By Angela

Tips for Dealing with Medication Challenges

People suffering brain injuries can have difficulties with memory, blurry vision, confusion and attention. When they have to take medication daily, this can become very challenging. Some live with family members who can provide some assistance with this. Others may live alone. Some family members may live far away, making it difficult to help even if they wanted to. Other families simply withdraw from the handicapped individual, too overwhelmed to deal with the complexities and difficulties of another person’s life.

Being a person with a brain injury who has lived alone and struggled with the many challenges related to medication, I have listed some of the problems I’ve had to work through. Under each problem, possible solutions are provided. I have also developed some forms which you may copy and use as long as you provide my copyright information.

Problem 1: I forget to take my medicine.

Keep your medication or pillbox in a place where you will see it every day – for example, next to the coffee maker or close to the kitchen sink. (Make sure this is out of the reach of young children)

Take your medicine at the same time each day.

Connect taking your medicine with an activity you do regularly every day – for example, eating breakfast or brushing your teeth.

If you link taking your medicine with a routine activity, keep your pillbox close to where this activity takes place. If it’s not in the line of your vision while doing this activity, you are still likely to forget your medicine.

If you only have a couple of pills to take, consider purchasing a timer cap for the bottle.

Program your cell phone, home voicemail, PDA or computer to remind you.

Hire a telephone wake up service to remind you to take your medicine in the morning. Examples: http://www.wakeupland.com, http://www.snoozester.com, http://www.mrwakeup.com, http://www.mycalls.net, http://www.wake123.com. (Check out this website about using wake up call services: http://www.howtowakeupearly.com/Use-wake-up-call-services.aspx)

If you have to take numerous medications multiple times per day, check into purchasing some kind of pillbox with multiple compartments and some kind of pill alarm or medication reminder wrist watch. Some medication systems have an alarm that is either built-in or comes with it. (Keep in mind that some alarms will shut off and go to the next time setting if you don’t respond to it after an hour.)

Problem 2: I forget if I’ve taken my medicine.

Use a weekly pillbox, sold at any drug store, with seven separate containers if you take medication once a day. If you take medication multiple times during the day, there are pillboxes which have slots designated for different times of the day (i.e., morning, noon, late afternoon, bedtime). If the container is empty, then you’ve taken your medications.

Place an index card on top of your pill box with the following words printed: “Today is __________.” This will remind you to stop and make certain what day of the week it is, so that you know you are taking the pills in the correct container.

Ask a family member or friend to call you when it’s time to take your medication and not hang up until you’ve taken it.

Keep a chart next to your medication that you check off as you take it. (See Medications – Chart E, Medication Checklist)

Problem 3: I have a hard time reading what’s on the medication bottle.

Ask the pharmacist to use labels with large type for your medication bottles, if possible.

Problem 4: I get overwhelmed by being on so many different medications and sometimes get the bottles mixed up.

Develop a color coding system (use either colored circle stickers or cut circles construction paper & glue on lid) for your medications so you have fewer bottles to sort through. For example, yellow might indicate meds taken in the morning; blue– meds taken in the evening; red – med for migraines; etc.

Post the key to your color coding system with your medications.

Problem 5: I get off track taking my medication when it’s time to refill my pillbox. I forget to fill the pillbox, and therefore, I don’t take my pills.

Get in the habit of refilling your pillbox on the same day each week (for example, every Monday after breakfast). Choose a day and time you typically have enough time to do this without rushing.

Ask a family member or friend to commit to a specific day every week to either come over and help you refill your pillbox or call to remind you and/or verify that you have refilled your pillbox. For people who qualify for visiting nurses, this is a task they may be able to help you with.

Problem 6: I have a hard time remembering when to get my prescriptions refilled and to allow enough time if I have to refill it by mail order.

Ask your pharmacy or mail-order prescription service if they have a reminder program or if they can automatically refill your prescription.

As soon as you fill a prescription, write on your calendar or planner when to refill your prescription. (For mail-order prescriptions, order your refill about 10 days before you run out of your medication.)

Write “Refill” and the date you should order a refill on a sticker and place it on your medication bottle.

Place your empty prescription bottle, or a taped note, next to your phone or in a prominent place as a reminder to refill your prescription.

Problem 7: I get confused when filling my pillboxes and sometimes put the wrong pill in the wrong place.

Make a chart which lists what pills go into which compartments. Keep this taped to the bottom of your pillbox. (See Medications – Form D, Meds for Pillbox Containers)

Develop a color coding system (use either colored circle stickers or cut circles construction paper & glue on lid) for your medications so you have fewer bottles to sort through. For example, yellow might indicate meds taken in the morning; red – meds taken at noon; green – meds taken at supper; and blue– meds taken at bedtime.

