When I first started working as a nurse on a day-surgery unit in large hospital, I was astonished how many of our patients could not name their medications – and they didn’t carry a list, either! It was not unusual for an older male patient to tell me to “ask his wife,” to get his medication list.
Over time, I came to appreciate that medication regimens can be very complicated, and they change frequently, especially for older people. Medications have long difficult names, and to make matters worse, they each have two names – a brand name and a generic name. Medication schedules add another layer of complexity. It’s not as simple as taking all pills in the morning. It gets challenging very quickly.
Family members and caregivers can really help, though. If there’s a detail-oriented person in your family involved in the Mom or Dad’s care, this job is a natural fit for them! Here’s how to do it:
Step 1: Make the List
The list should include:
- Prescribed medications
- Over-the-counter medications (i.e. medications you can buy without a prescription, such as Tylenol or Claritin)
- Dietary supplements, including herbs and minerals
Information to keep for each medication:
- Generic and brand name of medication
- This is the amount of the medication to take or administer at one time.
- Often it is in milligrams (mg) but can be in other units, such as drops (for eye drops), puffs (for inhalers), or units (for insulin), for example.
- Frequency and how it is taken
- This specifies how often and when the medication is to be taken/administered.
- Example: Twice a day, daily in the morning, etc.
- How it is taken is usually obvious (i.e. by mouth or inhaled) but can get complicated if, for example, only one eye receives drops. It never hurts to be specific!
- Reason for taking
- This indicates why the medication was prescribed.
- Who prescribed it (doctor, nurse practitioner, etc.)
- Special notes about taking this medication
- If there are special considerations for taking this medication, list them here.
- An example of a special note is that some medications should not be taken with food.
You can get most of this information from the label on the pill bottle. Sometimes the pharmacy will put colorful stickers on the pill bottle with the special instructions (item 6, above), but you should look at the printed instructions that come with with medication for more detail.
Don’t be surprised if it takes a few tries to get the complete list, particularly if you are starting from nothing except a cabinet full of pill bottles!
Step 2: Organize the List
I have found that for clients at home, it is most helpful to list prescription medications in groups according to the time of day taken. This organization works well when comparing the list to a pillbox.
On my list, I color code the time of day taken: yellow is for morning, blue is for evening, green is for twice a day morning and evening, and gray for any other schedule.
Step 3: Verify the List
It is a little more difficult to determine if Mom or Dad is really taking all of the medications exactly as they are prescribed. It may take a little detective work to figure out. Watch for these potential problems:
- Prescriptions for half a pill
- Seniors may have difficulty breaking a pill in half, especially if they don’t have a pill cutter
- Medications are prescribed this way for cost-cutting reasons
- Complicated regimens with different doses on different days of the week.
- Expensive medications
- Seniors on limited incomes may “ration” the pills to save money
- Pills that run out “too early.”
- The senior may be taking it more frequently than prescribed.
- Particularly watch medications prescribed to be taken “as needed.”
Step 4: Keep the List Up-to-Date
Any doctor (or dentist) appointment may result in a change to the medication regimen. Doctor’s offices give their patients written instructions at the end of a visit; check these instructions against your list every time. Watch for new medications or instructions to stop taking a medication.
Also be prepared to find differences in the list you keep and the office’s list for your loved one. You will need to figure out what the “truth” is and make the appropriate corrections.
Transitions of care are the most challenging times for keeping an accurate list. Changes in a medication regimen are more likely to occur when a person changes from one care setting to another and it is important to determine if a change is intended or if it is a mistake. Examples of transitions of care are:
- Getting discharged from the hospital, going home
- Discharged from the hospital to a rehabilitation facility
- Changing doctors or starting to see a new doctor
- Emergency room visits
Finally, whenever you change the list, type (or write) the date updated in the document.
You don’t have to start your list from scratch. Here are three medication list templates we like:
- My Medicine List ™ from the American Society of Health System Pharmacists
- Also available in Spanish!
- Universal Medication Form from the Institute for Safe Medication Practices
- My Medication Record from AARP