One of the biggest dangers facing our elderly today may be right there in their own homes. No, I'm not talking about Lawrence Welk reruns. I'm talking about their medicine cabinets.

Many elderly suffer ill effects, are hospitalized, or even die due to medication errors. No, not the ones committed by doctors and hospitals that 60 Minutes likes to rant on about. I'm talking about the patients' (or in-home caregivers') own errors. It is very easy for an elderly person to get confused and skip a medication or double it or otherwise handle it incorrectly. Let me explain how this can happen.

A medication Uncle Frank takes regularly becomes available in generic form. The pharmacist, in response to a request from Uncle Frank's insurance company, dutifully fills the generic. Uncle Frank becomes confused at the different name and appearance, thinks it is a totally new medication his doctor has ordered, and since he still had some of the old pills from last winter when he was hospitalized and did not take his home meds for awhile, continues to take the old meds and the new meds as well, essentially double-dosing himself.

Or try this one: Aunt Sally sees her family doctor, who noticing her blood pressure is up, starts a new medication to help control it. Aunt Sally forgets to mention that her cardiologist had added some pills at her last visit there, two months ago. In fact, Aunt Sally forgets to mention that her daughter had her see a cardiologist at all. As it turns out, the medications both physicians had added were identical, but neither physician knew.

Many elderly people are on multiple medications for very necessary reasons. Although doctors should and usually do make every effort to minimize the number of pills one person takes, sometimes managing multiple chronic health problems requires multiple different medications. The regimens can be complex enough to confuse anyone, let alone someone with failing eyesight and memory.

My own mother moved in with us a few months ago. She is a retired registered nurse, and with that level of training, I had little patience with her inability to keep up with her medications and at times her failure to take them correctly. Two weeks of trying to manage her medications for her had me apologizing profusely for my lack of empathy. She takes a total of 17 different pills that have are dosed at four different times of day. After the morning lot, she hardly has any room left in her stomach for breakfast!

It took some organizing and the purchase of a specialized divided pillbox, but we eventually worked out a good routine to make it easier for her. I suggest anyone watching out for an elderly relative take similar steps:

• Go through all the person's medication bottles, separating out any duplicate bottles or "old" doses. Often, the doctor might change the dosage, but our frugal elders, fearful of waste, hang on to the old bottles, which can add to confusion later.
  
  
• Get an updated list of medications from ALL of the person's doctors, to make sure they reconcile. An important medication might have been dropped by the patient or duplicated in some form by another physician. Create a "Master List" of meds to help with sorting pills each week and to also carry to doctor's appointments or the hospital in the event of an emergency.
  
  
• Obtain a pill box segregated by days of the week. Someone on many meds might need a box that also allows for a.m., noon, p.m., and bedtime dosing. Oversee filling of the box once weekly. Look in all the compartments to make sure the previous week's meds were taken as instructed.
  
  
• Check the "over the counter" med box as well. Throw out any expired medications, especially those containing expired acetaminophen (for example, Tylenol) as those can be hazardous to the liver.

Now that we have a good system, I can sort and prepare my mother's medications for the week in about ten minutes. It's not a large burden to me, and it has improved my mother's health as well as her peace of mind. I hope it can do the same for your loved one.

We are in the middle of hurricane season. Often the victims of an evacuation fiasco are unprepared older adults. In the previous two issues of Elder Law Update I stressed the need to work with your older loved ones to draft a written evacuation plan, and I discussed a number of critical areas. In this last installment, I'll address one last usually overlooked (but very important) issue, and give you a few summary pointers.

Pet Needs

Don't laugh! We all know how elders feel about leaving pets behind. A cherished pet It is imperative to have proof of the pet's rabies shot. Other pet health records are important too. Is there a pet carrier for the pet? A carrier is required in order to transport a pet on public transportation and to enter a shelter. Is a supply of pet food listed in the evacuation plan? Talk with your vet about your pet's evacuation needs.

And Finally . . .

Share your evacuation plan with all who need to know it. If your loved one lives in a senior living facility, be sure to provide the administrator in charge with a copy. Make an appointment with the administrator to discuss the plan. Senior living facilities have their own evacuation plan and it may not be consistent with your wishes or with the needs of your loved one.

If your loved one lives alone, and at a distance, communicate with local emergency management authorities about the best approach. Many communities maintain a list of older adults who will need help evacuating. Contact James Drinnon at Chatham Emergency Management Agency (CEMA) at (912) 201-4500 for information on assisting older adults with evacuation. CEMA's web site is full of up to date preparedness info. Check it out by clicking HERE.

We've skimmed the surface of a vast topic. For further help with planning, call you local chapter of the American Red Cross with your planning questions and for two excellent publications:  #A4499 and #A4497. Publication A4497 deals with planning for people with disabilities and other special needs. YOU MAY REACH THE SAVANNAH CHAPTER OF THE AMERICAN RED CROSS BY CALLING 912-651-5371 or stop by  906 Drayton, Savannah, GA 31412. Both CEMA and the Savannah Chapter of the American Red Cross offer speakers on all emergency preparedness topics.