September/October 2014 Print - Debra Levy Eldercare Associates

Is Dad taking his meds "as directed?"

A recent national survey suggests that every year nearly half of adults taking prescription medications for a chronic condition make errors in taking their meds. The most common problem areas:

Memory: Forgetting to take a medication
Organization: Failing to order a refill in time and running out of a drug
Convenience: Being away from home and missing dose(s)
Side effects: Experiencing unpleasant reactions
Cost: Affording the drug

Any deviation from what’s prescribed is risky. This is especially true for older adults in fragile health. Here’s what you can do to support your loved one in following the doctor’s orders.

Develop and monitor routines. A multi day pillbox may be all that’s necessary to resolve memory issues. Bring one as a present, along with your promise to keep the box filled and refills ordered on time. If more active reminders are needed, consider an automated, locking pill dispenser or a program that sends an alert when a dose is needed. See our earlier article about remembering to take medications.
Collaborate with the doctor. When you visit your relative’s primary care doctor, bring in every prescription and over-the-counter (OTC) drug being taken. Review the purpose of each drug. Are all of them still needed? Can the treatment be simplified? Perhaps there are alternatives that involve fewer doses.
Report problem side effects. Provide details about side effects that you and/or your relative have noticed. Simple changes in diet or the time a med is taken may help.
Address cost issues. Let the doctor know if cost is a problem. A generic version may be available, or the doctor may have samples. Price shop among local stores for prescription and OTC drugs. Consider mail order.
Connect with the pharmacy. The pharmacist can provide easy-off lids, large print on labels, and drug information. They can often help clarify doctor’s orders and offer advice concerning side effects.

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Use your mind to combat stress

Ever feel there is just too much on your plate? It’s common to assume that feeling better is right around the corner, just as soon as you get everything done. But when the “to do” list is infinite and your personal motor is always “on,” you are more likely to achieve breakdown sooner than completion.

Following are tips about ways to de-stress even when the circumstances haven’t changed. The goal is not to stop what you are doing. Instead, learn to keep going, but with more internal calm. According to the Mayo Clinic, learning to “adapt and accept” is an effective way to respond to situations that simply are beyond your control.

Stay positive. Train yourself to notice what’s going well or feels good. Put your mind’s spotlight on the good. “Dad enjoyed watching the ball game today. He laughed just like old times.” Give yourself positive feedback for your accomplishments, no matter how “small” they seem.
Accept imperfection. You don’t expect perfection in others! Extend the same graciousness to yourself. Give each task your best attention, and then accept the outcome without harsh self-judgment. Remind yourself, “There are only 24 hours in the day. I did my best, and that is all anyone can do!”
Find the lesson and move on. Dwelling on the negative takes energy and achieves nothing. Are you constantly revisiting a decision you made or an action of someone else’s that was not the wisest choice? Take some time to constructively reflect on what you could do differently “next time,” and then move forward.
Promote perspective. Imagine yourself some years into the future. Looking back on today, does what you’re anxious about still seem important? If not, don’t let it run your life. Save your energy for issues that WILL matter five years from now.

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What about your special needs sibling?

Is your aging parent still caring for your disabled brother or sister at home? Perhaps this care arrangement has worked fine for decades. But with your parent’s aging, it’s not too soon to start talking about your sibling’s future. Preparing now eliminates the potential for crisis and unnecessary stress.

The basics of care. The “future” can come very suddenly. If your parent has a health emergency, it will likely put you in charge. Assemble a binder to organize your sibling’s information:

Personal identity. Birth certificate and social security card.
Contact information for physicians, health providers, caseworkers, or special advocates.
Daily routines. What happens and when (at home, school, work, place of worship). How much help is needed and from whom. Favorite pastimes and usual responsibilities. Transportation or other community services involved. Respite care providers. Friends’ names and contact information.
Personal preferences. Special dietary needs or conditions. Special clothing or personal care needs. Best places to purchase these items.
Special challenges. The kinds of settings that might be problematic. Best techniques for calming or distraction.
Medical needs. Current medication list with details about drugs and dosage. Current health insurance information. Complete medical history.
Financial and legal arrangements. Income sources and management arrangements. Account information for banks, trusts, investments. Copies of legal documents, including powers of attorney or guardianship appointment, if applicable.

A plan of care. Ask your parent to write out plans made for your sibling’s long-term future care. Review where he or she will live. Talk about who will be in charge of care management. How will care be financed?

Legal legwork. If your sibling might receive an inheritance, life insurance distribution or other gift money, consult an attorney. Such generosity may jeopardize important public benefits. Look for an attorney with expertise in “special” or “supplemental” needs trusts.

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