Medication Safety - Dementia Caregiver Web Support
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Medication Safety

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This page reviews the importance of medication safety, which includes discussing all current medications with your loved one's physician and pharmacist, medication organization, and a brief overview of medications to avoid due to cognitive side effects.

Before reading the content on this page, it may be beneficial to review the following video(s) from the Office of Rural Health (ORH).

Medication Issues for People with Dementia
Length- 6:01 (Link opens to new page)
This video portrays different approaches for caregivers to organize and store medications, handle medication refusal and create medication lists.


Managing Your Loved One's Dementia Medication medicine in hand

Before your loved one begins taking any new medication, it is very important to discuss any current medications with his/her physician and pharmacist.  When you visit the doctor bring a medication list or the bottles with you.  If the doctor prescribes a new medication to your loved one, let the doctor know if about other medications your loved one is currently taking. This information will help the doctor identify any potential problems or drug interactions with the new medication. 

If a new medication is prescribed, make sure you do your research.  Ask the doctor or pharmacist when and how often it should be taken and if it should be taken with food.  This will ensure that the medicine is taken properly, and it can also help you develop a routine.  For example, if it is to be taken in the morning with food, the medication can be given every morning at breakfast.  If your loved one has difficulty swallowing, the medication may be available in another form so ask your doctor. 


Medication organization and safety tips

Some individuals take medications to treat other behaviors such as restlessness, anxiety, depression, and sleeping problems.  Experts agree that medications should be used to treat behavior problems only after trying other behavioral strategies.  Talk with your doctor about the safest and most effective medications to treat behavioral problems and dementia. 

You may run into difficulty getting your loved one to take the medication.  If they are resistant, do not force it.  Try again a little bit later. 

Keep all medications, vitamins and other supplements in a locked cabinet or other safe location. 

Using a Pill Box

To help you keep all medications organized, consider using a pill box.


Medication Card

A medication card is another tool you can use to help you stay organized. It will help you keep a list of all the current medications, the dose, prescribing physician, start date and number of refills available. Please review this link for a medication card that was developed for another VA project.

Medications to Avoid

As we age, the body can become more sensitive to the effects of medications. Negative side effects of medications are generally more noticeable in the elderly.  Older individuals with dementia often have a lower tolerance for medications than healthy adults and are more prone to drug-induced cognitive impairment, such as delirium or confusion.

Some medications to avoid are listed below:

Benzodiazepines are used to treat insomnia (sleeplessness), anxiety, and agitation.  These medications have been linked to a fast onset of confusion and behavioral problems in dementia patients. Common benzodiazepines: are Valium®, Xanax®, Librium®, Restoril®, Halcion®, ProSom®, and Ativan®

Sedatives have similar effects on the central nervous system as benzodiazepines. These include commonly used over-the-counter sleep medications such as Ambien®, Sonata® and Lunesta®. These medications can cause confusion and agitation and should be avoided.

Anticholinergic medications are used to treat a variety of disorders, including urinary incontinence, sleep disorders, depression, Parkinson’s disease and Irritable Bowel Disease (IBS). These medications may cause side effects, known as anticholinergic effects, which include increased confusion, hallucinations, urinary retention and constipation. Some common medications that fall into this category are Elavil and Tofranil (antidepressants), Benadryl (antihistamine), muscle relaxants and some antipsychotics. 

Muscle relaxants, such as Flexeril® or Robaxin®, can lead to grogginess and confusion, in turn, increasing the risks of falls.

Unless being treated for psychosis, avoid Antipsychotics. While these medications are commonly used to treat behavioral problems in older adults with dementia, they can cause tremors and increase the risk of falls. Haldol®, Risperdal®, and Seroquel® are commonly used antipsychotics.

Disclaimer:
Medication safety is critical for individuals with dementia.
Consult your loved one’s physician about any questions or concerns you have related
to the medications he or she is taking including over-the-counter medications,
as well as any symptoms or health problems he or she may be experiencing.

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VA Resources

US Department of Veterans Affairs
VA values your commitment as a partner in our pledge to care for those who have "borne the battle." We have several support and service options designed with you in mind. The programs are available both in and out of your home to help you care for yourself and the Veteran you love.

Geriatrics and Extended Care Services (GEC) is committed to optimizing the health and well-being of Veterans with multiple chronic conditions, life-limiting illness, frailty or disability associated with chronic disease, agining or injury. This VA site reviews information on delirium, dementia and Alzheimer's care, decision making, home and community based services, and advance care planning, among many other important topics that may be important for you as a caregiver.

Veteran's Crisis Line Phone: 1-800-273-8255 (Veterans Press 1)

The VA does not endorse the following resources or guarantee that their information is 100% accurate.  However, you may be able to find some helpful information by visiting the following pages:

Alzheimer's Association: Alzheimer's and Dementia Caregiving Center
Find out more information on Medication Safety.


References: Information adapted from Alzheimer’s Association, HealthyAging.com, Therapeutic Research Center and Office of Rural Health
If you have any questions or concerns, contact us.