Seniors and Medications: The Good, the Bad and the Dangerous
You've probably read news coverage of today's opioid epidemic. Federal data shows the problem is so serious that it has actually lowered the average life across the country.
Although the stereotype of a narcotics abuser is typically a younger person scoring drugs on a street corner, older adults are just as likely to improperly use codeine, oxycodone or hydrocodone. But most older adults begin with a legitimate prescription from their doctor (or, often, from a number of their doctors).
Only a few years ago, patients often would walk out of the doctor's office with a prescription for an opioid pain medication and the reassurance: "Don't worry about addiction; if you take these drugs for pain, you won't become addicted." But we now know that although most patients who take opioids do indeed take them only for a short time, an alarming minority of patients go on to misuse these drugs.
It is a balancing act.
Opioids aren't the only drugs that present health problems for seniors. Seniors take prescription medications to control a wide variety of health conditions and their symptoms. These drugs can lengthen and preserve the quality of lives. But changes in the way our body processes substances as we grow older might mean that some drugs we've taken for years are no longer safe.
Older adults are more likely to experience undesirable drug side effects, such as:
- Dizziness
- Depression
- Confusion
- Cone loss
Too Much or Too Little
A Caring Right at Home poll found that one-third of our respondents take five or more medications. This is about average for the total population of adults—and the number goes up as we grow older. This "polypharmacy" is a big part of the problem.
The more medicines we take, the harder it is to take them at the right time and in the right way. Should we take a medication in the morning? At night? With or without food? For how long? What side effects should we be aware of? When a new drug is added, is there a danger of a negative interaction with a drug we're already taking?
Medication Management for Patients with Multiple Health Conditions
In July 2016, the American Heart Association (AHA) warned heart failure patients that prescription drugs they were taking to manage other health conditions could worsen their heart condition, either by affecting the function of the heart, by making their heart failure medications less effective, or by interacting with their heart failure drugs in a dangerous way.
Prescription drugs weren't the only problem. The AHA noted that some nonprescription pain medications, such as ibuprofen, can cause dangerous fluid retention. Heartburn medications and cold remedies can be high in sodium. And many "natural remedies," among them St. John's wort, ginseng, hawthorn and green tea, are high in sodium or can interfere with heart failure medications.
So, How Can Patients Manage Prescriptions?
Keep a list of all your medications and doses to show at every medical visit, and inform a healthcare provider treating your heart failure before stopping or starting any medication. Ideally there should be a 'captain' who oversees your medications. This person might be a physician, advanced practice nurse, nurse or a pharmacist who is managing your heart failure.The first step is to have medications reviewed by their primary care physician and/or the pharmacist. Patients should ask their doctors about the medications they take. What is a medication for? Is it really needed?
- The first step is to have medications reviewed by their primary care physician and/or the pharmacist. Patients should ask their doctors about the medications they take. What is a medication for? Is it really needed?
- The second step is to get organized. Put a system in place for obtaining and taking medications. If possible, use a single pharmacy for all prescriptions. The pharmacy may be able to help simplify the management process.
- The third step may be to get help! The American Geriatrics Society recently reported that managing medications is especially challenging for seniors who are age 75 and older, who have memory problems, and who have problems performing the activities of daily living.
Help from home care
Medication assistance can be provided in a senior's home. This might include skilled nursing care to assist with administration and management of medications. Less costly nonmedical home care services also help clients overcome the top four obstacles to optimum medication management:
Home Caregivers Can Help
When clients can't drive, transportation may be the biggest obstacle. In-home caregivers can drive clients to the pharmacy or pick up prescriptions.
In-home caregivers can also provide medication reminders, and help clients with prescription memory aids, such as pill boxes, specially packaged doses, checklists and calendars.
Seniors who are experiencing side effects such as confusion, lethargy or depression may not be aware that it's happening. In-home caregivers are able to observe changes in condition of the client and report problems right away.
Most people with Alzheimer's disease or other dementia need help managing their medications. It's important to know that while antipsychotic drugs once were frequently prescribed to control agitation, aggression or sleep disturbances, the Alzheimer's Association now warns that these drugs are not appropriate for treating dementia symptoms. In-home care can help address the underlying causes of troubling behavior changes—which are often an expression of distress and unmet needs, frustration, loneliness or pain.
Beyond Medication
In-home caregivers help clients take part in non-drug treatments and lifestyle changes that can lessen pain and improve health in many ways, such as lowering cholesterol and blood pressure. This could include transportation to physical therapy or an exercise class, preparing meals as prescribed by the doctor and providing companionship and mental stimulation that benefits people of every health condition by warding off isolation and depression.
An important note: Consult with your doctor before stopping, starting or changing the way you take medications. The information in this article is not intended to replace the advice of a person's healthcare provider.
If you have any questions about the care we can provide for your loved one, contact us today!
