The Republican Agenda

Keeping Track of Medications

category_bug_journal2.gif I need to come down from yesterday's mad Republican rant so let's do something mundane but important today.

As reported yesterday in The New Old Age blog at The New York Times, a study was conducted with 464 Chicago-area adults between the ages of 55 and 74 asking how they would take seven medications.

”About a third didn’t think to take two of the drugs together, even though the instructions on their labels were identical. When one drug was supposed to be taken with food and water and another carried no such instructions, half the study participants didn’t plan to take them at the same time, though they could have.

“And two-thirds wouldn’t take pills together if one label specified 'twice daily' and the other said 'every 12 hours,' though those phrases mean the same thing.”

My initial thought was to wonder if they had checked IQs of the study subjects before accepting them. Then I recalled that until a year or so ago, I had taken two of the three supplements I use in the early morning and saved the third for later with breakfast even though I had several times read the label that states it is not necessary to take it with food.

Returning to earth...

I was surprised to learn that “the average adult over age 55 juggles six to eight medications daily” and dosage is a jungle of confusing instructions.

According to the researcher, Dr. Michael Wolf, who studies medication safety at Northwestern University,

“A review of thousands of prescriptions revealed, for instance, that pharmacists use literally dozens of different phrases that all mean: Take one tablet each day.”

Of course, this results in missed and/or double or triple dosages affecting the health of elders (or anyone younger too). One solution, according to Wolf, is to standardize the language of dosage instructions

“ four times of day: morning meds, noon meds, evening meds, bedtime meds.”

Although this idea has been floating around for several years, a big problem is that pharmacists answer to 50 different state regulators who each have their own rules. Standardization bills are pending in two states, reports The Times, but that is no more than a toe in the water.

Like other physicians, Dr. Wolf suggests people regularly review their medications with their physicians, particularly when more than one doctor are doing the prescribing. Further, he has a prescription himself for patients. Talk to your physician and

”...ask for help in simplifying our schedules. His suggested script: 'Help me reduce the number of times I have to take these medications, so that over months and years, it doesn’t become a drag.'”

How do you organize your prescriptions or help your parents with theirs?

At The Elder Storytelling Place today, Marcia Mayo: My Name is Marcia and I'm an Internet Addict


We had never had to take daily prescriptions until my husband's heart attack two years ago. He now takes eight medications per day which, after reviewing all the instructions, he divided into morning, afternoon, and one at bedtime.

He cleaned fourteen old prescription bottles and labeled them: Sunday Morning, Sunday Afternoon, Monday Morning, Monday Afternoon, etc. The one evening medication he just keeps in the original bottle.

Once a week he sets up the week's medication and lines the bottles up on the back of his bathroom sink.

He designed a two-week schedule in the computer with the dates and days and spots for checkmarks which he prints out once every two weeks.

As he takes the meds in each bottle he turns it over, checkmarks his schedule, and moves the next bottle forward.

As an example, this morning after breakfast, he took the pills in the bottle marked "Friday Morning", turned the bottle over at the rear of the sink, checkmarked his schedule, and moved forward the bottle marked "Friday Afternoon". After taking the afternnoon medications and checkmarking the sched., he moves that bottle back, and will move the bedtime one up. He will then move the "Saturday morning" bottle up...

Having the next bottle sitting at the front of the sink also gives both of us an opportunity to spot meds that should have been taken, because, if all else fails, I am the designated nag.

It seems complicated, but once it's set up - no problem.

Hope this is understandable...I can take pix...


I take 4 tablets a day. Three in the morning and one at bedtime.

The 3 I take in the morning,I take all at once and here is why I feel it is safe to do that even though they are all for different things.

I think that if I owned Merck Pharmaceuticals or Abbott Labs and I took 3 different medicines,I would instruct my pharmacists to combine all of my meds into one tablet for my convenience, and it would be perfectly safe to do that...So, I take all my pills at once and ta da,after all these years, I'm still here to tell you about it.

Other than supplements, the only thing I have to take is a statin which I forget once in awhile but try to remember. When I had my last physical, my doctor asked that I bring in everything I take including OTC; so he could see them and evaluate how they went together. Nothing conflicted at least that time... Having one doctor helps.

Oh, Lordy, this is fast becoming my nemesis--and I don't have any memory problems other than from normal aging, and a pretty damn good mind to start with. I sit once a week, un-distracted and apportion out my week's supply of about 14 meds and supplements into a container that has morning, noon, and night compartments. Even so, when I take them, I always look and count and I FREQUENTLY find errors, or a pill dropped under my recliner! I worry about my friends with serious memory and concentration problems. I'm paying for people to do almost everything else in my life for me: cleaning, shopping, cooking--maybe that's next! AND they all come due at different times, so just ordering and picking them up is another twice-weekly thing to remember! Sorry to be so wordy, Ronni, but boy, did you hit a nerve!

