One of the big things I worried about was Jim being alone all day with easy access to his medications.
He wasn’t scheduled to take medications during the day but with the way his memory was fading, I’d started to worry that he may get disoriented and start taking them anyway. I was beginning to look into better ways to manage his medications when an incident at dinner one night made me realize I had to do something fast.
Jim had set the table as usual. Normally, he would put out his evening medications beside his plate to help him remember to take them with his meal. When I poured drinks (milk for him, cranberry juice for me) just before serving supper, I didn’t see his meds so I put them out for him. After supper, we realized that two doses were on the table. The ones he’d set out after all and then the ones I put on the table.
He took one set and I put the other on the other side of the table and said we’d keep them there to take the following night. I got up, cleared the table and brought out dessert. In the space of 90 seconds while I was in the kitchen. Jim had forgotten he’d already taken his medications, saw the pills on the other side of the table and took them too.
When I came back into the dining room, I freaked out. Internally, that is. Externally, I very calmly asked him where the extra pills had gone. He couldn’t say for sure he’d taken them. He wasn’t sure what extra pills I was talking about. Never have I been so thankful that he was on relatively low doses for his meds and doubling up wouldn’t do him any harm, except for his diabetes medication. He got extra treats after supper and I monitored him to ensure his blood sugar didn’t drop to low.
A slow roll out of a new medication management system was no longer possible. It had to happen yesterday.
We’d been keeping his medications in a decorative container on the counter. While they were out of sight, they were still accessible. All he had to do was lift the lid and he could potentially swallow an entire three month supply of medications.
As with everything I reorganized behind his back, I tried to preserve his independence while eliminating the risk of harm.
Priority was to stop him from dispensing the pills himself directly from the prescription bottles. I bought a great little pill dispenser that held a week’s worth of individual daily pill boxes. I prefer this style because Jim’s hands have a slight tremor and most of the flat version pill dispensers have a single cover for the entire case. Which means if the container is dropped and the cover falls off, the entire week’s worth of medication can fall out.
Having separate boxes for each day means that Jim and I both can easily double check his routine. In the morning he takes out the clearly marked pill box for the day and then after he takes his morning pills, he puts the box on the dining room table ready for our evening meal. This works because it’s just the two of us, I don’t have to worry about curious little fingers or paws getting to his medication. Eventually, I’ll have to revamp this process once Jim loses the ability to discern when he should take medication.
Another advantage is that if we go out for a meal, we just grab his pill box which is small enough to put in his breast pocket.
I moved all of his medication bottles to a lockable medication container that I stored out of sight. He’s hardly noticed that the bottles for his prescriptions were missing. As long as I keep his pill dispenser full, he doesn’t question the new process or go looking for the actual pill bottles.
My only complaint about these dispensers is that the writing wears off within a few months. A couple of the Dementia care-giver books I’ve read suggest the purchase of a label maker. I’ll do a blog post on how much I love my label maker later but for now it’s enough to mention that you can make labels to replace the worn ink and keep your spouse safe.
I will caution – If you’re dealing with someone who has high dose medications, you may need to find another way to manage their medications. Jim’s medications are all fairly low dose so keeping the whole pill dispenser container on the counter works for us at this stage of his decline. I recognize that eventually I’ll have to move it as well.
One step at a time.