As our 55 and over population continues to rise, so does the concern of health professionals regarding how to best manage their health and safety. One such concern is for the number of medications that are prescribed for seniors. According to the Journal of the American Medical Association, nearly one-third of Americans ages 57-85 take at least five or more prescription drugs, and some with chronic illness may take as many as 20. Medication has tremendous benefits to curing, preventing and easing chronic conditions. At the same time, the combination of medicines can lead to negative effects on the body, or even dangerous outcomes, if not carefully monitored. Elderly patients are particularly susceptible to issues caused by polypharmacy, a term used when a patient is taking over four different medications increasing the risk of misuse or negative effects.
As a Certified Nurse Practitioner (CNP), Brenda Blackshear, is all too familiar with the challenges of polypharmacy. Ms. Blackshear has managed and prescribed medications for over 20 years. As a full time CNP for Kingston Residence of Sylvania, an assisted living and memory care community for seniors, she has seen how the stress of keeping track of medications can take a toll on residents and caregivers. “In some cases, it’s the medication overload that is the tipping point for choosing to come to assisted living.”
“At Kingston, we have many residents who can manage their own medications on a daily basis, then as they age or their symptoms continue to worsen, the pill burden can become overwhelming. Fortunately, residents can choose to have our clinical staff monitor their medications and look for changes in their health or behaviors,” states Ms. Blackshear.
Part of Ms. Blackshear’s experience is de-prescribing medications for residents to improve their well-being and quality of life. “What you find is that people will take the same medication for years without question, or have prescriptions from the cardiologists, pulmonologist and family physician. It’s a case of having several healthcare providers prescribing medicines without having the entire picture. So people get a number of pills and doses that could create potentially negative outcomes like higher risks of falls or hospitalization,” Ms. Blackshear explains.
The success of any medicine truly hinges upon the communication among patients, doctors and caregivers. A few simple measures can be taken to bridge communication to increase the success of a medication program and hinder the risks of medical mishaps.
- Create a medication journal and keep it up to date
This is particularly important for patients who take multiple medications. Be sure to include the physician, date the medication was originally prescribed, diagnosis (why and what it will be used for), and how long it needs to be taken. Write down both the brand and generic name of the medication as well as the pharmacy source. If you use a smart phone, take a picture of all your prescription labels. Make a few notes about a drug after you start taking it. Include positive and negative effects that it caused you such as nausea, anxiety or joint pain. Remember to include over the counter medication and herbal remedies as well. Tell your loved ones about the journal and where to find it in case of an emergency health situation.
- Bring your medication journal everywhere you will receive healthcare
Your healthcare is a team effort with you being the key player. Keep all your doctors informed about your medications to ensure that you do not run the risk of having drug-related problems. Review your medications frequently with your physicians, particularly if you have been taking them for quite some time. The pharmaceutical market is continually making progress, you may find that new alternatives are available for your condition.
- Choose one pharmacy source if possible
Many drugs come with pages of information that are prone to be confusing rather than educational. Find a pharmacy that has a strong team of experts who take the time to answer your questions and follow your medication closely. Studies show, that about 40% of seniors fail to take their medication as instructed. Take advantage of your pharmacy’s counseling service when you have a question about a medicine. Be sure to review your prescription if you have any doubt as to how and when to take it. If you take generic drugs, ask the pharmacists if the company providing your medication has changed. Even though drugs are closely monitored, they can have a small change from one generic provider to the next. A change to your generic prescription could cause new side effects. Contact your pharmacist if you suspect that your generic prescription is different.
- Pay close attention to changes to your body or behavior
Just as your body changes over time, so can the way you react to a certain medication. Symptoms such as headaches, dizziness, lethargy, irritability or forgetfulness could be caused by alterations in the way you are reacting to your medications. Dr. Chad R. Worz, PHARMD, a pharmacy expert for Kingston HealthCare shares, “older adults metabolize medication differently than younger adults. This will affect how the medication works as people age and also how medications may interact with one another.” Ask your spouse or caregiver to mention changes in your behavior that you may not be aware of such as confusion or anger. Be sure to call your physician when you notice a difference in how you feel and act.
- Accept help
Often seniors avoid asking for help for fear of being seen as less independent or weak. In the case of medication, one should consider that the result could be a better quality of life versus dire consequences. Seek help of a caregiver such as spouse or other family member. Involve them with your medication journal and together seek resources to help manage your medication. Ask your pharmacist or physician about resources that they recommend for your particular needs.
While medications are necessary and invaluable for help managing illness and experiencing better quality of life, it is important to be aware of mishaps that could occur by taking an uneducated approach to medicine whether it be over the counter, natural remedies or pharmaceuticals. By becoming more informed and involving your loved ones and clinical care givers you increase the chances of having the best outcomes for health and wellness.