At 83 years old, Martha still lived in her own home, and enjoyed working in her garden and canning peaches. It was becoming harder to motivate herself, to get up in the mornings and achieve the day’s tasks. She disclosed to her daughter that she felt anxious and exhausted. Her daughter, who was taking medication for her anxiety, took Martha to her own doctor, not Martha’s and got her a prescription for Valium. In doing so, the daughter’s doctor, who had never seen Martha and who did not have her medical history, was only aware of a few medications they told him she was taking.
Martha, in fact, was taking 9 different medications as well as herbal supplements. The addition of Valium to her existing list of prescribed drugs sent her to the emergency room with respiratory distress. If she had gone to her own doctor, he would have found that a dosage adjustment of her current medications would have solved her anxiety.
Medication errors are common in the elderly. Many seniors take on average 6- 8 different prescriptions as well as over the counter drugs. Many times the elderly will not go back to their doctor to have their dosage evaluated and changed if necessary. Family members should be aware, that elderly parents may tend to take the family’s advice over going to their own doctor. Even though children want to help increase the health and stamina of their parents, they may in fact be causing damage by misdirecting their loved ones.
Where a younger person can benefit from herbal supplements like Ginkgo Biloba, Saw Palmetto and others, in older people, these herbals may cause adverse reactions with their prescription medications.
In 2003, a panel of experts put together a list of potential medications that would not be appropriate to give to seniors. This is called the “ Beers List ” after one of the research professionals.
Dr. Donna M Fick, R.N. one of the panel members for updating the “Beers List,” states in her article on Seniorjournal.com:
Just as our bodies physically slow down as we age, changes occur in the way that older bodies handle pharmaceuticals, and this has motivated experts to develop a list of drugs that may be harmful to elderly patients.
“With age, drugs tend to build up in the body, and the distribution and elimination of drugs from the body changes as well,” says Dr. Donna M. Fick, R.N., associate professor of nursing at Penn State. “Many drugs, like diazepam (Valium) and other anti-anxiety drugs build up fast.”
An on-line article on HealthSquare.com, Titled “Drugs and the Elderly,” talks about physical symptoms and medications.
“ Among the first signs that a drug may not be working properly in an older person is a change in mood, energy, attitude, or memory. Too often, these alterations are overlooked, ignored, or chalked off to “old age” or senility. Older people may themselves feel that their blue mood is caused by something external such as the death of a friend or simply by boredom. Nothing could be farther from the truth. Virtually every heart medication, blood pressure drug, sleeping pill, and tranquilizer has been known to trigger depressive symptoms.When a psychological symptom appears in an older person, examine his or her medication or drug use first. Consider, too, factors like alcohol intake, poor nutrition, and hormone imbalance. And never dismiss the possibility that a real psychological problem has developed and may itself require medication.”
There are many things family members can do to help monitor medications for their elderly parents.
- Make a list of medicines prescribed and all supplements being taken.
- Give this list to the doctor and pharmacist and have one on hand for emergencies.
- Use the same Pharmacy to fill all prescriptions. Pharmacies keep a record of your prescribed drugs and will verify your doctor’s instructions. They will also tell you if foods or over the counter supplements will interact with a prescription.
- Dispense pills in a daily pill organizer box.
- Have a family member be responsible to call or physically monitor the taking of medication
Family members who live long distances from their elders have available to them new technology in medication monitoring.
- Alarms for pill boxes, watch alarms, medical alarm bands and necklaces that ring a reminder.
- Computerized pill box dispensers that ring a designated number if the pills have not been taken.
- Home Telehealth –
“Technology has developed computer and computer cameras to help the elderly in their homes stay safe and healthy. Home telehealth-set up by medical professionals in the home–enables providers to monitor such things as medications and blood pressure and actually see the patient. Patient questions are answered and advice is given, while the monitoring nurse views through the video phone how his or her patient looks physically.” The 4 Steps of Long Term Care Planning, Pg 92
- Home Care Agencies – Home care companies offer a variety of service options in helping families care for and properly dispense medication to their elder parents.
Find a home care agency in your area http://www.longtermcarelink.net/a7homecare.htm
Overmedication or taking medication incorrectly may lead to early mental confusion and decline in health in seniors. “If medication problems were ranked as a disease in cause of death it would be the 5th leading cause in the United States”. (from article on LongTermLiving)
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About Evan H Farr, CELA, CAP
