Medications for the Medically Complex Senior

Yesterday I wrote a post about the severe challenge facing hospitals, right now, due to changes to Medicare under the new health care reform law.  One of the leading causes of hospital readmissions, especially for elders, is medication non-compliance.

That situation arises for a number of reasons:

  • Some seniors try to save money by “stretching” out their medications, taking less or less frequently than prescribed.
  • If the senior does not have transportation, prescriptions sometimes do not get picked up in a timely fashion.
  • Even without dementia, a “pile” of medications can be confusing.  With dementia, compliance on the part of the patient is not going to happen.
  • Just being busy (visiting grandchildren, for example) can easily get in the way of taking medication on schedule.
  • Medications may not be reconciled between a hospital doctor and the senior’s primary care physician and / or specialists the elder is seeing — we have seen this too many times, at Support For Home.

Medication Compliance and Hospital Readmissions

Regardless of the reasons, not being compliant with one’s medication creates a pretty strong probability of a hospital readmission.

So, what can help?

  • There needs to be a complete list of all medications and their purposes.  We also recommend the list include the side effects of the drugs as well as the doctor’s priority for each medication.
  • A blister / bubble pack is excellent for organizing medication.  One of the great advantages over a pillbox (our second choice) is that the pharmacy actually organizes the blister pack and mails or delivers.  Not every pharmacy does blister packs, but finding one is a great idea. 

Blister Packs for Medication

  • Even with a blister pack (or at least pillboxes), for elders with dementia, or anyone with a brain injury or developmental disabilities, compliance with medication prescriptions is far from assured.  If there is not support throughout the day from family caregivers, hiring a reputable home care agency whose employees can help ensure compliance may be the best option.

The goal of dramatically reducing readmissions of seniors (and even first admissions) to the hospital is not just important to the hospital.  Hospitalization for seniors is, by itself, a very traumatic and weakening experience.  We need to make sure medication issues are not the reason they end up there.

Best wishes.  Bert



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