Breakfast of Pills

It seems as if everyone takes some pills, and some people take a whole bunch—not to mention self-administered drops, sprays, inhalers, injections, suppositories—you name it. There are all kinds of pillboxes, alarms, organizers, and other apparatuses available as memory aids; and suggestions and discussions exist. For example, here.

The problem is an important one, because we have an aging population, with many baby boomers already retired, and huge numbers still to come. So, even if memory for meds isn’t a problem for you now, it might be one for your parents or grandparents.

There are two contradictory trends affecting memory for meds that suggest we change the way we think about the problem. The first is that the older people get, the longer and more complicated their medication regimen. Someone, who at 60 might be taking two or three pills a day, might at 75 be taking ten or fifteen in a complex schedule, some together or separately, with or without food, and at different times of the day or on different days of the week. (I’ll be using the word "pills" to refer to any kind of medication.) The second trend is that memory deteriorates with age. I’m not speaking about people with dementia—they have special issues that need special attention. This piece is about normal age-related memory loss. And the problem is that as people’s medication schedules get longer, their memory gets shorter.

My first suggestion is that we think about memory for meds differently, not as an isolated problem with a solution, but rather as an issue that develops as people age. In other words, it is a trend requiring increasing attention and evolving strategies over time.

There are two main kinds of memory errors: forgetting to take a pill, which can lead to dangers of under-medication; and forgetting that one has already taken a pill and taking it again, which can lead to the dangers of overdose*. Other confusions include taking the wrong pill at the wrong time, or otherwise not following the prescribed regimen.

My second suggestion is to take notes, and keep them in one place, e.g., in a notebook or folder, with a date on each note.  Every time you make an error, or think you might have made an error, write down the details so that you can consider it at leisure, alone or with a friend. The goal is to propose a practical solution and then see how it works. This is a standard problem-solving procedure--using feedback to improve. Perhaps a solution will work for a few years and then fail, so that a modification is needed to get thing going smoothly again.

Every person is different and every household is different, so the idea is to evolve a strategy that works for you, and then improve on it whenever necessary.

For example, people living alone don’t have to worry about children swallowing their pills or pets knocking them on the floor, but they also don’t have someone to remind them or to discuss their medication regimen with.

Here are a few strategies to start the ball rolling:

Associate pills with the time of day and place where you take them. Put morning pills on the breakfast table, and nighttime pills at your bedside.

Use pill organizers for medications taken at the same time.

Have a separate calendar for each pill (or group of pills) located right next to it; and write the time that you took it, instead of just checking it off.

You might need to wear a calendar watch or have some other easy way of verifying which date and day of the week it is before taking your pills. For some retired people there isn’t much difference between weekdays and weekends. Especially when a person is sleepy at bedtime or on waking up in the morning, it might be easy to swallow a pill first and then realize the mistake.

When, despite all your precautions, a medication error occurs—as it inevitably will from time to time—a useful reaction is to ask, “What can I learn from this so as to make it less likely in the future?

 *If you have any questions, you can call Poison Control at 1-800-222-1222.

FYI--A follow-up piece is How Common Are Medication Memory Errors? 

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Breakfast of Pills by Ash TheFreecycler

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