Caregiver Question:

"My father plays around with his medication. Sometimes he takes it, and sometimes he doesn't. Sometimes it's half a dose, and sometimes it's double. His medications are not just aspirin; they are blood pressure and heart medications. I think he's messed around with his medication his entire life. It's aggravating when I am the one picking up his prescriptions and trying to make sure he has what he needs. Taking to him about it usually does nothing. What should I do?"
 

Mary's Answer:

Your father is one of my favorite kinds of patients. There is a mystery here that needs to be unlocked, and you have an opportunity to find the key. Think of it as a treasure hunt.

I am guessing you have exhausted your attempts to address his medication “mismanagement." I imagine the frustration of making trips to the pharmacy to pick up off-cycle medication. You may even be calling his doctor to have prescriptions filled when pills are missing. If he is on the plethora of medications we often see with our elderly population, your frustration is well founded and well deserved.
 

Helping a Father Who Ignores Recommended Dosage

You start by finding a quiet block of time to talk about one of his medications in a non-confrontational manner. Ask him what he thinks about that specific medication, and follow that with silence. Do not lecture, do not advise; simply listen to what he has to say about it. You may ask additional questions, all the while being open and curious. You are gathering information, finding out what the patient thinks.  His logic may be completely flawed, or it may be sound. Either way, it will be interesting to learn. Watch his body language while you gather information. No eye-rolling, turning away, laughing, or anything that would give him the impression you are anything but interested in what he thinks. You need to know what his logic is.

Simply telling someone to take a medication on an imposed schedule works for only some patients. Many others do exactly what they wish. Your father may be having unpleasant side effects, he may not believe the drug does anything for him, he may be afraid of it, or he may simply be against medication in general. You will never know unless you ask.

Once you learn your father's thought process, make a plan and take action. You can plan to have a prescription changed, you can have an informed conversation with him, or you might find an outcome that is better for the both of you.

I wish you the best.