by Eileen Rivera Ley
If you are new to blindness, you may feel nervous about how you will manage
your medicines on your own. Fear not! There are methods you can use to make
sure you know just which ones are which. You may be surprised to learn that
many blind people identify pills by their shape, size, texture, smell, and
even the rattle they make. Nevertheless, as more prescriptions are added and
generics prescribed, distinguishing pills using these conventional non-visual
techniques may become more difficult. Thankfully, imagination and ingenuity
are limitless, and blind people continue to find ways to manage their medications
safely and independently through a variety of low vision, no vision, low-tech
and high-tech options. The key is to develop your own
system, then stick to it.
You can Manage on Your Own—With a System
NFB Chapter President Peggy Cowgill, who has been legally blind all her life, is an independent living specialist for the Disability Resource Center in Alamogordo, NM and works with people to make sure they can manage medications whether or not they can see them. Peggy suggests marking the lids of each prescription and over-the-counter medication, and stresses the importance of creating symbols which can be read right side up or upside-down. She recommends using Liquid Tactile Markers available through the NFB Independence Market, (410) 659-9314 ($4 plus shipping and handling—Product Code AIL40M). This product is similar to, but more durable than, a puffy fabric marker (Note: Dries in 24 hours).
Peggy uses the following system: For Tylenol (acetaminophen) she makes a big X on the cap (she stores aspirin in a different room to prevent mix-ups). She uses a single dot for medicines she takes once per day, a dot and line for medicines she takes both in the morning and at night, and a single line for nighttime-only medication.
For easy scanning, Peggy recommends keeping medicine bottles in a flat bottomed basket, the type you find at the dollar store, so that the marked caps can be face up at all times. Ziplocs also work well, especially when traveling.
Creating your System
When creating a system for marking the medicine, you should have symbols for the dose and time to be taken. For example you might use dots to indicate the dose and dashes to represent the time of day. More elaborate systems may indicate the name of the medicine and the name of the person taking the medicine. Make a system which works whether or not you are wearing your glasses or contacts and whether or not you are having a good eye day.
Many blind people use rubber bands to mark their medications. Use high quality rubber bands or ponytail holders for this, as a broken or accidentally moved band will cause system failure! Perhaps placing some clear packing tape over the rubber bands will add to the stability and protect the bands from breaking.
Be creative! Glue different-shaped buttons to the container or string beads onto elastic and put them around the bottle neck. Buttons might indicate the number of pills and rubber bands in different places on the bottle can identify when or how many times per day you should take the medicine. For example, if you need to take the pill once in the morning and once at night you can wrap two rubber bands around the bottle, one securely along the top of the bottle and the other near the base. If you need to take two pills each time, you can glue two buttons onto the cap of the bottle that has the rubber bands. Rubber bands also work well on insulin bottles. If you have two kinds of insulin, you can place a rubber band around one to distinguish it from the other.
Managing Meds for More than One Person
In my home we have four people, and each takes a number of medicines. In addition to marking the medicines, I store them in different rooms as a secondary precaution. I also use different sized bottles for each of the people in my family. If a refill comes in a different style bottle and threatens to disturb my system I simply transfer the pills and discard the new bottle. I also mark the initials of the user on the label.
Sharpie brand markers are a great help if you have stable, usable vision. Since I have some limited vision, I use these permanent, waterproof markers to mark both the bottoms and tops of our white medication bottles with the first initial of the medicine. At first, I only marked the cap, but then discovered that some caps are interchangeable, even on different sized bottles. So as a back up, I began marking the bottom of the bottles as well. I would then put the initials of the person taking the medicine in jumbo print on the label. I write the first initial of the medication on the bottom of the bottle. If the plastic was a dark color, I simply added a piece of duct tape and wrote over that. On the side of the label, I use the marker to denote the dose, quantity over frequency, for example #2/3x or #1/1x. You can use the tactile marker for the same system if you can’t see.
Whether you are just very busy or just plain forgetful, you may need a way of making sure you take your medicines. Some people I know keep a log or mark the calendar. Others find the classic 7-day pill sorter box keeps them on track. One Voice reader reports that she flips her bottles over after taking her morning medicines then realigns them after taking her evening dose.
Braille readers use a sticky clear tape called Dymotape (also available at the NFB Independence Market) to create custom Braille labels. You need not be fluent in Braille to use these labels. In fact, marking your meds with a few Braille numbers and letters may be an ideal way to integrate it into your daily life. Just this year, our mail order pharmacy, MedcoByMail, began shipping our meds with Braille labels so my husband could identify his countless post-transplant medicines on his own. Check with your pharmacy to see if they can do this for you.
Talking Rx Readers
Joyce Kane, Diabetes Action Network Board Member and local NFB chapter president, was a beta tester for a talking prescription reader developed by a pharmacist in Connecticut. The Talking Prescription Readers, manufactured by the Millennium Compliance Corporation, cost $15 each and are available through the NFB Independence Market (#AIM27T). These reusable readers attach to the bottom of most standard sized pill bottles. The device allows you or a pharmacist to record up to a minute of detailed instructions and precautions on its digital recording chip (in any language). Joyce has been very happy with this method and told me “once I started using the readers, all of a sudden I had my independence back. I could manage my meds on my own.”
To Sort or Not to Sort
Many people, even those with perfect vision, use medication dispensers with daily compartments. Some pill boxes come divided for mornings, noon, evenings and night, and pre-sorting medicines into these boxes can save time and can also help those with limited dexterity. And if you take lots of medicines, the sorter will save you the time of opening and closing countless bottles.
With a few adaptations, you need not be at the mercy of sighted help to fill your pill sorters. You can fill them yourself. Some people use two different sorters, one for morning and one for evening. Find a creative way to distinguish one from the other. To enhance your flexibility, splurge for a few extra sorters and organize your entire month of medicines at once.
Keep Information Handy for Sighted Helpers
If your markings make reading the original labels difficult, keep notes or a chart of your medicines on a pad for doctor visits and emergencies. If you use a computer, create a spreadsheet with the pertinent data. Note cards work particularly well since they are easy to carry and update as needed.
A Final Note on Safety
Donna Goodman, a blind pharmacist, uses Ziploc plastic bags to separate her once-a-day and twice-a-day medicines. She urges fellow low-vision and blind diabetics to be proactive about medicines because anyone can make a mistake, and mistakes can be dangerous. When the doctor writes you a new prescription, insist that he or she read it aloud and ask if there are special instructions for taking the medication. When you get your medicine from the pharmacy or mail order company, have someone read you the labels to verify that you got the proper medicine in the proper dose. If, upon inspection, you notice that your pills look or feel like a different shape or size, don’t be shy. Pick up the phone and ask. By doing so you may avert a medication error and even save your life.