It seems like one of those unnecessary cruelties of age and infirmity that the more wobbly you get, the smaller the pills seem to get, and the more complicated the medication regime. It also goes without saying that, especially if you suffer from a chronic condition, the volume of medication also goes up exponentially, leaving you fumbling to handle all the pills and half-pills you are prescribed, while also scrabbling to remember which one and how much is taken when. Throw in a little dementia or Alzheimer’s - or, frankly, just a natural forgetfulness - combined with the dire consequences you are warned about getting the dosages and times wrong, and suddenly medication management becomes a full-blown hazard.

Even our usually-cheery and indefatigable Spring Chicken friend and mentor, Michael Wolff, admits to feeling frustrated by the Pill Protocol, in his brilliant article [link] ‘80 Not Out: Reflections of an Octogenarian Refusing to Play Ball’

I notice I seem to need more and more little pills. I have to struggle to remind myself to take them on time… But, and I find this perplexing and even scary, a few moments after taking them, I can’t remember whether I did or didn’t!

But help is at hand. Read on and discover the little tips that make pill-popping more palatable, the products that can help, and the news that the NHS can be asked to dose out your prescriptions in a new(ish) free service

A plethora of pills

If you factor in the pills for a chronic condition, the pills you may be on for an acute condition plus the vitamin supplements that your children insist you should take, that can add up to a lot of pills, all with different dosages and strictures.

So your first step is to ask your GP Surgery to offer you a free structured medication review with a pharmacist. The advantage of this is that having an overview of all the pills is at best a good way of checking that the medicines you are taking are right for you and that they don’t overlap: something that one doctor has prescribed and an over-the-counter medicine advised by another healthcare professional can very occasionally clash with each other.

Add everything to the review and the pharmacist will be able to flag up the potential issues at a glance - and you’ll have a record of your medication that you know to be right and accurate.

It’s all in the timing

Inevitably, medications have different timings about whether you take them in the morning, afternoon or evening, and some have strictures about taking them before, during or after food. Of course, this just makes it all more complicated - and more likely that you’re going to get things wrong.

Do you know what the key to comedy is? Timing. Do you know what the key to timing is? Comedy.

Don’t panic. There are products that can be set to beep when it’s the appointed hour for a pill - but the first thing to do is to sit down and take the old-fashioned simple approach: make a chart of your typical day and mark in which pills are taken when - perhaps colour coding the ones that need to be taken with food?

Help is at hand - some tips

• For complicated medication management, Dosette boxes are the answer to your prayers - plastic boxes with small compartments that clearly show which pills are to be taken and at which time of day. Or you can go the fancy bespoke way, with an electronic timed dispenser...
• It’s a bore having to organise these each week but the NHS now has a free service whereby - if you ask - the pharmacist can be persuaded to give you your prescriptions already arranged into Dosette boxes.
• There is also a bespoke service, Pilltime, that can do this from source: bagging up each daily dose into pouches within pouches and posting them out to you.
• At the very least, remember you can ask for your prescriptions to be sent directly to your pharmacy, some of which also offer home delivery services for people who can’t easily get out of the house
• As a rule of thumb, make sure all your medicines are kept in one place in the home, locked away or kept up high out of grandchildren’s or pets’ reach
• Each time you collect a new prescription, write on a calendar or put into your phone the date on which the next collection is due - and start it a couple of days early so that you don’t forget
• If you miss a dose, don’t double up at the next timeslot - twice isn’t nice in this respect, and is often even dangerous!
• Similarly, never take out of date medicines: at best, they are useless, at worst, the effect can be actually malign. If you’re worried about a build-up of old medicines at home, the pharmacist will always take them off your hands and dispose of them safely
• If you begin to dread taking so many pills, you can maybe grind them into a powder, washed down with water (check first to see if this affects the efficacy of the medication), or ask your GP or pharmacist if any of them can be supplied in a soluble or liquid or even patch form: not everything has to be swallowed in solid form
• For grinding down, or cutting a large pill into a half-dose, this nifty little device does both and stores the other half if required
• Sometimes even the popping of the pill out of the foil can be tricky if you have hand mobility issues, so why not try a pill popper?

For carers

The NHS has a great page with practical tips if you care for someone,  that covers most of these points from the perspective of the carer, who is often the person who ends up supervising and reminding the person in their care about their medication management.