When it comes to taking prescription medications, I am fortunate that I take only one medication and it’s a generic one.

I have taken this medication for years now. Each time I get a refill, I receive the same familiar yellow colored, flat oval tablet with tapered ends.

I don’t use a pill dispenser since I am only taking this one medication, once a day. I just combine the few supplements I take with my prescription medication in one bottle and each morning pop one of each into my mouth during my morning routine.

So, when I visited my mother recently, I was left speechless by the navigating she had to do in her medication journey.

My mother showed me a huge supply of pills that her online pharmacy has sent her, as well as some she received from her local CVS.

In some instances, the online pharmacy sent her a six-month (or more) supply of a medication, packaged in bottles with 30 pills each. Some of her medications (she takes seven) were sent in multiple bottles, each bearing a different expiration date.

My sister and I helped to place the bottles in order of the most recent expiration date to the one furthest away. They are lined up now in a separate box, so my mom can take out a new pill bottle in the order they were received.

We then noticed that she had received medication where the newer pills looked nothing like the pills she had been taking. As we Googled the image of a particular generic medication she takes, we found that different manufacturers have different pill shapes and sizes for the exact same generic drug.

Once a branded medication becomes generic, different companies will make their own versions. Each manufacturer will choose its own size, shape, and color for the pill.

How confusing for a senior. With each new delivery, the look of the pill they take may change. I can’t imagine how confusing it would be to fill a pill dispenser with a large white tablet for one month and a large blue and white capsule the next month for the same medication.

My mother has recently been prescribed Metformin.

The initial pills she received were small, white, and round. The next prescription’s pills were a large white and oblong pill, which, unfortunately, looks exactly like the generic Cardizem (Diltiazem CD) she takes. Both those medications need to be taken in the morning, but at different times.

To help my mother distinguish between the two, we took a food safe marker and marked the generic Diltiazem with a capital D on each pill.  That way she can tell the difference between Metformin and Diltiazem when she takes them from her pill dispenser. We suggested she ask her pharmacist for the small, white, round pills for her next refill.

Today, generic drugs make up about 90% of dispensed prescriptions in the United States.

According to researchers from Brigham and Women’s Hospital and Harvard Medical School, if someone is taking a lot of medications, there is a higher probability of mixing up the tablets, as generic medicines do not have a “brand” or distinct look. And because the appearance of pills changes, the odds of patients stopping or delaying essential drugs are increased.

In a recent study of 1,000 pharmacists, over 70% reported changes in pill appearance occurring frequently in their pharmacies, with almost half reporting that changes occurred six or more times per month.

Most pharmacists reported notifying patients about the changes verbally, 88%, or via sticker, 77%. However, in my mother’s case, her online pharmacy provided no notification.

Almost 90% of older adults regularly take at least 1 prescription drug, almost 80% regularly take at least 2 prescription drugs, and 36% regularly take at least 5 different prescription drugs. Lots of medications, with varying sizes, colors, and shapes, are bound to create confusion.

One solution to consider, pill packs, sometimes called blister packs, which encase your medications in bubbles on a card. Each bubble contains a dose of one or more medications and is marked with the time it should be taken.

The Food and Drug Administration should be looking into the difficulty in differentiating between the various medicines we consume. At least I hope so.

In the meantime, please be diligent with your, and your loved one’s medications.