I take 3 meds twice a day, two pills and one inhaled. Sigh, just part of the ongoing maintenance of me. I take them around breakfast and the same at dinner. Not a great method but it mostly works. Compared to my friends I feel lucky they are so few. My pulmonologist is very specific about how and when to take meds including hints to remember. The inhaled med I take after I eat and before brushing my teeth. Brushing is helpful to get the residue out of my mouth since it can cause thrush.

Here 5 pills in the morning and one at night. I have a two week pill holder, and every two weeks I put all the right pills in the spaces. I turn over the containers. When I empty out the days' pills, I put one back for the evening. I take them in the morning with food.

I would only take four pills in the morning and none at night but for cost savings. Prescription for one is 200 some bucks per month vs OTC for two a weeks at 24 bucks. My blood pressure med is either one pill at a hundred some co pay for a month, or two pills for 6 bucks co pay for three months.

I get all the meds reviewed by my wonderful doctor once a year. Hey, my BP is normal, my allergies are light, and my sense of humor is pretty good for an old lady. :)

I found out in 2008, that one needs to use the Internet to research any and all medications you take,(or meds you give as a caregiver) based on many reasons. What are the side effects of the meds? How do they interfere with other meds? What are the risks of taking the meds? Do they need to be taken after eating, etc.? Then, print a chart out with all this information, such as med name, time to take it, dose (X1, X2, etc.) and if it should be taken with food? If taking a lot of meds, and say 4 times a day, go buy a week pill holder that has 4 case boxes. Put the time on each box instead of using morning, noon, afternoon and night. This is so much simpler than opening a bottle each time you need to take the meds. And in my opinion, a much safer alternative.

When I was living with an elder lady as supervisor of 4 caregivers, I researched and printed out the info on every medication she took. I had each caregiver read it as well and initial that they did read it. The caregivers needed to know what to look for in side effects, and how this should be handled. I found out that one a day vitamins can interfere and make other meds not do their job, including antibiotics, if taken at the same time. This information made it clear to give the vitamins at different times with certain meds. There are also risks of taking certain meds with other prescribed meds. I was very angry at the elder lady's Dr., as she prescribed a drug for her, without looking at her own records of what Eileen (elder lady) was taking. If I had given her this new drug, (and I am not exaggerating}. it would have been Eileen's last drug ever taken.

I have two pill boxes that I fill weekly. Both have daily compartments. I put my morning pills in one box and the evening supplement in a different colored box. In the morning I take one pill from the original container with a glass of water when I get up. I have to wait an hour before eating or drinking anything. Then I take a BP pill with breakfast. At noon I take 2 supplements and another at night with my evening meal. The last 3 capsules are in the daily compartment of the pink box.

On Sunday I have to take a second pill after my fasting hour and wait another 1/2 hour before eating. That's the one that's hard to remember when I am away from home because one day seems just like another.

There have been days when I found a supplement still in the box and know I forgot to take it. As it's just calcium and I drink milk I don't worry about it.

I use a locally owned neighborhood pharmacy where the pharmacist knows me by name and by sight. Any time I get a new Rx he makes recommendations about the drug's use and alerts me to any interactions/caveats. I sort my several Rxs, supplements and analgesics into two compartmented pill boxes each week plus one for a first thing in the morning pill. Besides helping to keep everything organized, it also tells me what day it is! Remembering to take my most important morning (heart) med is a problem when travelling.

I hate having to take any medication, but I'm so glad that modern medicine can make a very nasty arrhythmia go away. But I fight like hell when my Dr. starts wanting to add on stuff, like statins and fosamax. Boo. So I've been motivated to work on my bone health the natural way, with weight bearing exercise which ought to help the LDL number too.

PS: I always check out my meds at reliable online sources like Mayo Clinic.

“And two-thirds wouldn’t take pills together if one label specified 'twice daily' and the other said 'every 12 hours,' though those phrases mean the same thing.”

I disagree that "those phrases mean the same thing" and worry about anyone who thinks they do. (Their knowledge of functional English is limited!)

Twice daily may mean that it is acceptable to take one dose with breakfast and one dose with dinner. It might also mean that it is acceptable to take two doses 15 minutes apart. For this reason, I don't think that the phrase "twice daily" should ever be used.

My mother moved to my area several months before her death. I took her to my own physician and worked out her pill schedule so that instead of taking medications 13 times during each day, she was able to take medications 5 times. Each Sunday I put her medications into 5 weekly pill holders that were labeled as to time of day. In addition, I printed out a spreadsheet where she could, like Susan G's husband, check off each dose as she took it.

So far I have avoided having to take medications, but my mother in law had a pill regimen. I think those pill boxes with compartments are invaluable, along with a list of meds.
Right now I only have to worry about one pill for my dog, who has a heart ailment. Even at that, I sometimes forget to give it to him.

