Tips for Helping Seniors with Their Medications
Steve Leuck, PharmD, has been practicing both hospital and community pharmacy for over 30 years. He founded AudibleRx, in 2011, which provides Consumer Medication Information in an easy-to-listen audible format. Increased health literacy means better outcomes.
What tools should pharmacists use to help older people maintain adherence and understand their medications?
I recently received a request from a pharmacy technician who fills in at our store now and again. He is in nursing school, and in his pharmacology class they were tasked with coming up with useful ways to teach seniors medication adherence and help them increase their understanding of their medications. He asked me if I had any specific tools I use with senior patients to fulfill these specific needs.
This just happens to be one of my favorite topics, and yes, I do have some favorite tools. Of course, each scenario has its own specific needs. However, with a little thought, I came up with my top 5 or 6 criteria in each section.
Helping seniors take their medications:
- It is super important to help people decrease the number of times they take pills each day. Most seniors tell me that they spread out taking their pills to 6 or 7 times per day (before and after each meal, bedtime, nap time, or a multitude of other specific situations.) Whenever possible, I like to help them decrease the number of dosing times to 3 per day at most, though sometimes, it must be 4, and other times, we can get it down to 2. We take some time to look at everything and discuss what can be given together. Often, seniors mistakenly think that they can't take one pill with another. In this situation, simple education goes a long way toward ensuring medication adherence.
- Create a one-page personal medication record, and help them fill it out. Make sure that patients understand how to use this record.
- Help the senior pick out a useable pill box. Show them all the options, let them choose the one they want, and make sure that they know how to use it. I will even ask them to bring it in and show me what it looks like when it is filled up.
- Make sure that they fully understand what to do if they miss a dose.
- Most importantly, make sure that the senior understands that they shouldn't guess with their medications. If they have a question, encourage them to call their pharmacist or doctor. Quite often, seniors feel as if they don't want to bother their pharmacist with questions. They need to know and understand that we work for them and are a resource.
Helping seniors understand their medications:
- Before beginning a discussion, evaluate the patient and understand any specific barriers to counseling that they may have, such as a lack of education, specific religious beliefs, language skills, social concerns, eyesight problems, speech issues, stigmas, or any other concerns. The pharmacist's counseling will change for each patient as different barriers are uncovered. There is no one-size-fits-all counseling method. Each patient gets his or her own custom-built counseling session.
- At the basic level, senior patients should have a one-word answer to why they are taking each medication, ie, "what is it for?" When I am counseling patients, while preparing their personal medication records, I write the indication on the record, next to the medication. At this point, I have the senior patient match up the indication to the medication name.
- As we are completing the personal medication record, I have patients explain how they take their medications and show them how that fits onto the record. Next, it is important that they can verbalize what they do if they miss a dose.
- Ask patients if they know what to look for to tell whether a medication is working. This can be a great teachable moment to discuss how their disease states are improving or not.
- Finally, based on the barriers discussed, figure out how much more information you think the patient can handle. Tell them about a couple of the most significant adverse effects, and let them know what they should do if they experience these. Then ask them what adverse effects they will look for and what they will do about them if they occur.
This is a lot of information to take in, but it is extremely important to keep It simple. Pharmacists must understand patients' specific barriers, provide information, and then have them teach it back.