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The term polypharmacy refers to when a person regularly takes five or more prescriptions a day. That describes Mom. She takes eight prescription pills, two supplements and one multi-vitamin every day. Since the supplement dosages are more than once per day, all total she swallows 15 pills per day, three times a day. And that’s an improvement. By questioning her doctors, (yes, that’s not only allowed, but encouraged) we were able to get her off two medications she didn’t need to be on (see my blog Dementia Did Not Have To Happen), incorporate several individual vitamins into one multi-vitamin, and reduce the frequency of a couple of medications from twice a day to just once a day. (She is not only still alive, she’s thriving, physically, and all her chronic conditions are completely under control. Take that Dr. Prescription Pad!)
And it’s up to me to make sure she takes all her meds properly and consistently. It can sometimes be a struggle. She’ll swear up and down and on my grandmother’s grave that she already took the pills I just put in front of her. I don’t take any of her guff, though, and although she grumbles, she invariably takes them like a good girl.
An Activity of Daily Living
When I applied with the Veteran’s Administration to get Mom the benefits she was entitled to, I, and her doctor, had to declare that she needed my help with at least one activity of daily living (ADL). ADLs include not just medication management, but preparing meals, eating, getting in and out of bed or chairs, bathing, etc. Of all the activities of daily living that Mom struggles with, medication management ranks number one, and has consistently since I became her caregiver.
Before I moved her in with me, I would regularly help her refill her weekly pill dispenser, and it was a can of worms. Her system was to sit on the couch, with all her pill bottles jammed into trays that weren’t big enough to hold them all, balance her dispenser on her knees, and fill it by reading off each and every bottle and referencing a cheat sheet. In front of the TV. Just watching her made my head hurt. No wonder her meds were all out whack in her system. How long before I moved here had she been regularly screwing up her dosages?
Keep It Simple, Stupid
Ah, my favorite catch-line. The K.I.S.S. Principle. I also am very fond of, “Work smart, not hard.” I couldn’t let Mom continue to organize her meds in such a disorderly way. But when I would sit down to set up her weekly regimen using her cheat sheet, it wasn’t much better than her at the couch and the afternoon shows. Yes, I’d sit at the table with a light on, all her pill bottles lined up like little soldiers. But going back and forth between each bottle label and her cheat sheet was just a pain.
So, I figured, “Hey, I used to be a manager. I used to have to organize people and stuff and budgets. I used Excel spreadsheets to keep track of everything. I got this!” So, I put together this elaborate spreadsheet with pictures and descriptions, generic and brand names, where to put in the pill box, even what each treated, etc.
Four pages! What a beautiful spreadsheet! Why yes. My middle name is, in fact, Overkill. And my cheat sheet didn’t make the job any easier. There had to be a better way.
Enter the Label Maker
I invested $20 bucks into a label maker, and another 20 or so in two plastic containers big enough to hold her open and inventoried bottles, and simplified my life. Everything is stashed and organized neatly. I label the bottles AM, Noon and PM. What was once a cumbersome, time-consuming, weekly pain in the ass takes a little more than five minutes and I know I’m dosing her properly. And if someone like my brother or sister has to pinch hit for me, no training required. Just follow the labels.
I also keep the containers OUT of Mom’s reach. The last thing I need is for her to decide to dose her own meds again. At first, she didn’t like it. But now she doesn’t even know that I do her meds for her. Everybody’s happy.