Dementia Care 101: Tips for Medication Management

Lots of people with Alzheimer’s disease and other types of dementia take more than one medicine. While certain drugs are very good at relieving symptoms, they can also present risks. 

If your family member or loved one takes multiple prescription medicines, keeping track of them is essential to their health.

To learn more about managing medications in dementia care, we spoke with Laura Herman. Herman is the on-staff elder and dementia care specialist at Safer Senior Care. She has over 25 years of experience providing skilled nursing and memory healthcare to people with dementia.

According to Herman, with some planning and preparation, you can keep your loved one safe and on a medication schedule.

What Are Medication Management Basics?

If you’re helping a family member or loved one with Alzheimer’s disease or dementia manage their medication(s), there are several things you can do to make things easier, including:

1) Make A List of All Medicines Your Loved One Takes

Proper medication management starts with good documentation. “Maintain a complete medication list containing every prescription and over-the-counter drug and supplement your loved one takes,” Herman said. “Even if they take it only occasionally.”

2) Understand How Each Medicine Works

“The rule in medications for older adults, especially those with dementia, is to start low and go slow,” explained Herman. “Consult with your loved one’s pharmacist to ensure you understand when and how they should take each medication.”

Important considerations include:

• Should the medicine be taken with or without food? Morning or night?

• Are there any foods or other medications that should be avoided?

• What type of side effects can be expected?

3) Be Clear On The Purpose of Each Medication

You must know the goal behind each of your family member or loved one’s medications. Whenever a new medicine gets prescribed, Herman recommends asking your loved one’s doctor the following questions:

• Why are they taking this particular drug?

• How will I know if it’s working?

• How long should they expect to take it?

“Many medications can and should be discontinued after the need is gone,” Herman said. “But there is a tendency for doctors to keep adding medications without routinely reviewing and removing them. Be proactive in asking and advocating for your loved one to use as few medications as necessary to achieve the goal.”

4) Fill All Medicines At One Pharmacy

The pharmacy must have a record of all the medicines your loved one takes. This can save you time when getting refills but also reduces the risk of side effects. If your loved one’s doctor prescribes a new medicine, a pharmacist can warn you of drug interactions.

5) Try to Reduce the Amount of Medication Your Loved One Takes

Certain medicines your loved one takes may not be necessary. “Consult with a geriatric pharmacist to safety de-prescribe as many meds as possible,” Herman said. “If that isn’t possible, work with a doctor or your neighborhood pharmacist to do so. The fewer meds your loved one has to manage, the less risk of complications exists.”

6) Keep a Medication Schedule

For medicine to work, the body needs access to a certain amount of the drug. If your loved one doesn't take their medication at specific times, they won't work as well as they should. A schedule creates a routine that becomes a habit.

7) Watch Your Loved One Take their Medicine

When it's time for medicine, watch your family member or loved one take it. Consider using a pill box or an electronic pill dispenser if that's not possible. "These devices help you tell whether the medicine was taken," Herman said. "Some pill dispensers run on a timer or send alerts to help users take their pills as prescribed.

If you provide long-distance care, Herman says to watch for medication non-adherence. "For example, running out of pills before it's time to refill or having a pileup of medicine bottles."

8) Store Medicine Properly

Keep all your loved one’s medications together in a cool, dry place. This includes their prescriptions, nutritional supplements, vitamins, and over-the-counter products. 

If your loved one often leaves home, keep their medicines in a purse or backpack for easy access. 

How Can I Spot Abnormal Side Effects and Symptoms of New Medications?

The aging process affects how our bodies respond to medicine. 

“It’s crucial to realize that older people don’t process medications as efficiently as they did when they were younger, so they build up and lead to complications more frequently than people realize,” Herman said. 

Even so, these complications aren’t always easy to spot. 

“Stay on the lookout for unexplained changes in your loved one’s behavior, mood, cognition, or ability to function for weeks or months after any change in their medication or dosage,” said Herman.

“In fact, the first thing to consider when unexplained changes happen is whether there have been any recent medication changes. Call the doctor right away to discuss any concerns. Don’t stop or change your loved one’s medication without talking to a doctor first.”

Commonly Asked Questions

1) Is it possible to overmedicate someone?

It isn’t talked about very often, but overmedication does happen. One study by the Lown Institute found that 42% of seniors take five or more medicines.

“Taking multiple medications greatly increases the likelihood of falls, cognitive decline, and hospitalization from complications,” Herman said. “Talk to your loved one’s doctor about what you can do to reduce these risks.”

2) What factors affect how medication works?

Anything that goes into your family member or loved one’s body, such as foods, supplements, herbs, or natural remedies, can affect how a medication is metabolized. 

“That’s why it’s so important to have a complete picture of everything your loved one takes, as well as a clear plan for what time to take each to minimize drug interactions,” Herman said. 

3) What if I struggle to manage my loved one’s medications?

Caring for a loved one with Alzheimer’s disease or another type of dementia is hard work.

“If you’re struggling with medication management or other challenging symptoms of dementia, talk to your loved one’s doctor about palliative care,” Herman said. “Palliative care is appropriate for anyone with a serious chronic illness, like Alzheimer’s diseas, and can provide a team of skilled healthcare professionals to help manage your loved one’s symptoms and challenges in order to maximize their quality of life.

Takeaways

Managing medications is one of the most challenging aspects of caregiving. But if you take the time to document each medicine, do your research, and play an active role at doctor’s visits, you can reduce drug interactions and keep your loved one safe. If you still feel like you need additional help to ensure your loved one is appropriately taking their medications, don’t hesitate to speak with their doctor or a geriatric pharmacist or seek palliative care to assist you.