Caring for a parent with several conditions and several medicines

As a parent gets older, conditions usually build up one by one: blood pressure, blood sugar, thyroid, heart, joints. Each condition brings a medicine or two, and each medicine brings a doctor. Many sons and daughters suddenly find themselves the person who holds all this information together. This article is for them.

One file, not several pieces

The most important thing is to have all the information in one place:

• The medicine list. healthdirect advises keeping an up-to-date list of all medicines, including vitamins and herbal remedies, with the purpose, the dose, the time and whether it is taken with food. A paper list or a list on a phone both work. Show it at every visit and every pharmacy trip so everyone knows what is being taken.
• Test results and reports in date order, and any hospital discharge summary or earlier heart tracing (ECG)
• Allergies and side effects they have had before
• The names of the doctors and what each one is for

If there are several doctors, say at every visit who made the latest change.

Medicines

The healthdirect source regards the chance of interactions and mistakes as higher when someone takes five or more medicines, and suggests asking the doctor or pharmacist for a regular medicine review; in that source “ideal” is every 6 to 12 months. This figure comes from an Australian source, and the doctor decides the right schedule for you.

• Do not stop or change any medicine yourself. healthdirect says the carer should talk to the doctor or pharmacist before stopping or changing any medicine.
• A weekly pill organiser or pharmacy packaging can reduce mistakes. Ask the pharmacist.
• If forgetfulness, confusion or dizziness is new, tell the doctor instead of putting it down to “old age”. The source says it may be a medicine side effect.
• Before adding a painkiller, medicine or supplement, ask the doctor or pharmacist.

Signs in older people can differ

Illnesses do not always start the way the textbook says:

• Heart attack. According to MedlinePlus, older people, women and patients with diabetes may have little chest pain or none, and have shortness of breath, tiredness and weakness instead. Take such signs seriously (see the guide “When should I call urgently?”).
• Overactive thyroid. NIDDK says the signs in older people may be, for example, loss of appetite and withdrawal, and can be mistaken for depression or dementia.
• Low blood sugar. Confusion, dizziness, tiredness, blurred vision and headache can be signs of it (NIDDK). If the person becomes confused and has diabetes, first check blood sugar or get it checked with the doctor’s help.

If you see a sudden change in alertness, speech, walking or balance, do not put it down to ageing; call 115 (the emergency number in Iran), as these may be signs of a stroke.

The visit

• Go with them to the visit and write the questions beforehand. MedlinePlus suggests that a family member or friend sits with the patient at the visit and writes down the answers.
• Ask the doctor which medicine is for what, what the targets for blood sugar and blood pressure are, and, if there are several medicines, whether all of them are still needed.
• Targets differ for each older person. A number that suits one person may not suit another. The decision on a target is the doctor’s.
• Ask questions such as “What happens if the medicine is not taken?” or “Which side effects should worry us?”

The carer is human too

Harvard Health says the strain of caring can harm your own health. Its advice:

• Keep up your own food, rest and exercise
• Share the work. Tell the family exactly what is needed; if someone offers help, accept it, and if no one does, ask.
• Keep a list of small tasks (phone calls, shopping, going along) so each person can take one
• Set aside time for rest and something you enjoy
• A support group or a social worker can help

Tiredness, anger, guilt and sadness are common in carers. If these feelings go beyond what you can bear, talk to your own doctor.

When should you call urgently?

Call 115 (the emergency number in Iran) if your father or mother has chest pain or pressure, severe shortness of breath, signs of a stroke, loss of consciousness or sudden confusion, or has low blood sugar and cannot swallow. Other emergency signs are in the guide “When should I call urgently?”.

Every patient’s treatment plan is different; ask the doctor about your own situation.