A walk, two pill boxes and a thought
Fifteen medicines, six conditions, four specialists. Sorting my father’s pill box one Saturday morning, a question surfaced that I have not been able to put down: who is looking at the whole picture?
5 AM. Wake up.
Then my favourite hour of the day, a walk in the park.
No music. No phone. No distractions.
Just me, the breeze, the trees, the birds and a little quiet time with myself.
Once I got back and started on my weekend tasks, the first one on my list was to organise my parents’ pill boxes.
I started with Dad.
It took me about 10 minutes just to find the latest prescriptions from 11 similar-looking hospital folders, plus a few documents buried in my WhatsApp threads.
Then I sat down with the medicines, the pill organiser and the latest prescription.
And I remembered something Dad had asked me a few days ago:
“Why am I taking so many medicines? Who decided that I need so many?”
At the time, I gave him the obvious answer.
He has Parkinson’s, diabetes, a cardiac condition, a previous stroke and a few other issues. Different medicines are prescribed for different conditions.
But sitting there with 15 medicines prescribed by four different specialists, another question came to mind.
Who is looking at the whole picture? And how often?
Not necessarily whether any one doctor had prescribed the wrong medicine.
But whether someone was looking at all 15 medicines together.
That question stayed with me.
Over the years, I have gone through different stages of caring for my parents.
Support and guidance, stepping in when needed.
Adaptation and safeguarding, making the home safer, arranging assistance, getting grab bars, pill organisers and other support in place.
Comfort and presence, making things as peaceful and comfortable as possible.
And somewhere through this journey, I realised how much difference there could have been if there was simply a frictionless way to maintain one source of truth for their current medication.
Something that could be updated whenever a doctor added, changed or stopped a medicine.
Something everyone involved in their care could rely on.
One current list. One clear picture. No guesswork.
Because this is where things can get complicated.
One doctor sees one part of the picture.
Another sees something else.
A medicine gets added.
Another gets changed.
Something that was supposed to be stopped continues.
And the person at home, often the family caregiver is left trying to connect the dots.
So, what does this actually look like in everyday life?
It could be as simple as:
- A medicine Dad was taking is missing from the new list.
- The dose is different from what he was actually taking.
- A medicine is being taken more or less often than it should be.
- Two medicines are essentially duplicates or even interacting.
- A medicine that was supposed to be stopped is still on the list.
- Or a medicine that should continue has somehow disappeared.
On paper, these may look like small differences.
For an 84-year-old taking 15 medicines, they aren’t necessarily small.
I have seen this personally.
A few months ago, after my mother was discharged from a leading private hospital, I noticed that one of her important medicines, a blood thinner was missing from the discharge summary.
I raised it with the doctor a few days later.
It was corrected.
But it left me with one uncomfortable thought:
What if I hadn’t noticed?
That, to me, is the real issue.
Medication reconciliation isn’t about creating another medication list.
It is about making sure the medication list reflects reality.
And this is not necessarily something an individual specialist can own. Each doctor sees a part of the patient’s medical picture. Bringing those different pieces together requires someone or something to look at the whole picture.
Well, there is certainly some good news, hospitals are putting processes in place to improve medication safety. Clinical pharmacists and pharmacy teams are increasingly involved in reviewing medicines, checking for interactions, identifying duplicates or omissions, and making sure medication lists are accurate when patients are admitted or discharged. NABH’s patient-safety initiatives also recognise the role of clinical-pharmacy verification.
That’s a welcome change and I really hope this is implemented and governed across the spectrum. The change is taking effect slowly at an institutional level.
But then the patient comes home.
So how do we manage this at home?
What happens when an elderly parent is seeing multiple specialists, getting prescriptions from different hospitals, and having medicines added, changed or stopped over time?
Who keeps track of the complete picture?
Who makes sure the latest prescription from one doctor doesn’t conflict with what another doctor prescribed three months ago?
And when a medicine changes, who makes sure the old one is actually removed from the pill box?
For families managing an elderly parent, medication reconciliation cannot stop at the hospital discharge counter.
It has to continue at home.
Which brings me back to my Saturday morning.
Dad’s pill box was finally organised.
Now it was time to do Mum’s.
One current list. One clear picture.
CareIntell™ keeps one organised medical history your family, doctors and caregivers can all rely on.
Deepak Kumar
Founder, CareIntell™
Lives with and cares for both his parents, in their eighties, both with Parkinson’s. Spent nearly a decade coordinating their care from another country before moving home. Writes about what that work actually involves.