With old age usually comes an accumulation of more chronic health conditions. To obtain optimal symptom relief and disease management, treatment with medication is usually needed.

Given that seniors tend to have numerous comorbidities, it is not uncommon for them to need to take multiple pills and tablets each day. 

When this occurs, managing to take the right medication at the right time can be overwhelming and may lead to poor compliance with medical advice and worse disease control.

This article will focus on some of the medication challenges seniors have and offer some solutions that can help with better compliance.

Medication Safety Issues in Older Adults

Within the elderly, the following issues often contribute to medication problems:

Transfering pills to different bottles that belong to other medications

A medication mistake that seniors make is that they transfer medication from one pill bottle into another one. 

Their reasoning behind this is usually:

• a pill bottle is almost empty, so the drugs are moved to another bottle to discard the empty one
• pill bottles take up too much space, so medications are transferred all into one container to save room
• desire to take only medicine bottle on a short trip or outing with all the meds rather than carry multiple pill containers
• prescription medication are mixed in with vitamins and over the counter medicine

The problem with combining medications into one pill bottle is that one may get confused more easily and it can lead to medication errors. 

Some examples of potential issues include:

• may forget how many pills, how often and when to take the medication as the original prescription label will not be present
• can confuse one tablet for another medication and potentially double dose or overdose
• there is little space on the drug itself to properly label and identify it by its full name, so it will be hard to understand what each pill treats
• medical practitioners and emergency care providers will have a harder time to identify what treatment you are on and any potential drug interactions if all your pills are scattered in one bottle with no identifying label

Given the above issues, it is best to keep the medication in its original packaging, and explore different storage methods such as a blister package or dosette.

Not understanding what medications are for

Many times, people have a poor understanding of why they need to take certain medications and what conditions each drug treats.

Some seniors just take their medication because the doctor has prescribed it and they have trust in their physician’s knowledge, training and therapeutic expertise. 

However, medication dispensing errors occur regularly for a variety of reasons and can lead to significant health issues or hospital admissions.

For this reason, it is important to always have a comprehensive list of current treatments to better communicate with your doctor, pharmacist and other healthcare providers. 

This can be used to monitor for any potential drug interactions, manage adverse symptoms and related side effects to obtain more optimal chronic disease control.

Stopping medications without consulting their doctor

Some individuals stop taking their medications because they have adverse symptoms that make them feel unwell. Unfortunately, they sometimes discontinue medication without consulting their doctor, which can leave their health conditions untreated and poorly managed.

For instance, seniors that stop taking their high blood pressure medication due to an unwanted side effect place themselves at higher risk of having a stroke or heart attack.

Your physician prescribed the treatment because the benefit was felt to outweigh any potential risks. So it is best to talk to your physician prior to making any changes to how you take your medication.

Making the doctor aware there is an issue can prompt them to explore other treatment options that have less intense side effects or add an additional drug to manage symptoms.

Forgetting to take medications

Having a complex medication regimen with multiple pills that must be taken at different intervals can be confusing to some seniors. 

As an example, some common medication administration instructions include:

• take every 4, 6, 8, 12, 24 hours, 7 days, or as needed
• take with food or on an empty stomach
• take in conjunction with another medication
• take only at night or in the morning

Given the above combinations, it can be understood why some people may get confused with medication management, especially those that have numerous pills for several health conditions.

Medication services and supports for the elderly

Supports that can help seniors be more accurate and reliable with taking their medication include:

Blister packages

Blister packaging is one method of organizing medication into individual bubbles. These small pockets are broken when needing to take the medication stored inside them. 

Blister packages have two key features:

• Small bubbles organized into different days of the week and times of the day that contain all the medication you need take at these intervals
• A list of current prescriptions with dosages, frequencies, renewals, etc

A blister package eliminates the guesswork of taking your medication and offers a quick way for caregivers or medical practitioners to visually check that someone is taking their meds as prescribed ie. not taking the wrong time / date or missing doses.

When seniors start to make medication errors, such as skipping bubbles or popping the wrong bubble for the current day of the week, it could be a sign that increased caregiver assistance with managing meds may be needed.

A disadvantage to using a bubble pack is that a new sheet of medication needs to be created every time a prescription is added or changed. 

As a result of this, blister packages are usually prepared for a two week period, so someone may still need to take medication from a pill bottle until the medicine can be introduced into the next blister packaging.

Blister packs are prepared by most dispensing pharmacies. However, if your local drug store does not offer this service, or it is prohibitively expensive to get them to prepare a blister package, you can create your own by using blank sheets sold online.

It is best to have a reliable family member review all your medications and organize them into individual bubbles as needed. They can also write down the full list of pills that you are on to keep track of dosing, frequency and condition that it is supposed to treat.

Medication reminding service

Some senior call services can phone at preset intervals and provide reminders to take medication. 

This can be helpful for those that live alone and struggle with memory deficits, which causes them to forget to take their meds.

Depending on where you live, there may be social service programs that offer medication reminder calls for free. If no government agency provides assistance with this, you can pay a private agency to follow up with you.

Medication reminders from family

For seniors that live with family, they may be able to have someone supervise and assist them with medication if needed. This can involve not only reminders, but also guidance on which medication to take and how many tablets to have.

For seniors that live alone, family may be able to call by phone for medication reminders, or use video chat to see the individual physically take the medicine. 

This can provide reassurance to caregivers that a treatment plan is being followed, but also assure seniors that they are taking the right stuff at the right time.

Pill organizers

Pill organizers are similar to a blister package, however they usually do not have an attached list of medications that one is taking. 

These pill containers are organized by family or the person taking the medication on a weekly basis to help keep track of whether medications have been taken and when the next doses are due.

These containers are usually made to be senior friendly with colored coded days of the week and large labels for easy reading. They can be simple twice a day boxes or more complex with sections for breakfast, lunch, dinner and bedtime.

Medication alarm or timer

A medication alarm or timer is a simple device that produces an audible alert at preset times to help elderly remember to take their medication.

The alarm itself offers no further information beyond its altering noise, so the elderly need to be trained to understand what the alarm means and what actions they need to take when they hear it.

For those with a cognitive impairment that are unable to learn or remember what the alert means, this device may not be helpful to improve their compliance with medication. In these situations, other supports need to be explored.

Daily medication chart for elderly

Daily medication templates allow a caregiver to write down the treatment plan that someone is on and highlight what pills need to be taken and at what time.

After a senior reads this reference sheet that lists and summarizes all their meds, they would need to locate the right medicine bottle and take their individual pills as needed.

Compared to a blister package where medications are already pre-sorted into small bubbles, using a daily medication chart requires someone to filter through their pill bottles to find and take the right pills at the right time. 

For individuals that may get easily overwhelmed by a lot of information or confused by referring to the chart, this method may not be helpful for them. 

On the other hand, physicians and healthcare practitioners, appreciate these charts as they can quickly glance at all the medicine someone is on. This allows them to better plan for any medication adjustments or new prescriptions while considering potential drug interaction.

Medication management system for seniors

A helpful medication management tool for older adults is an automatic medication dispenser .

This system not only prevents the elderly from opening the device to access the medications at an incorrect time, it dispenses medication based on the pre-programmed settings and produces an alarm to alert someone that it is time to take their medicine.

This device can be loaded and organized by a reliable family member and reduces confusion with medication administration as it only dispenses pills that need to be taken at set times.