Medication Safety and Dementia Care

Canadian seniors who were prescribed 10 to 14 drug classes (types of medication) were over five times more likely to be hospitalized for adverse drug reactions than seniors prescribed between one and four drug classes, according to The Canadian Institute for Health Information (CIHI). 

This is not a rarity. In 2016:

• 65.7% of seniors were prescribed five or more different drug classes
• 26.5% of seniors were prescribed 10 or more different drug classes
• 8.4% of seniors prescribed 15 or more drug classes

When a person takes five or more medications (including both prescription and nonprescription products) during the same time period, this is called polypharmacy, which can increase the risk for adverse drug reactions.

This risk rises when dementia is involved because the person may not remember when or even if they had taken their medications. So, they may take their dose multiple times. They may even take the incorrect prescription or become confused by the instructions, such as not understanding that they can take two drugs together if one label read “every 12 hours” and the other “twice daily.”

There are many ways to reduce the risk of medication errors. The right approach (or combination of methods) should be personalized: Consider their living situation, personality, remaining abilities, functional losses and where their medication regimen fails. Here are three ways that you can help:

1. Organization – Some people with dementia can more readily use a multi-dose, pre-packed pillbox that organizes each day’s dose in its own section (if the pillbox is organized correctly). Others, though, may need to have their medications secured and put away except when taking a dose. 
2. Technology – There are a few different smartphone apps that can alert the person with dementia or their caregiver when it is time to take a medication. There are also machines that sort and dispense pre-loaded medications. Many have noisy alarms and flashing lights that remind the person to take their medicine. Machines that control dosages and times can help prevent someone from taking multiple doses too close together. However, the person with dementia may accidentally skip a dose by receiving the medicines from the machine but forget to actually take them. It is very difficult to know whether the person took their medications on time, much less at all, if there is no one to witness it.
3. Guidance – Another way to help is by reminding the person with dementia when it is time to take medication, either in person, over the phone or via video chat. This could be a family member, friend, neighbour, paid caregiver or service. However, the person with dementia could still take medications too often if they have unlimited access to them.

If the person with dementia is overwhelmed by prescription instructions, gadgets or storage, approaches should be combined with human oversight to ensure the correct pills are taken at the correct time. ComForCare Home Care can help with that! We provide medication reminders, assist with meal preparation, and help with hygiene and grooming. Contact us today to learn more.