Remember those youthful rites of passage: first day of school, first date, first time behind the wheel of a car, first kiss?

As I grow older, I realize we elders have our own rites of passage: first Social Security check, first Medicare card and, inevitably, our first pill dispenser box.

When my husband handed me that 7-inch-long blue box with its neat little compartments for each day of the week, it sure didn’t feel like a first kiss.

Great, I thought, one more sign I’m growing older – as if the wrinkles and gray hair weren’t enough.

Still, I’m wise enough to see the importance of having a structure for organizing the medicines we take daily.

For those who take pills at different times of the day, there are weekly pillboxes with daily compartments for morning, noon, evening and bedtime. Most physicians recommend this kind of box.

Furthermore, we should carry a record of the drugs we take with us every time we visit any doctor and have it easily accessible in our homes in the event of an emergency.

Last week, an elderly man on our block who lives alone was found screaming in pain by a neighbor who’d stopped to give him a piece of homemade pie. He has cancer. He said his pain medications were not working.

He asked for an ambulance.

When one arrived, he could not tell paramedics what medicine he was taking, nor exactly what had been prescribed by the various doctors he’d seen for treatment.

On his kitchen table were more than a dozen containers with pills. There were more in the bathroom. Not all appeared to be current prescriptions.

The paramedics had to gather all of them up and take them with him to the hospital for the emergency room staff to sort out.

Because he did not give paramedics the correct name of his oncologist nor tell them where he had been treated for his cancer, he was initially taken to the wrong hospital. Once stabilized, he was transferred to the hospital where his oncologist practiced and he’d previously been treated.

A simple list with his current physician’s names, the hospital where they practice and the medications they had prescribed for his current treatment would have saved significant time for medical workers, as well as the cost of a second ambulance trip.

That list is something each of us should have right now, before an emergency presents itself.

Beyond that, we need to be very careful about ensuring all the doctors we see know about all the drugs we take.

Patients over 65, who often have chronic conditions and see several doctors, had a drug error rate nearly seven times greater than those under 65, according to study by Medco Health Solutions, a company that manages prescription benefits.

The Medco analysis also found that seniors who got prescriptions from two or more doctors had up to 27 prescriptions a year and were at risk of an average of 10 errors. Those with five or more doctors got an average of 42 prescriptions annually and were at risk for 16 errors.

I call those numbers very scary, indeed.

Following on that study, when the American Geriatrics Society met in Seattle early in May for its annual scientific meeting, members heard the warning sounded again.

“A significant number of older adults who take multiple drugs may be taking potentially inappropriate medications and experiencing adverse drug reactions,” they were told.

Further boosting risks of such reactions, many older adults don’t use pillboxes or, if they do, they don’t use them correctly, researchers reported.

More than 76 percent of the seniors surveyed by researchers at Mount Allison University in New Brunswick said they didn’t refer to the written directions or medication labels to remind themselves of their medication regimens when filling their boxes, attendees at the geriatrics society sessions were told.

Even more said they never bothered to have someone else check their pillboxes to ensure they were filled correctly, the study said.

Medications require our full attention and absolute accuracy if they are to do their jobs for our health. Certainly we are old enough now to understand that responsibility.

Some of us still don’t, it appears.

“We certainly advocate that all patients carry this information (record of drugs) with them, but how many do this themselves … very few,” says Tony Roon, medical director of Healthcare Access for the Providence Everett Healthcare Clinic.

If they are unsure or unable to do this themselves, seniors should get their health-care providers or their pharmacies to help them compile an accurate list of their current medications, Roon says.

It’s a good idea review your medications – all of them, including over-the-counter stuff – when you visit your physician. Then carry this up-to-date information with your insurance and Medicare cards.

Not too far in the future, many medical facilities throughout the country will have a system of electronic medical records for patients. It will be available for patients to carry with them as well as accessible from remote sites, Roon says.

For now, however, knowing what pills we take, why we take them, when we take them and then using that information wisely is truly a matter of life or death.

Linda Bryant Smith writes about life as a senior citizen and the issues that concern, annoy and often irritate the heck out of her now that she lives in a world where nothing is ever truly fixed but her income. You can e-mail her at ljbryantsmith@ yahoo.com.