Question:

"When I visit my dad, I often notice that he runs out of medication too soon and mixes pills together in bottles.  He is refusing all help from me, and I do not know what to do!"
 

Answer:

You have a touchy situation with your father. If helives alone and manages his own affairs, he may resent your comments. On the other hand, with some gentle support, he may engage you about his health decisions. 

Many individuals have incomplete information about medications.  In fact, most consumers have muddled knowledge when it comes to how medication works, what therapeutic dosing is all about, and when it is okay to take more or less of a medication.  Each of us brings our own biases into our decision-making process, whether they come from from magazines, the internet, newspapers, television, friends or family .  Sometimes we cut back on medications to lessen side effects, other times we take more to get a better result, and things also change when we try to save money.  There are so many variations and reasons for self-medicating in a way that is different than recommended or ordered by your physician.

Your father may be one of many individuals who has trouble managing medication, or he may simply not understand the ramifications of improperly taking his medication. This is not an uncommon phenomenon in the elderly.  This demographic also takes the most medication on average, making it even harder for them to manage.

Most often when we are prescribed a new medication, it is at a physician visit when we as patients are distracted and a bit anxious.  Someone hurriedly gives you instructions, and off you go.  The patients are half-listening, trying to collect their things, and possibly wondering if they remembered where they parked.  It is not an ideal learning situation. 

If your father is homebound, a Medicare requirement, this may be a good time for a home care nurse to make a few visits for medication teaching.  Your father is more likely to listen to a professional than you, even if you are a professional.  Medication teaching is one of the primary purposes of many nursing visits in home care.  A few calm, sit-down sessions with a nurse can be so helpful.   If your father is actually confused, the nurse will figure that out and help to devise a solution. 

If Dad is refusing your help, he may also refuse a nurse.  This is when you ask your father to humor you and let you set up a nurse’s visit at no cost to him.  Don’t worry! You don’t have to pay for it either, as Medicare pays for home care at 100% under Part A.  Call the doctor and choose a home care agency for the doctor to call.  As long as your father has seen his doctor in the last three months you are good to go. 

Another option is to make an appointment with his physician and go along.  Gather up all of the medications and bring them along.   Sometimes just saying, “Dad I am really confused about some of these medications. Would you mind if I come along to your next doctor’s appointment to ask some questions?”  He might surprise you and say "Yes." 

I wish you success with this challenge.  Managing medications is not easy for any of us, regardless of our age.