The short answer
- Never assume an over-the-counter medicine is safe to addParacetamol, ibuprofen and herbal remedies can all interact with a prescribed drug. Check with the GP or pharmacist first, even for something bought without a prescription.
- Six checks catch most mistakesPerson, medicine, dose, route, time, and the right to decline. Running through them before every dose is what carers and nurses are trained to do.
- A dosette box solves the most common problemMissed, doubled and muddled doses are usually a sorting problem rather than a memory problem, and a weekly box from the pharmacy fixes most of it.
- Refusing medicine is different from forgetting itAn adult who understands the consequences can refuse their medicine, and hiding it in food without the proper process can be classed as abuse.
Carers on PrimeCarers charge £18 to £25 an hour with our fee included, and what a carer will help with around medication is something you agree directly with the carer you choose.
The basics
The six checks worth making before every dose
Most medication mistakes are not about the wrong drug altogether. They are a mix-up against one of a handful of details, and a short routine of checks, the same one carers and nurses are trained to use, catches nearly all of it.
Right person
Check the medicine is your relative's own, especially if you look after more than one person or the box has been left out on a shared table.
Right medicine
Read the name on the label against the prescription or the pharmacy print-out. Do not rely on the shape or colour of a tablet, since packaging changes between suppliers. Check it is in date and that the container or packaging has not been tampered with, and do not give anything past its expiry date or from a container that looks disturbed.
Right dose
Check the strength and the number of tablets match what was prescribed. A change of brand can mean the same drug comes in a different strength.
Right route
Confirm how it should be taken: swallowed whole, dissolved in water, or applied to the skin. Crushing a tablet or opening a capsule can change how it works.
Right time
Give it when it is due, with or without food if the label says so, and space doses out evenly rather than doubling up if one was missed.
Right to decline
An adult who understands the consequences can refuse their medicine. Note the refusal and tell the GP or pharmacist rather than deciding alone what to do about it.
Any medicine your relative takes regularly should have been prescribed or agreed by a GP, and that includes tablets bought over the counter. Paracetamol and ibuprofen both react with a range of prescribed drugs, and mixing the wrong two can be dangerous. The same is true of herbal and complementary remedies: St John's Wort, ginkgo and high-dose vitamins can all change how a prescribed medicine works, so mention anything your relative takes to the GP or pharmacist rather than assuming it is harmless because it did not need a prescription. Alcohol interacts with a wide range of common medicines too, sometimes even at ordinary drinking levels. Understanding drug interactions, from the NHS Specialist Pharmacy Service, sets out how these interactions happen and why a pharmacist needs the full list of what someone takes, not just what is on the latest prescription. Many tablets are also timed around meals, so if getting your relative to eat properly is already a struggle, that is one more reason to get mealtimes settled first.
This page is part of the wider elderly care guide, which covers activities, exercise, legal questions and more; here the focus stays on medicines.
Setting up the routine
Dosette box or original packaging: which suits your relative
There are two ways medicines are usually organised at home, and most households end up using a mix of both.
A dosette box
Best for regular, everyday tablets
Original packaging
Best for as-needed or specially stored medicines
Ask your relative's community pharmacist whether a dosette box would suit them, rather than buying one and hoping. Who qualifies for a dosette box? covers how that assessment works, and what is a dosette box? has more on how they are filled and collected. Some pharmacies still use flat blister packs rather than the tray style pictured above; are blister packs being phased out? looks at why that is changing in some areas.
Keeping track
Stock, the MAR sheet and reminders that work
Once the routine is set up, the job becomes keeping it running: enough medicine in the house, a true record of what has been taken, and a way to prompt your relative that does not turn into nagging.
- 1
Order the next prescription early
About 5 working days before you run outRepeat prescriptions can be ordered through the NHS App, the GP surgery, or a pharmacy with repeat dispensing set up. The NHS advises ordering roughly five working days before the medicine is needed, so a delay at the surgery or pharmacy does not turn into a missed dose. - 2
Keep a MAR sheet
Medicine Administration RecordA MAR sheet records what was taken, by whom, and when, with space to note if a dose was refused or missed. If your relative ever needs an ambulance, paramedics can see straight away what is already in their system rather than relying on you to remember under pressure. - 3
Set reminders that do not rely on memory
Yours or theirsA phone call at the right time, an alarm on a smart speaker such as an Amazon Echo, or simply leaving the dosette box somewhere visible all work better than hoping the routine is remembered. Using Alexa to make life easier has more on setting a reminder like this up. - 4
Check the box or packet weekly
Not just when something looks wrongA quick weekly count against the MAR sheet catches a problem while it is small, rather than a fortnight later when several doses are unaccounted for.
