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Managing dementia medications?

Domenica asked...

My husband has dementia and orders his medicines by mail. I am puzzled about the best way to track his meds for the days allowed with the prescription before the refill date ends. I am trying to think of a simple chart but unsure of how to begin. Thank you so much.

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

Managing dementia medications is rather like trying to stuff a cat into a paper bag - something always seems to be left out and occasionally there's a claw at the end of it! It is often seen as 'interference' when a conscientious caregiver wants to take over medication management and the person with memory impairment reacts with animosity. It underscores what the patient already knows - he is failing in everyday tasks that were once easy to complete.

Trying to rationalize with someone, who has lost the ability to do so, just confounds the situation while letting him make errors is simply not feasible when necessary medications are involved.

Here are some suggestions that may turn out to be a solution:

  • Come to grips with having to take over ordering his medications.
  • If he is to purchase and take his meds appropriately, it has to be with your help.
  • Hopefully you already use 'fiblets' in your daily carepartnering. Fiblets are rather like therapeutic lies used to create harmonious interactions and reduce negative feelings. So rather than stating that you now need to take over handling the meds, you say "the medical supplier is going out of business and we will now need to get your meds at our local pharmacy".
  • If you are hesitant about the use of fiblets, try one! The positive reaction underscores how much better it is to have harmony and self-esteem rather than an unpleasant interchange leading to negative emotions that may last for days.
  • The goal is to keep him from feeling the change in ordering is related to his demise but is instead because of some change in the supplier's status. The system failed - not him!
  • Using a local pharmacy can be a real bonus in many unexpected ways. I always suggest that on the day of diagnosis, your pharmacist should become your most trusted partner. They help with drug interactions and substitutions, and cost-saving, and much more.

You do need to find another way to order meds that does not directly involve his ordering by mail. You also want to keep him feeling that he is still a functioning human being; he does not need to feel that something else is being taken away from him. Instead place it in the hands of a third party - the local pharmacist.

Remember to take care of yourself.