/ Jan-Feb 2008 / Developing an Organized Medication
System at Home
By Sandra Fuson, Staff Writer
Caregivers can be overwhelmed with the number of
medications that their loved ones need to take on a daily basis.
Medication errors are too common, with administration of drugs
accounting for 38 percent of errors. According to the ALARIS Center
for Medication Safety and Clinical Improvement, at least 7,000
deaths annually are blamed on medication errors.
There are many options on the market for an
organization system. Deciding which one is right for your family
needs to be the driving force behind the system that you ultimately
choose. Most of us are familiar with pill organizer boxes with
various slots for time of day and days of the week. There are other
options, though, that can be just as effective when implemented
There are many issues to consider when setting
up an organization system for your loved one. Some of these include:
How old is the person who is taking
medication? Are they old enough to take their own medication or
do they need someone else to give it for them?
Are they capable of taking their medication
independent of your help? Perhaps your loved one needs help in
keeping track of which medications need to be given at a
particular time of day, but they may be capable of choosing the
correct medication from the shelf.
Do they have impaired eyesight? Would it
help to have larger print on the bottles?
Does your loved one understand why they take
each medication? (NOTE: Patients with some level of dementia and
even children may not be able to comprehend the medications
given.) It is important that persons understand the reason
behind the medication to the best of their ability. As people
age, the answer, “Because the doctor said so,” may not be
Will others who may assist with caregiving
be able to understand the system readily? If you leave town or
are a long-distance caregiver, the system needs to be readily
understandable to other friends, family, or even paid caregivers
who may be in the household while you are away.
Is the system flexible so that changes in
medications and dosing schedules can be adjusted? It is not
uncommon for doctors to change medications when there are
chronic conditions involved. Be sure to develop a system that
can adapt to these modifications and be implemented without
confusion to your loved one.
No matter what system is chosen, proper storage
of medications is essential. Keep medicines stored in a cool, dry
area away from moisture or heat. The kitchen cabinets often serve as
a favorite place to keep medicines. Be sure that the cabinets chosen
aren’t subject to the moisture or heat changes near refrigerators,
dishwasher steam, or even steam from the kitchen sink. This holds
true for bathroom cabinets as well.
Also, keep medications in their original
container until they are ready to be administered or placed into a
pill organizer. It is okay to make notes on the bottle with a black
marker, such as a Sharpie®, to make instructions more clear for your
loved one or other caregivers. When moving medicines into a pill
organizer, make sure not to take out more than one week’s worth.
The Canadian National Institute for the Blind
recommends some of the following methods when considering a system
to organize medications:
Using a pill organizer with one or more
sections for each day. If your loved one is taking multiple
medications, it may be best to associate these with a meal or
event rather than a particular time of the day. You can
“re-label” the time slots with the event to make it more
There are electronic pill organizers which
can dispense medications on a set schedule. Some of these only
have beepers or other reminders to let individuals know when
medications need to be dispensed. Others can dispense
medications on a pre-programmed schedule. The only caution with
these is the programming and being certain
that the device helps in your particular environment. The
elderly may or may not be receptive to their use.
Organizing medication on one shelf
alphabetically or according to their frequency of use. If you
choose this method, be sure that your loved one can read the
labels on the bottle and that they are able to open the bottles
without help. Also, you may need to set reminders to let them
know when it is time to take each dose.
Using personal markers or even colors on the
top of the bottle so each medication can be readily identified.
Blind persons can even put Braille wording on the top of the cap
to make sure that each medication is taken accurately.
Changing pill bottle shapes or sizes to
differentiate between medications.
Also, putting rubber bands on the bottle to
indicate how many doses need to be taken each day. Each time a
dosage is taken, remove a rubber band and at the end of the day,
While these suggestions may work well for
individuals who can give medications to themselves, there are still
others that may help individuals who are in the home providing care
one-on-one. These suggestions include:
Using a dry erase or bulletin board to write
the medicine schedule. You can color code if needed. Dry erase
boards need to be mounted to a wall rather than carried around
the house since they can be erased easily, thus contributing to
more medication errors. Poster board can also be used for this
same purpose. A simple grid with medications down the side and
dosing times across the top will help keep you organized.
There are several online communities that
offer simple medication logs where patients and caregivers can
track the medications they need to take and when they need to be
taken. Insert the log into a three-ring binder and keep it in a
place where it is easily accessible. Find one that works for
your situation and use it on a regular basis.
Taking medications that center on events such as
breakfast, lunch, dinner, or bedtime may be easier than trying to
maintain an elaborate time schedule. There is less room for error
and it serves as a good reminder of when medications may be needed.
Plus, with the number of medications that need to be taken with
food, centering some drug administration at meal times makes it more
comfortable for the patient.
These are a few ideas that will help get
caregivers thinking about how to manage medications in the home.
Certainly, there is no wrong way to develop a system as long as it
meets physician orders and provides the necessary medications when
they are needed. Being comfortable with the solution is just as
important as finding the solution. To the extent possible, involve
your family members in the planning process. They may provide
insight and suggestions that you have overlooked.