Are You Taking Your Medicine Safely?

Lesson Objective:

This class will help older adults understand how to use and store their medicine safely. By reviewing the 5 Guidelines of Medicine Safety, older adults will gain a better understanding of their own medication and be more prepared to speak to their doctors. Class participants will also know who to call in case of a medication question or emergency. 

Teacher Narrative:

Introduce the following statistics. Ask the audience to consider what these statistics might mean to them.

  • Most adults 65 years and older regularly take at least 5 different medicines. 
  • Along with prescription medicines, many older adults use over-the-counter medicines, dietary supplements, and vitamins. 
  • Medicine mishaps such as interactions and side effects cause over 700,000 emergency department visits each year. 
  • Older adults are twice as likely as younger patients to visit the emergency department for problems with their medicines.
  • Older adults are nearly 7 times more likely to be hospitalized after an emergency visit!

The big question for many older adults is this: Are you taking your medicine safely? In today’s lesson, we’ll discuss reminders for future doctor visits, understand the importance of reading medicine labels, talk about a medicine list, and make sure we have a reminder of who to call in case of emergency. 

Lesson Instructions:

A. 5 Guidelines of Medicine Safety20 – 30 minutes

Introduce the 5 Guidelines of Medicine Safety [download]. Note: this information can be passed out as a handout or displayed. As you go through each of the guidelines aloud, ask participants to jot down any questions or concerns they may have.

1. Participate. It’s your health!

  • It’s your health. Be an active, assertive participant in your own healthcare. Safe medicine use is a shared responsibility between you, your doctor, the pharmacist, and your other healthcare professionals. It’s great if you have someone to help you manage your medicines, but think of yourself as the boss of your own medicines.
  • Make a point of discussing your medicines with your doctors and anyone else who helps you with your medical care. Make sure each of your healthcare professionals knows all of the medicines you take, including over-the-counter medicines. Also, make sure each of your healthcare professionals knows about any vitamins or supplements that you take.
  • If you have any questions about your medicine, do not guess! Ask the experts at your poison center, your doctors, or your pharmacists.

2. Read and follow the entire label.

  • Always read and follow the entire label and instructions that come with each of your medicines, including over-the-counter medicines.
  • Just because you have taken a medicine before doesn’t mean it’s still safe for you to take now. So, before you stop or start any medicine, check with your doctor or pharmacist.
  •  If a medicine comes with a dosing device like a cup or syringe, always use that dosing device to measure that medicine. Never use kitchen spoons to administer medicine.
  • Keeping medicine in its original, child-resistant container is ideal. However, if you put over-the-counter pills in a pill sorter or anything other than the original packaging, be sure to keep the original packaging so you can refer to the label and instructions.

3. Write it down 

  • Keep an up-to-date list of all the medicines you are taking, which includes why you are taking each of your medicines; how much medicine to take and when; whether there are certain foods, beverages, or other medicines you should avoid while taking your medicines; and possible side effects of your medicines.
  • Bring your medicine list with you whenever you go to a doctor or drugstore. Make sure every doctor you see has a copy of your chart and reviews it at every visit. Ask your doctor to help you keep it updated at every appointment.
  • Only take your prescription medicines. Never take prescription medicines your doctor has not prescribed for you.
  • If possible, get all of your prescription medicines from one pharmacy.

4. Keep medicine up, away, and out of sight!

  •  At home, keep your medicines up, away, and out of sight of children and teens, adult visitors, and pets.
  • Keep medicines that you have with you when you’re away from home, like in your pocket, purse, or car, in child-resistant containers. Remember that there is no such thing as “childproof” packaging. Do not depend on child-resistant packaging to keep children out of any medicine.
  • If you use a pill sorter, use the kind that is child-resistant and keep the pill sorter up and away from children. Also, make sure your pill sorter looks different from anyone else’s in your house.
  • Do not keep expired or unneeded medicines. To find out how to get rid of your expired or unneeded medicines safely, call your pharmacy or the Missouri Poison Center at 1-800-222-1222.

5. Be prepared: Know who to call.

  • Save the Missouri Poison Center number in your phone or display it somewhere visible in your house, like on the refrigerator or close to your telephone or computer. The number is 1-800-222-1222.
  • You can call the Missouri Poison Center free, any time, year-round, if you have questions about your medicine, if you make a medicine mistake, or if you think you may be experiencing a harmful interaction or side effect. Missouri Poison Center calls are private and confidential, and they’re answered by experts you can trust.
  • Keep the Missouri Poison Center number and the numbers for all of your doctors and your pharmacy in one place, preferably on an up-to-date list of all the medicines you take.

Next, open the discussion up to the group. Discussion prompts may include: 

  • Have you experienced a time when you were afraid to speak up about a medication problem? What happened as a result? 
  • Do you read the labels of all the medicines you take? Why do you think it might be beneficial that you do so? 
  • Have you ever forgotten some of the medications you take while at the doctor’s office or pharmacy? What kinds of problems has this caused or could this cause in the future?
  • What might happen if a child, pet, or visitor had access to your medications? 
  • Do you know who you would call in case of emergency? Is the number to the Missouri Poison Center easy to find in your home? What if there was an emergency and you were not able to communicate?

B. Scenarios and Discussion Questions30 minutes

For each scenario, read or paraphrase the text in bold.  Ensure that either the participants or you make the points in italics before moving on to the next scenario.