Have someone else fill your pillbox (i.e., family member, neighbor, home visiting nurse).

Have another person watch you and double check what you are doing. Ask them to do this until you are able to fill your pillbox without making any mistakes for at least a month.

If you are going through more stress than usual, ask someone to either double check you or do it for you until things settle down.

Examples of Medication Reminders

Below are some pictures of various kinds of medication reminder products. I have listed website information where these products can be purchased. You may want to also check with your pharmacy to see if they carry some of these items or something comparable.

e-pill Medication Reminders from Epill.com – Multi-dose Pill Box Weekly Planner, CADEX Medication Reminder Watch & Medical ID, MeDose 6 Alarm Vibrating Wrist Watch, Automatic Pill Dispenser & Organizer Pill Box, Multi-Alarm POCKET. <http://www.epill.com&gt;

MedCenter System.

http://www.medcentersystems.com/zMedCenterSystem.html

Other Important Tips

In addition to problem solving challenges related to taking your medications regularly, here are a few other important medication-related tips.

1. You should know the following about each of your medications:

What is the name of the medication?

Is this a brand name or generic drug?

Does taking the brand name or generic makes a difference?

What is the medication for and what it is supposed to do?

Does it matter the time of day it is taken?

How long will you need to be on this medication?

How long will it take before it starts working? How will you know if it’s working?

Are there certain foods, medications and/or drinks to avoid while taking this medication?

What are the possible side effects? What should you do if you experience any of these side effects?

Are there conditions or side effects in which you should stop taking it immediately?

2. Post a list of medications you take in a prominent place where you or someone else can refer to it as needed. For example, I tape mine on one of my kitchen cabinets. (See Medications – Form B, Medication Information) Include the following information: name of medication, strength, how often and when it is taken, reason it is prescribed, the name of the prescribing physician, and allergies.

3. Keep a list of medications you take on your person whenever you go outside your home, and particularly when you go to a doctor’s appointment. (See Medications – Form A, Medication Information. This can be cut out and pasted onto a 5 x 7” index card)

4. Let your doctor or pharmacist know if your medication routine is too complicated or if the medications are too expensive. There may be some alternatives or ways to problem-solve these issues.

5. If you have difficulty understanding or remembering what your doctor or pharmacist says about your medications, have another person go along with you.

6. When starting new medications, keep track of any questions, comments or observations you have. (See Medications – Form C, Medication Questions) Discuss these issues with your doctor at your next appointment.

7. Before you stop taking any medications, be sure to talk with your doctor. Some medications are dangerous to stop immediately and need to be tapered off gradually.

If you have additional problems, solutions and useful websites related to medication challenges, I’d love to hear from you so that I can include additional information to help others who are struggling.

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Medication Forms

Medication Information, index card size medication-form-a

Medication Information, full sheet medications-form-b

Medication Questions medications-form-c

Meds for Pillbox Containers medications-form-d

Medication Checklist for once and 2x/day medications-form-e1

Medication Checklist for 3x and 4x/day medications-form-e2

Handout on Medication Challenges

Page 1 medication-challenges-p1

Page 2 medication-challenges-p2

Page 3 medication-challenges-p3

Page 4 medication-challenges-p4

Page 5 medication-challenges-p5

Page 6 medication-challenges-p6

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Sources:

Hanauer, MD, Stephen B. “Staying on Medication – Your Health Depends on It.” Salix Pharmaceuticals Inc.: Patient Newsletter Volume 1, Feb 2004. 4 October 2008. <http://www.salix.com/gastroenterology-resource/patient/newsletter/vol1/index.aspx>.

Henry, Sarah. “How to help your parent with diabetes follow medication recommendations.” Caring.com. 4 October 2008. <http://www.caring.com/articles/how-to-help-your-parent-with-diabetes-follow-medication-recommendations>.

Medicine Management. American Heart Association. 4 Oct 2008. <http://www.americanheart.org/presenter.jhtml?identifier=149>.

“Tip 25: Use Wake Up Call Services.” How To Wake Up Early.com. 29 July 2007. 5 October 2008. <http://www.howtowakeupearly.com/Use-wake-up-call-services.aspx>.

© Angela Cramer, 2008

Clipart, photos and product images come from the following sources:
1) Jupiterimages made available through subscription: © Jupiterimages Corporation, 2008 www.clipart.com

2) Angela Cramer, 2008

3) Internet product listings specified on http://www.epill.com and http://www.medcentersystems.com/zMedCenterSystem.html

Tags: TBI, traumatic brain injury, acquired brain injury, post concussion syndrome, medication challenges, medication reminders


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