Why Pharmacists Should Be Every Caregiver’s Go-To Ally

From there, the pharmacist can fill in the gaps: when the medicine should start working, what side effects to look out for and how to know when it is working.​Caregivers should also press further, asking about:

• ​Timing (morning versus evening dosing)​
• Food interactions and can or should it be taken with food​
• Compatibility with other medications​
• Possible side effects​
• What to do if a dose is missed or symptoms don’t improve​

“People who leave the doctor’s office are overwhelmed and may not remember every detail,” Krinsky says. “We should be reinforcing that with information and providing details to ensure safe use.”​

Krinsky also emphasizes a technique called “teach-back,” where individuals or caregivers repeat instructions in their own words. “It’s the best way to make sure the information actually sticks.”​

Navigating specialty medications

​For caregivers managing complex, chronic illnesses, the pharmacy counter is only part of the story. Increasingly, the most critical medications are handled through a different channel altogether: specialty pharmacy.​

“Specialty therapies are typically for chronic, very complex and often rare conditions,” says Lucille Accetta, chief pharmacy officer at CVS Health, which runs one of the country’s largest specialty pharmacy operations. “They involve medications that require special handling, careful monitoring and a much more hands-on level of support.”​

Though they represent just 4 to 6 percent of all prescriptions in the U.S. (roughly 250 million to 350 million annual claims), specialty drugs account for a disproportionate share of overall drug spending, reflecting both their complexity and higher cost. ​

These medications are different by design. Many are biologics or advanced therapies that require careful handling, including injectables, infusions or drugs that must be refrigerated and delivered under tightly controlled conditions. Newer treatments for Alzheimer’s disease, Parkinson’s disease and certain cancers, for example, may involve infusion-based therapies administered in clinical settings, often with ongoing monitoring for side effects.​

Natalie Elliott Handy credits CVS with being a lifeline in caring for her mom, who has Parkinson’s and lives in an assisted living facility in Tennessee. When a Medicare claim was mistakenly denied because her mom was flagged as deceased, CVS quickly identified the problem, helped resolve it and ensured her mom’s medications continued without interruption. From overnight shipping of temperature-sensitive Parkinson’s medications to constant updates by text and email, Handy describes their support as a “concierge service.”

“Specialty pharmacists operate within a coordinated, high-touch model that has extended far beyond dispensing in our case,” says Handy, CEO of CareForward, a technology platform that matches people to volunteers offering time, talent or resources.

Request a medication review

Many caregivers do not fully realize that pharmacists are available to provide formal medication reviews. Medication therapy management (MTM), a range of patient-focused services, includes comprehensive medication reviews (CMR), in which pharmacists check all prescriptions for effectiveness, drug interactions and gaps in care.

“These reviews can take 30 minutes to an hour,” says Schreiner, president of the Pharmacy Society of Wisconsin. “We’re looking at the full picture: what’s working, what’s not and what might be missing.”​

These sessions are often covered by insurance, including Medicare with preapproval, or cost $100 to $150 out of pocket. But there’s a catch: Caregivers often hit a legal roadblock. To speak directly with a pharmacist about a loved one’s medications, they usually must provide documentation, such as Health Insurance Portability and Accountability Act (HIPAA) authorization, medical power of attorney or court-appointed guardianship, before gaining access to critical, potentially lifesaving information.

“Some pharmacies will accept verbal approvals from the patient so the caregiver can ask questions and get the full picture,” says Schreiner.​

Daryl Nauman organizes his wife's medications in his home office in Lancaster County, Pennsylvania.

Courtesy Daryl Nauman

Caregivers as medication advocates

In long-term care settings, caregiver advocacy becomes especially important. Most nursing homes do not employ full-time, in-house pharmacists. Instead, medication management is typically provided through long-term care pharmacies and consultant pharmacists who serve multiple facilities. In this situation, pharmacists work largely behind the scenes with nursing staff, making communication and coordination essential.​

“Because caregivers are often the first to notice changes in their loved one’s condition, it’s important to raise concerns and request medication reviews to ensure treatments remain appropriate as conditions evolve and to help prevent problems before they escalate,” says Schreiner.​

Handy and her family have learned the hard way that caregivers can’t afford to be passive when it comes to medications. “We have to be advocates, coordinators and problem solvers because the system doesn’t always catch what’s falling through the cracks.”​

Daryl Nauman has learned that managing medications is as much about advocacy as organization. His wife’s prescriptions are spread across multiple pharmacies: a local chain, a cancer center pharmacy and a specialty pharmacy that dramatically reduced the cost of one drug from $600 a month to just $18. With multiple specialists involved, her hematologist stepped in to coordinate most of her medicines and provides input when they need more specialized medication advice.

Pharmacists could play a similar role, especially when caregivers actively engage them. “Pharmacists are the drug therapy experts,” Krinsky says. “We need to share that knowledge, but caregivers also need to ask for it.”​

Different pharmacies may not have a complete view of someone’s medication list, increasing the chance of duplication or dangerous interactions. For Daryl, that’s the next step. “I need to bring all of her medications under one umbrella so I can build a better relationship with a pharmacy team,” he admits. “It hasn’t happened yet, but it will.”​