Keeping a medication list and a shared dose log

Two records, two jobs

It helps to keep two separate records, because they answer different questions:

• The medication list says what your parent is supposed to take. It changes only when a doctor changes something.
• The dose log says what actually happened: which doses were given, which were skipped, by whom and when. It grows every day.

Mixing them up is where confusion starts. If someone crosses out a dose on the list because it was missed, the list now looks like the prescription changed. Keep the plan and the record apart.

What goes on the medication list

The FDA recommends that a medication list include every medicine, vitamin and supplement, with the name, the strength, what it’s taken for, and how much to take and when. It also suggests adding allergies and emergency contacts. The FDA’s guide to keeping a medication list is short and worth reading in full. For a list shared by a family, a few extra details help:

• Over-the-counter medicines and supplements, including things taken only now and then, like a sleep aid or pain reliever. The NIA advises telling doctors about all of them, even ones used infrequently.
• Who prescribed each one, and why. The NIA suggests noting the prescribing doctor and the reason for each prescription.
• What each pill looks like. The NIA recommends being able to tell medicines apart by size, shape, color or the number printed on them. That matters when the person giving them isn’t the person who usually does.
• Special instructions, such as “with food” or “not with grapefruit juice,” copied exactly from the label or the pharmacist.
• The pharmacy and its phone number.
• A “last updated” date, and who updated it.

If something is stopped, don’t delete it. Move it to a short “stopped” section with the date. When a doctor asks “has she ever taken…?”, you’ll have the answer.

What goes in the dose log

A dose log can be a sheet on the fridge or an app, as long as everyone uses the same one. Each entry needs:

• The medicine and the scheduled time (“Amlodipine, 8 AM”)
• What happened: given or skipped
• Who recorded it, and when
• A note when anything is unusual: refused, vomited, given late, or a new bottle that looks different

For “as needed” medicines, also record the time and the reason (“acetaminophen 2 PM, knee pain after walk”), so the next person knows when the last one was given. If you’re unsure how “as needed” or “four times a day” applies, ask the pharmacist. The NIA’s guide to taking medicines safely lists both as good questions for the pharmacy, along with what to do if a dose is forgotten.

Record a skipped dose as skipped instead of leaving it blank. A blank could mean “skipped,” “forgot to write it down” or “not yet,” and the next person can’t tell which.

A handover example

The log really proves its worth at handovers, when care passes from one person to the next. Here’s what a weekend handover might look like.

Notice what makes this useful: exact times and names, a reason for the skipped dose, a question passed to the right person, and the supply warning. For everything else that belongs in a handover, see the caregiver handover checklist.

Keeping both records current

A list that’s six months out of date is worse than none, because people trust it. The FDA advises reviewing and updating the list often, especially whenever something changes: a new prescription, a different dose, or a medicine stopped.

• Update it the same day. Whoever comes back from the appointment or the pharmacy updates the list before doing anything else.
• Bring it to every appointment. The NIA suggests telling each provider about every medicine and asking whether all of them are still needed.
• Use one pharmacy if you can. The NIA notes that filling prescriptions in one place keeps the records together, which helps the pharmacist spot problems. If that’s not possible, share the list at each pharmacy.
• Keep copies where they’re needed. The FDA recommends sharing the list with a trusted relative or caregiver, especially anyone who goes to appointments or might speak for your parent in an emergency, and always keeping a copy with you.

Recordkeeping checklist