Read or paraphrase: “Judy and Ron have just celebrated their 40th wedding anniversary. Judy has high blood pressure, diabetes, and arthritis. Ron has had some blood clots and he has allergies. Like a lot of older adults and probably some of you, Ron and Judy each take a few different vitamins, over-the-counter medicines, and several prescription medicines.”

Scenario 1: Pill sorters and medicine mix-up – Covers core messages 4 (safe storage) and 5 (be prepared by knowing who to call)

Read or paraphrase:  “Ron and Judy both keep their medicines in pill sorter boxes. They keep the pill sorter boxes on the kitchen counter. Ron has poor eyesight. One morning, Ron accidentally takes the pills from Judy’s pill sorter box. He does not realize what he has done until Judy asks him what happened to her pills.  How do you keep your medicines organized?”

Discuss; ensure the following points are made:

  •       Pill sorters should be kept up and away and out of reach of kids.
  •       Make sure your pill sorter is different from everyone else’s in your house, or clearly marked as yours.
  •       If you keep your medicine in your purse, consider using a child-resistant pill box. Never store medicine in baggies because kids equate baggies with treats.

Read or paraphrase: “What would you do if you were Ron and Judy in this situation, and why?”

Discuss; ensure the following points are made:

  •       It can be harmful to take someone else’s prescription medicine because of potential interactions, allergies, and other potential adverse events.
  •       This is a great example of a reason to call the poison center; point out stickers and/or magnets that will be in participants’ goodie bags.
  •       If you put over-the-counter pills in a pill sorter or anything other than the original packaging, be sure to keep the original packaging so you can refer to the label and instructions. This will help if you need to call the poison center. 

Scenario 2: Child gets into your medicine – covers core messages 4 (safe storage) and 5 (be prepared by knowing who to call)

Read or paraphrase:  “Judy and Ron take care of their 3-year-old grandson, Oliver, in their home two or three times a week while their daughter works. One morning, Judy goes to the kitchen to make some coffee. When she comes back to the living room, she finds Oliver sitting on the couch with her open purse, holding some of her pills in his hand. Judy can’t tell for sure if he has swallowed any of the pills, but he is acting normally, so Judy isn’t sure if it’s an emergency or not.”

1 in 10 kids are living with a grandparent, and 13 percent of grandparents are relied on to be a trusted caregiver. Does anyone here either live with or take care of grandchildren sometimes?”

Read or paraphrase:  “A couple of years ago a study found that in over a third of cases where a child got into someone’s medicine and went to the emergency room, the medicine belonged to a grandparent. That’s one in three!  Why do you think it can be harmful for kids to take their grandparents’ medicines?”

Discuss; ensure that the following point is made:

  •       Medicine that is meant for adults can be very harmful when a child takes it because kids’ bodies process medicine differently than adults, plus they weigh a lot less. Children are not just small versions of adults when it comes to medicines!

Read or paraphrase:  “What would you do if one of your grandchildren or a child that comes to visit you got into your medicine?”

Discuss; ensure the following point is made:

  •       One can call the poison center in this scenario.

Read or paraphrase:  “What could Judy do differently to help prevent this from happening again?”

Discuss; ensure the following points are made:

  •       The best way to store medicine is up, away, out of sight of kids. If you must keep medicines in your purse, keep your medicine in child-resistant containers and keep your purse up, away, out of sight.
  •       Child-resistant packaging should not be used as a substitute for keeping medicines out of reach of kids. There is no such thing as “child-proof!”

Scenario 3: Forgot to tell doctor about a medicine; doctor prescribes a new medicine. – Covers core messages 1 (be an active participant), 2 (follow label and instructions), 3 (write down medicines), and 5 (be prepared by knowing who to call)

Read or paraphrase:  “Last month, Judy had appointments to see her regular family doctor who checks her blood pressure, another doctor for her diabetes, and a third doctor for her arthritis. Each doctor asked her to write down every medicine she was taking. Sound familiar? Judy did her best to remember all of her medicines at each visit, but it was difficult!  After Judy got home from one of her appointments, she realized that she forgot to write down one of her over-the-counter pain medicines that she takes to help relieve her arthritis pain. Now that she’s home, what should Judy do about that forgotten medicine?”

Discuss; ensure the following points are made:

  •       Judy should call the doctor’s office and tell them about the forgotten medicine. The doctor needs to know about all of your medicines so he or she can make sure you aren’t taking medicines that can be harmful when taken together, or that you’re not taking medicines that you shouldn’t be taking based on your other medicines, past and existing health conditions or your age.

Read or paraphrase:  “One of Judy’s doctors prescribed a new medicine for her, but she’s not sure what it’s for, so she decides not to take it. Do you agree with Judy’s decision to not take the new medicine?”

Discuss; ensure the following points are made:

  •       Judy should find out why she was prescribed the medicine or what it’s for by calling the doctor or pharmacy, and she should take the medicine as prescribed, provided the doctor who prescribed it knows about all of her other medicines, including that over-the-counter medicine she forgot to tell him about.
  •       Keep the Missouri Poison Center number and the numbers for all of your doctors and your pharmacy in one place, preferably on an up-to-date list of all of the medicines that you take, so you have the numbers ready to call if you have questions.

C. Handouts and Further Instructions 

At the end of the session, hand out Missouri Poison Center magnets, brochures, or printed materials. Encourage participants to update or start a medicine list to have available for doctor visits or emergencies.