Even in cases of mild or early dementia, it's common to have poor prospective memory -- that is, memory for events in the future -- like taking medication or keeping appointments. It's also hard to form new habits, whereas longtime pill-taking routines may be easier to remember and maintain.
A multidimensional approach is often needed. One step may be to set up a pillbox in which you can put a week's worth of pills sorted by day, for example. If you're not available to do it, have a home health care worker who can come into the home regularly take responsibility.
See whether your dad can keep up with his medication regimen by checking the pillbox every day. If that's not enough of a reminder, you might look into some kind of system that uses the phone or computer. For example, caregivertech.com offers software that uses the computer's internal clock to remind the person to take a pill. When the person takes it, he presses a key to confirm that it's been done. There are also Internet video systems available that let you verify whether someone is taking medication.
At the Mayo Clinic, we teach a calendar, or journaling, system over a six-week period to help people keep track of dates and things to do. In between sessions with us, a study partner -- a spouse, an adult child, or someone else -- cues the person at home, reminding him to carry and use the calendar. The person is prompted every day: "Do you have your calendar?" "Do you have your journal?" "That's an appointment. Did you write it in your calendar?"
The idea is to get the patient to overlearn the system so he can do it automatically. At the end of six weeks, 90 percent of people are able to use the system, and it helps carry them further into the illness functioning independently than they might have been able to do on their own. You can ask at an area medical center for aging whether this kind of resource is available near you.
When a parent can no longer take care of himself in this way -- keeping track of medications and appointments -- it may be time for assisted living or a move to a situation in which the environment is structured to help with these things.