensure that nothing gets overlooked, and it provides a quick visual reference during consultations.
IMPORTANT: Make sure you check and update the list regularly, especially after any new prescriptions or changes in treatment plans. Always read the medication labels carefully, especially after refills, as dosages or instructions may change.
Learn about each medication
Make sure you know exactly what each medication is for, how it works, and its potential side effects or interactions with foods or other drugs. If you find reading the Patient Information Leaflets in the drug packets overwhelming, don’t be afraid to ask their doctor or pharmacist to help you.
Specifically, you’ll want to know:
- What is this medication treating?
- How should they take it? (e.g. once/twice a day, in the morning/evening, with/without food)
- How long will they need to take it?
- What are the common side effects?
- Are there any foods/drinks or activities to avoid?
- What should they do if they miss a dose or take the wrong amount?
- Are there any medications or supplements they shouldn’t take when taking this medicine?
Help them organise their medication
Good organisation makes a big difference. As well as making sure medications are stored together properly in one place, and any expired ones are thrown away, you might want to consider the following:
Pill organisers
Pill organisers – also known as ‘dosette boxes’ – can help you and your parent ensure they are taking their medications correctly. They come in several styles and sizes, to suit a wide range of medication regimens. For example, some come with just seven compartments, one for each day of the week, like this Seven day pill box reminder from Superdrug, while others have multiple compartments for each day like this Safe and Sound Weekly Pill Organiser from Boots. For something more discreet or stylish, there are also lots of different options on Amazon to choose from.
Pill packs
Some pharmacies offer pre-packaged medication doses for each day or week, which can further streamline this process.
Automatic dispensers
If there is a lot of medication and the dosing is complicated, you might want to consider an automatic pill dispenser. These devices release the correct dose at the correct time, which can help reduce confusion.
Utilise pharmacy services
To avoid forgetting to re-order repeat prescriptions, and potentially running out of meds, consider setting up automatic prescription refills or using pharmacy delivery services.
Some pharmacies will send reminders when it’s time to reorder medications or offer home delivery services.
If you set up an account with Boots Online Prescriptions, you can order NHS repeat prescriptions for your parent and get them delivered (for free if they live in England) from your app. Learn more about the service and how it works here.
Set up reminders
Setting repeat daily alarms on your or your parent’s phone will really help, particularly where medications have to be taken at the same time each day.
There are also specific ‘pill reminder’ apps and devices you can use.
Popular pill reminder apps include Medisafe which not only sends reminders and tracks medication, but also has a family and friends feature.
Monitor for potential side effects or drug interactions
Bear in mind that, due to physiological changes in the body, older people are more sensitive to the side effects of medications.
Keep an eye out for things like nausea, dizziness, loss of appetite, low mood, weight loss, muscle weakness and delirium. If you notice anything concerning, contact their doctor before making any adjustments to their medications yourself.
Taking multiple medications can also carry the risk of drug interactions. Their doctor should be monitoring for these – but nevertheless it’s worth double checking to see if you need to be mindful of this. If possible, fill all prescriptions at the same pharmacy so the pharmacist can help spot potential interactions.
Schedule regular medication reviews
Your parent’s GP practice should automatically schedule medication reviews (meetings about their medicines) at least once a year. If they aren’t having these, check with the GP to set them up.
During these reviews, the doctor or pharmacist at the practice will reassess whether the medications are still needed, check for any side effects, and determine if any medicines should be reduced or stopped. Being on too many prescribed medications (known as ‘polypharmacy’) can sometimes cause more harm than good, particularly for older people, so it’s important to have regular reviews.
It can be really helpful to attend these reviews with your parent if you can, particularly if they are prone to memory lapses. You can also clarify the purpose of the medicines, discuss any concerns with managing them, and highlight any health issues you may have noted that could be due to side effects or drug interactions.
Double-check medications after hospital discharge
If your parent is admitted to hospital (in an emergency or for treatment or surgery), it’s important to make sure their medications are correct when they leave. Sometimes mistakes happen, like wrong dosages or missing meds.
Keep in mind that some medications, especially for conditions like high blood pressure or mood disorders, might need to be gradually increased. For example, a doctor might plan to raise the dose after two weeks, so make sure follow-up appointments are set and changes are clearly understood.
Stay on top of medicines reconciliation
Medicines reconciliation is medical jargon for making sure all doctors and healthcare providers are on the same page about your parent’s medications, so there are no mix-ups or missed changes.
If a doctor or consultant changes your parent’s medication, like stopping or adjusting a dose, they’ll usually notify the GP. But it can take time for those updates to be processed.
It’s a good idea to check in with the GP after a week or two to confirm the changes have been made. This helps ensure your parent isn’t accidentally taking meds that should’ve been stopped or missing new ones they need.
In summary
Managing complicated medication regimens can be overwhelming for anyone, and older people can struggle, particularly if they have memory issues or physical limitations – such as poor eyesight or arthritis. They may also not take their medications properly in order to avoid side effects, because they don’t think they need them or because it is unpleasant.
Staying informed and organised, attending regular reviews, and the use of tools like pill organisers or reminder apps can make a huge difference. If you’re worried your parent isn’t taking their medication properly, don’t hesitate to seek help from their doctor and check if their pharmacist can offer additional support.
Common questions
- Why do elderly refuse medication?
Older people may refuse medication for several reasons, such as fear of side effects, difficulty swallowing pills, or feeling that the medication isn’t helping. Problems with memory and cognition can also be a factor.
- What do I do if my parent is not taking their medication?
If your parent isn’t taking their medications properly, try to find out the reason why. If they are avoiding it because of side effects or difficulty taking it – such as the pills being difficult to swallow – speak to their doctor about possible alternatives.
- How can I help my parents take their medications properly if I’m not there?
Unless you live with your parent and watch them 24/7, you can’t. Getting them set up with a pill organiser and routine can help – ensuring you or they re-fill it on the same day each week. Make sure it is kept somewhere where they can easily see it, like next to the kettle. Consider setting up daily reminders on their phone or using a reminder app that alerts both of you.
