Every year, 50,000 people age 80+ are hospitalized due to emergency drug reactions in the United States.
Many common prescriptions are characterized as high risk medications for people 65+. These drugs can have serious health consequences when not taken correctly or not monitored. This includes commonly prescribed medications for diabetes, hormone replacement therapy, urinary tract infections, allergies, heart and gastrointestinal conditions, antidepressants and anti-anxiety drugs.
Are Seniors Taking Too Many Drugs?
It is rare to find an adult that doesn’t take at least one prescription medication. One-quarter of people age 65 to 69 take at least 5 prescription drugs. Sound like a lot? Among people 70 to 79, 46% are taking 5+ prescription drugs. That doesn’t include over-the-counter medications, herbal supplements, alcohol, marijuana and narcotics.
Risks of Too Many Medications for Seniors
- More Health Challenges Equal More Medications: As people age, they may have more medical problems. Examples include diabetes, heart conditions, high blood pressure, dementia, and osteoporosis. This means they are more likely to take several medications. A contributing factor in falls is medications, especially multiple medications. In the medical literature, polypharmacy means taking 5 or more prescription medications. The leading cause of injury related deaths in older adults is falls.
- Multiple Medications Can Have Adverse Effects: The more medications someone takes, the greater the risk of side effects. These include: dizziness, fatigue, mental confusion, sleep problems, appetite problems, dehydration. In a Canadian study, 12% of seniors taking 5+ prescription drugs had to visit a doctor or emergency room because of bad side effects.
- Doctors Don’t Catch Everything: Every medical professional involved in care is responsible for thoroughly assessing their patient. However, in real life, doctors can miss the big picture and prescribe a medication with only one specific reason in mind. So, doctors can miss the potential adverse effects of combining medications. Also, different doctors can prescribe medications that are fine on their own, but have negative side effects when taken together.
- Inconsistent Compliance: Under or overtaking medications means that medical conditions are inadequately treated. Or not treated at all.
Are Medications Taken Correctly?
As a family caregiver, you may assume that medications are being taken as prescribed. Diving a little deeper may be quite revealing. Don’t assume that what your parent or spouse tells you is true or accurate.
- Start With the Bottles. Go through all the bottles of medications. Check prescribing physician, refill dates, and expiration dates.
- Keep Track With a Medication List. Take the time to find out what condition each medication is treating. You may be surprised to find that your parent or spouse has medical conditions that you didn’t know about. Write down each medication. Also record the amount, time of day and any contraindications.
- Identify the Method Used to Take Medications. Is your parent or spouse taking medications right from the bottle? Is there a 7-day plastic pill box? If there is a 7-day plastic pill box, check the original labeling to see that the medications for each day are taken properly.
- Look for Physical or Mental Changes. Has there been an increase in falls, dizziness, or confusion?
Reasons People Don’t Take Their Medicine
Take the time to examine these reasons why medications may not be taken correctly:
- Difficult to Understand Instructions. Your parent or spouse doesn’t understand why they are taking a particular medication. (There is a full study about that here) Therefore, they think it isn’t important. Get involved. Call the prescribing physician. Ask why particular medications are being prescribed. Or better yet, attend the next primary care appointment. Inform the primary care physician if any other doctor is prescribing medicines. Ask the primary care physician if all the medications are necessary. Can some be eliminated or dosages reduced?
- Physical or Mental Challenges. This includes poor eyesight, memory problems, or hearing impairment. Are the med boxes or bottles difficult to open?
- Confusing Methods. Perhaps the pill box doesn’t hold enough medications for a day or week. Is your fancy dispenser too challenging for your parent or spouse to use?
- Know the Prescriptions and Over-the-Counter Drugs. Talk to the primary care physician or pharmacist about any over the counter medications. There are certain over-the-counter medications that are contraindicated for older adults.
- Difficult to Take. Check out this Family Caregivers Video Guide to Managing Medications. Pills aren’t the only medications you may have to deal with. This guide talks about insulin injections, eye drops, suppositories, and patches.
- Difficult to Remember. Enlist the help of a paid caregiver if possible. Paid caregiverss can administer medications in some states, if they have certain licensing. In states where this is not allowed, ask the caregiver to be involved. Caregivers can be invaluable in giving reminders. They can check medication boxes to see that medications are being taken correctly. They can alert family members or the agency when they notice that medications are running low.
Ideas to Make Organizing Medications Easier
- Simple Pill Boxes. A simple pill box is best for people who don’t have cognitive or physical issues. You can fill them or a nurse can fill weekly. You could use one simple pill box for each time of day — morning, mid-day, evening, or use a “twice a day” double-sided dispenser.
- Automated Systems. Consider systems that automatically dispense medications with reminders. One easy to use system is Med-Q. Keep in mind that you or a medical caregiver will need to fill the medication dispenser every week. However it will be much easier for the person taking the medication to have timed, audible and visual reminders.
- Blister Packs. Many pharmacies will fill your parent or spouse’s medications in self-contained packs. These can often be mailed directly to the home. Some people find these packs easier to manage.
Medication errors can have serious consequences. Develop a system that works for you and your parent, spouse or friend. You will rest easier.
- Emergency Hospitalizations for Adverse Drug Events in Older Americans
- The Impact of Polypharmacy on the Health of Canadian Seniors
- Frail Elderly Patients’ Experiences of Information on Medication
- Med-Q Medication Management System
- The Other Big Drug Problem: Older People Taking Too Many Pills
- Family Caregiver’s Video Guide to Managing Medications
- Comparison: Automated Medication Dispensers
- Use of High-Risk Medications in the Elderly
- High Risk Medications (pdf)