A pharmacy can usually supply a MAR sheet template, or you can set up something similar yourself: a grid with the medicine, the dose, the time it is due, and a box to tick or initial once it has been given. Using Alexa to make everyone's life easier goes into more detail on setting a voice reminder up if your relative lives alone for parts of the day.
If they refuse
What to do if your relative won't take their medication
An adult with the capacity to understand the consequences has the right to refuse a medicine, and there is nothing you can do to force it. What is worth trying is understanding why, and knowing where the line sits if it becomes a question of their safety rather than yours.
What tends to help
- Involve them in decisions at the GP appointment, rather than deciding for them
- Explain plainly what the medicine is for and what is likely to happen if they stop taking it
- Try again later if they refuse in the moment, rather than pushing
- Ask the GP or pharmacist whether a different form, such as a liquid, would be easier to take
What to avoid
- Crush a tablet or open a capsule into food without checking with a pharmacist first, since it can change how the drug works or make it unsafe
- Hide medicine in food or drink without the capacity assessment described below
- Argue about it in the moment; it rarely changes their mind
- Assume refusal is stubbornness rather than a side effect, discomfort, or difficulty swallowing
If your relative regularly refuses a medicine a GP considers essential to their health, and there is a genuine question over whether they still understand the consequences of refusing it, the guidance on covert administration, giving medicine disguised in food or drink without their knowledge, is stricter than "do it if they can't swallow" suggests. It can only happen after a formal assessment finds the person lacks the mental capacity to make that specific decision, under the Mental Capacity Act 2005, and after every other option has been tried and ruled out. The decision has to be made in the person's best interests with the GP or pharmacist involved, written into a care plan, and reviewed regularly, not decided alone at the kitchen table. The CQC's guidance on covert administration of medicines sets out what is expected before it happens. Dysphagia, difficulty swallowing, is one of the reasons a GP might change the form of a medicine rather than have it hidden, so raise it directly rather than assuming crushing tablets into food is the answer.
Getting help
What a private carer can do to help with medication
Family are not the only ones who can help keep a routine running. A carer's visit can be built around medication times, and it is worth being clear from the first conversation about what you want help with.
Prompting and reminding
The most common kind of help
Helping with the medicine itself
Agree it directly with the carer
Watching for problems
An extra pair of eyes
What stays with the GP or pharmacist
Carers are checked, not clinically trained
If your relative has just come out of hospital with a new set of medicines to manage, hourly care after a hospital stay covers the short-term support that often follows a discharge. Search hourly carers near you is free, with no obligation to book.
Questions
Questions families ask about medication
Yes. There is no legal barrier to a family member helping with medicines at home, and most families do exactly that. What matters is following the same checks a professional would: the right person, medicine, dose, route and time, and keeping a record of what has been given. If your relative's needs are becoming more complex, for example several medicines with different timings, ask the GP or a district nurse for advice rather than working it out alone.
A MAR sheet, or Medicine Administration Record, is a simple log of what was taken, by whom, and when. Care services are required to keep one, and it is worth using at home too, particularly if more than one person helps with medicines or your relative sometimes forgets whether they have already taken a dose. It also gives paramedics an accurate picture if there is ever an emergency.
Not without checking first. Crushing a tablet or opening a capsule can change how quickly a drug is absorbed, destroy a coating that protects the stomach, or make a slow-release medicine act all at once, and some formulations should never be crushed at all. Ask the pharmacist before changing how any medicine is taken. If the concern is disguising medicine from someone who is refusing it, that is a different question governed by the Mental Capacity Act rather than a decision to make alone.
Ask their community pharmacist, who decides whether a dosette box would help rather than the GP. Who qualifies for a dosette box? covers how that assessment works and what happens once a pharmacy agrees to fill one.
An adult who understands the consequences of refusing has the right to say no, and there is nothing you can do to force it. Note the refusal, try again later rather than in the moment, and tell the GP or pharmacist if it keeps happening, since a different form of the medicine or a change to the routine sometimes solves it.
Most carers are comfortable prompting and reminding, and some are happy to open a dosette box or hand over tablets, but this is agreed directly between you and the carer rather than set by PrimeCarers, which is an introductory service and does not employ or manage carers. What carers can help with covers this in more depth.
Call 999, or go to A&E, if your relative may have taken too much of a medicine, has collapsed, or is having severe difficulty breathing. Call NHS 111 for anything urgent but not life-threatening, such as a missed dose you are unsure how to handle. NHS guidance on poisoning sets out what counts as an emergency.