Taking prescribed medication...what could be easier? I mean the directions are all spelled out there right on the bottle. I just have to take three of these pills, along with two of these, and one of those in the morning. Then at noon I take three more of these capsules, but wait... Did I take them this morning? I don't know...I better take five to be safe, that'll be a dose and a half. What about the little blue ones? Beats me... Did I take any of my medications this morning...What about last night? I just can't remember...

Sound familiar? Well, then you're not alone. Maintaining a regular medication schedule for the cognitively impaired requires a lot more thought and planning then would be immediately obvious. I originally believed that I would have no problems remembering the "what's and when's"of my own medication schedule. Instead I found myself consistently confused about how much medication I had actually taken, or whether I'd missed my last dose. Many times I'd remember only after I started to feel my head pounding again. If I was distracted between the time that I intended to take my medications, and when I actually picked up the prescription bottle, I couldn't remember if I'd already taken the drugs or whether I was just planning to.

Thankfully things are improving for me, but I still can't discard the tools and processes that I employ to ensure that I receive only the amount of drugs that are prescribed, no more, and no less.

Many drug stores sell weekly pillboxes. I found one in particular that has all seven days of the week. Each day is removable and has a compartment for morning, noon, evening, and bedtime. If left in an obvious location, say the living room or the kitchen; it's a constant visual reminder that I'm on a medication schedule. It also helps me keep track of what drugs I've already taken, since there's an empty compartment for whatever date & time that I took my last dosage.

I'm also able to take along just one day's medications when I head out to work. I try to keep the pill box in the top pocket of my shirt, since it's the most obvious location, or in the same pocket with my car keys so that I'll feel it every time I reach for the keys.

I change the location of my medications from time-to-time. I've found that if they're in the same place for too long, they become a fixture, and blend in with the rest of the room. Just like a new piece of furniture will stand out in a room until you become accustomed to it.

It's also helpful to set alarms for myself. This can be done with something as simple as a wristwatch, or as sophisticated as one of the many personal digital assistants (PDA) on the market today. There are a host of these electronic aids that can assist in numerous ways to compensate for short-term memory deficiencies. It seems as though each new day brings further advancement to these PDAs, reducing their cost, and simplifying their operation.I'm able to setup my medication schedule on my computer, set alarms for the events, and then upload that schedule into my Palm Pilot. Using a case with a belt clip, I'm able to carry the PDA with me, and take my medication when the alarm sounds. But I have to stop whatever I'm doing and take my prescriptions immediately, or there's a very good chance that I'll forget.

I thought that this transition would be a relatively easy one for me, as I already use Microsoft Outlook to organize my work schedule and a Palm Pilot (PDA) to bring that schedule along with me. But It's difficult to have to work so hard to organize and focus my attention at my job, let alone need a similar effort at home. I've found that by the time I finished up at work, that's about all the planning and compensating I want to do for the day. Sometimes it's a real struggle staying motivated to use these methods.

These tools are worthless if I fail to use them correctly. It's very easy to keep falling back to the same old habits that I acquired before my traumatic brain injury. The real discipline is not in recognizing the manners in which I can compensate, but is actually in implementing and following through with them.

And no system is perfect. As I sit here typing away, I just realized that not only did I forget to take my morning medication, but my pillbox is sitting on the end table in my living room, twenty-five miles away. But a least that's the exception now, rather than the rule.

Revised: Saturday, February 23, 2002 08:42 AM