Question 

My 90-year-old father is gradually declining, like most people his age. Based on his poor diabetes and blood pressure management, I am wondering if he is taking his medication properly.  

Last week I took him to his doctor's appointment, as he no longer is driving. His doctor seems puzzled as to why his blood pressure is so variable. When he asks dad about how he takes his medication, dad tells him, “Every day, like I should.” I think it is all baloney. Dad is not one to admit that he doesn’t do something that he should.  

I too wonder how compliant dad is with his medication schedule. He has never been a real rule follower. I also know that dad is suspicious of doctors and their “true knowledge” as he puts it.  

I would like to set up dad’s medication in a weekly box like so many people do. When I suggested it, I got a look of disbelief. It seems that I crossed a line that he was not ready for. Is there a better way to approach it?  

Answer 

There is no easy way to tell an adult who is managing their affairs independently what to do. Imagine how you might respond to that request if it were from one of your children. That does not mean that your father will not come to that point where he requires you to set up his medication in a planner. It just might not be today.  

For now, you will need to approach the issue like you would with any other adult that you care about, carefully, and with diplomacy.  

Let’s start with your father and his specific beliefs. You said that he does not trust his doctor. He may also not trust medication. Many people do not understand how medications work, how they come to the marketplace, and how science changes over time. With advancing knowledge, new drugs and information become available that changes what we thought we knew to be true. This creates distrust in the population when we all prefer absolutes. COVID is a good example. This new highly contagious disease enters the human population and spreads quickly. The Center for Disease Control (CDC) tries to put out information as accurately and quickly as it can. With more information and data, the message changes and the public becomes distrustful because we are more comfortable with absolutes. The vaccine came to the market with record speed, which also created distrust. Then the virus mutates, creating even more confusion and revised messaging. It is no surprise that people lack a bit of trust.  

Back to your father. Managing the human body and medications is complex. He may be taking his medication differently than prescribed, which is not uncommon. Oftentimes when people are taking blood pressure medication for a while, their blood pressure normalizes, and they mistakenly believe that they do not need the medication anymore. What really happened is that the medication is managing their blood pressure. They were not cured, they were managed, a big difference.  

Some individuals decrease their medication dosing to save money. The pills go farther if you do not take them as often after all.  

There is also the possibility that his short-term memory is not great, and he cannot remember if he took his medication. That is where the planner comes in very handy.  

It sounds like your father is independent for the most part and restive of your idea to use a planner. Unless you live with him, you will never know for sure. I do have a few suggestions you could consider for the time being:  

• You could look at his pill bottles and count the pills remaining. The bottle will have the date of filling, and you can figure out how many pills should be left.  

• Since you are doing the driving, you could mark a chart of when you take him to the pharmacy for refills and note the number of days. It is usually a month’s worth at a time. That is assuming he gets his medication from a pharmacy that you drive to.  

• You could just leave a planner at his house, saying you bought it and thought that someday he might find it useful in the future.  

• Consider providing him with written information about his medication if he is a reader. If he rarely reads, maybe a video, podcast, or flyer about his medications. 

• We are often influenced by friends and the information they share. If you could figure out a way to connect him with others who might be on similar medications. Though they could be a negative influence if they think like him.  

• Lastly, simply ask him how he takes his medications. You might want to share your own thoughts on taking medications. A dialog would be best, rather than a lecture, as I highly doubt that will go over well.  

It is never easy to influence another to change a course of action. The reality is though, we do listen to the ideas of others even when we do not agree with them. Just think about your children. They may seem to reject everything you say, though they are absorbing it.  

I applaud your efforts to care for your father. I recommend that you gently persist as his health may depend on it. I wish you well as you navigate this sensitive territory with your father. Life is a journey that we all take, and this is one of the stops along the way.