Here is a letter I recently got from a reader:

How to remind a child to take his medication?

Dear Dan,

My son has Type I diabetes. He is constantly forgetting to check his blood sugar level and inject insulin when he needs it, and I am forced to remind him every couple of hours. I hate to nag him, and know it doesn’t help him become more independent. On the other hand, if he keeps forgetting he could become severely ill. What should we do?

Tal

Dear Tal,

It is often hard to remember to take medication, especially when you hardly feel the severity of the illness or the relief of the medication. On the other hand, no one forgets to take heartburn medication – you’ll probably sprint for it as soon as heartburn begins to set in. With asthma and other inflictions that require more preventative measures, forgetting to take your medication will exacerbate symptoms and eventually lead to greater consequences. But until this critical point, there is no definitive moment where long-term preventative medication clearly needs to be taken. If you have an asthma attack, you can always pull out your inhaler. Similarly, diabetes does not cause chronic excruciating pain and won’t remind you to take your medication.

As for reminding your son, you might not have a choice. No one wants to monitor glucose levels all day, and he may need reminders to do so. But the reminders can and should come from his environment, as well as from habits you and your son can create together. Rather than reminding him every few hours yourself, create a mechanism that will remind him automatically.

Several doctors whom I’ve talked to told me that they recommend patients who need to take medications twice a day to put it next to their toothbrush. This way, this new habit is combined with the existing habit of brushing your teeth. But if you need to take your medication more than twice a day, the toothbrush will not be enough.

So the question is what regular activity can be tied to your son’s medications? Can you do something that is connected to his meals, or that is connected to other desires or hobbies? Can you set an electronic reminder in his cell phone? Once he has established a habit of checking his blood sugar, he may not even need these reminders anymore – but they can help build this habit until it takes on a life of its own.

It is also important that your son have a way to tell you that he has taken his medication without asking him. For example, you can make a board that he can mark when he checks his blood sugar and when he takes the insulin, or a designated can to put the used syringes. He could even upload this information to the internet – there is probably an app for that. If you are creative, you can find the right solution for you and your son with minimal effort.