Helping a loved one with Alzheimer’s manage medications
As a caregiver you will likely be organizing and administering medications as part of your loved one’s daily care routine. Medication management also includes discussing both existing and new medications with doctors, filling prescriptions, monitoring medication effects and ensuring that all medications are safely stored.
You are also the primary advocate in understanding the purpose and benefit of each medication, as well as its potential side effects. Early on in the disease, medications may consist only of those required for other health conditions, such as blood pressure issues. Disease-specific medications may be added, along with medications to treat depression, sleeplessness and other symptoms. Over the counter (OTC) medications may consist of laxatives, antacids, vitamins and herbal supplements. ALL of this , including OTC medications, needs to be written down, discussed and regularly shared with all doctors, as well as kept updated.
You can create a medication log yourself or find one online. Create a list that shows the name, purpose (lower blood pressure), strength (10mg) and dosage (one pill per day, with food, in the a.m.). Add subsequent pages to make notes as medications change, so: “On February 2, 2014 Dr. Smith changed Medication X to 2 pills per day instead of one, due to continued high blood pressure of X.” A current copy should always be available with your loved one.
Be sure to ask if medications can be crushed, need to be taken with or without food, need to be taken with water, etc. Some people have difficulty in swallowing and often medication cannot be crushed. Use a single pharmacy, so that they have your complete record in one place, and can assess the list for potential drug interaction issues. Ask about known food-drug interactions or check drug manufacturers’ websites for information and tips.
When starting or stopping medications (only under a doctor’s order, please!) symptom changes can occur, either social behavior (sleeping or eating patterns) or changes in cognitive function. Keep a notebook to share your observations with the doctor. Your loved one will be less able to effectively communicate potential ill effects as their disease progresses. They may not recognize a new drug is causing constipation, for example.
Early in the disease, medications may be organized in a pill box dispenser, assuming the number of pills is not too great to cause confusion. Consistency and routine will help, and there are reminder alarms and other technology solutions (reminder phone calls, computerized pill boxes that alarm if pills are not taken on time) to help. At some point, a member of the caregiving team should have the responsibility to provide all medication, using specific instructions (“Here’s the pill for your high blood pressure. Put it in your mouth and drink some water”) and recording any observations.
If your loved one refuses to take their medication, don’t argue with them. Come back a few minutes later and try a different tactic. Using familiar words may help. Some people take their own vitamins/pills in front of their loved one, so the pill taking seems like more of a routine. Others do not elaborate on the actual medication purpose, but say something like, “It will help you be happy, or it will help you sleep”. If nothing works, ask your doctor if an alternative form of the medication is available. The important thing is to be patient, calm and caring.
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Blog written by Alzheimer’s Association Volunteer Diane Blum