I found a very handy weekly pill container at Target which has compartments for 8am, noon, 5pm and 8pm. Each week I use a list from the nursing home with dosages and time to take the meds and separate the pills into each appropriate compartment.
When my mom went into assisted living, I assumed that medication supervision would be part of the service. It is not, at least without a substantial fee.
We had a major problem this past fall when my mom got severely confused as the result of a UTI, and was not taking her meds. She is doing much better, but I am monitoring her meds now, even though she thinks I am overreacting.

Well, I see I am not much of a pill-taker -- I only take a dozen supplements daily -- yet still I have occasionally forgotten to take them because it completely slipped my mind.

So, now right before bed I turn one of the bottles upside-down. Then I will see it there tomorrow on the bathroom counter, to remind me that I need to take them, after which the upside-down bottle is set right-side-up again, until I go to bed. And the process starts over. Simple, and easy to remember.

I also struggled with remembering when and what to resupply, so I save the empty bottles and take them to the store next time so I know exactly what to buy. Now I never stray off the right dosage and brand, and always stay resupplied over the course of time.... except for that time I forget to buy more Glucosamine/Chondroitin for a few months and suffered the painful consequences....

Incidentally, (I used to be a software guy) these are called simple token systems -- good for forgetful old codgers.

My sister went through all of Mom's prescriptions, reading the pharmaceutical inserts to check for interactions, side effects, etc. Then she set up a chart for us to check as Mom takes her meds. She also uses the 7 day container with the 4 times a day spots. Up til then Mom was taking meds that were cancelling each other out and/or not taking with or without food as prescribed. Sadly Mom is losing her memory now so this system is invaluable in keeping her healthy. My sister did check with Mom's doctor to be sure all was set up correctly with the meds.

As an aside and as a cautionary note to all of us taking care of our elderly parents: if lab work is being done in a home health situation (tech comes to home, draws blood, sends blood for testing) be sure the blood is stored properly and gotten to the lab right away! We nearly lost Mom due to lab inefficiency and INCORRECT results bc the blood was sitting for hours on end. The results indicated that Mom's potassium levels were skyhigh and she needed to have her system flushed repeatedly to lower the level. In FACT, her levels were normal and the flushing (had we continued) would have caused a heart attack and death! So ALWAYS ask how long before this blood will be tested??! (We fired the service and the doctor over this!)

I take four meds, each to be taken only once a day. They could all be taken at the same time as they do not interfere with one another but simply because I find it easy, I take two in the morning after brushing my teeth and two in the evening after brushing my teeth. I keep the bottle on the shelf next to teh toothpaste. All are of the "forever" sort; it's just another part of an ingrained routine.

Mr. kenju takes 8-9 different RX's each day; some in the a.m. and some at night. We have the divided pill boxes, which I fill for him weekly (otherwise, nothing would get taken on time!)

I only take two (so far): blood pressure and low-dose aspirin. I still have trouble remembering to take them, so I've gotten in the habit of having a glass of water at breakfast. If the glass is still full when I'm ready to leave the table, it means I still need to take my meds!

When my mother was alive, though, we needed a chart to keep track of her meds.

Regarding college degrees ... I only managed a year and a half the first time. Then 37 years later I went back and enrolled in the West Virginia University Regents Program, a program for us older "non-traditional" students with a whole lot of life experience. I chose the final 2-1/2 years worth of credits from the University's current catalog and set about "challenging" each class. For each class I wrote briefs of my life experience in that particular field and included letters of recommendation and samples of my achievements. Then packaged everything up for each class in folders, binders and briefcases to give to each professor. In one semester I earned, at the cost of only around $200, the entire balance of my necessary credits and graduated with a Board of Regents Bachelor of Arts degree in Marketing which, by the way, would have allowed me full privileges to obtain higher degrees.

I then proceeded to graduate from college in a formal parade with other graduating seniors that year in full cap and gown, with my three adult children cheering madly in the audience.

I only took on the above chore to see if I could finally get that degree and to quietly encourage my adult children to finish their educations -- with both of these goals succeeding blazingly well!

I have 2 different shape/color "seven day" containers. One for morning, one for evening. My husband and I rely on habits. And so, each morning, he puts his and my pill containers on the counter next to the coffee pot. The evening pills get put ON the coffee pot each afternoon when we empty the dishwasher. That way, I take them after dinner when I pre-make our coffee for the next morning.
Traveling?? Yeah, throws the whole system off but so far, we're still around...
We don't wait until we're running out to order refills. Most have a "reorder date" on the label and that's when I call in our refills.
It works for us.

I keep a list of all my Dad's medications and doses in a Google Doc which I update whenever there is a change. That way I can access it from anywhere and always have a list available when ever one is needed.

He is 84.
He has been a type 1 diabetic for 50 years, he has vision, neuropathy, heart problems etc. But he is amazingly good health on a day to day to day basis. problems

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