Too many pills? If you’re helping an older person, chances are that person is taking at least a few prescription medications, if not several. Do you ever wonder if he or she is on the right medications? Do you worry about side-effects and interactions?
These are legitimate concerns. Although medications do often help maintain a person’s health and well being, there are lots of older adults end up suffering from problems related to medication.
Keep a list of all of the medications that your senior takes — both non-prescription and prescription. This includes any supplements that you take, such as vitamins, minerals, herbs and essential oils. List the doses, what its being taken for, and when taken. Remember to bring the list with you whenever you take your senior to see a healthcare professional. This way, their doctors will know what medications and supplements are being taken. Ask both the doctor and the pharmacist about possible side effects and interactions, especially if taken along with a new medication. Then watch for them. If you think your senior may be having a bad reaction to a medication, or if you think a medication is not working, tell the healthcare provider as soon as possible. However, don’t stop taking a medication without first checking with a healthcare professional. Ask if it takes time for the drug to be totally effective, some drugs need time to build in the system before working.
If the purpose of a medication is to control a sign or symptom, take note of when the symptom was last checked on, and how it’s been doing. Ask if there might be a safer or more effective alternative. The way a person responds to a medication or medications can differ from the way other people respond to it. Review the Beers List of Potentially Inappropriate Medications for Older Adults, and see if your senior is taking medications on the list. If you need help spotting risky medications, consider asking a pharmacist for assistance.
There are many reasons why seniors don't take their medications as prescribed.
Vision Problems – Ask for Large Print. If your parent has vision problems, ask the pharmacist for medications labels in a larger print size.
Memory Loss – Use a Pill Organizer. There are many types of products available: computerized pill box dispensers that ring a designated number if the pills have not been taken, watch alarms and necklaces that ring a reminder.
Income – Low-income elders – Use Generics. Generic drugs are the same medications as their brand-name counterparts, but are less expensive. Ask if a generic alternative is available. Find Financial Assistance for prescription medication. Research Prescription Assistance Programs. Also, ask your pharmacy about discount programs that are available. Go to the drug manufacturer's website, to see if discount programs are available. And look for low-cost prescription savings plans. Visit Benefits Checkup.org to find out if your parent is eligible for financial assistance or prescription savings plans.
Swallowing Problems – Some seniors have trouble swallowing a tablet or capsule due to health conditions. They try to chew, crush, break or mix the tablet or capsule in food or drink. Don't Crush Pills. Ask for Liquids. If your parent has trouble swallowing medicines, ask the doctor or pharmacist if the drug comes in a liquid.
Hearing Loss – Get Instructions in Writing. If your parent has trouble hearing, talk to them about not being embarrassed about their hearing loss. If they can't hear what the doctor or pharmacist is saying, ask them to repeat it. Use Hearing Devices. Make sure your parent wears their hearing aid to doctor's appointments and pharmacies.
Social Isolation – Many elderly people live alone. Several studies have shown that people who live alone more often fail to comply with medication regimens. Get In-Home Help. If your parent lives alone, consider home health care. Tell the agency that your parent needs help with taking their medications, and inform the agency of the elder's required medication schedule.
All medications can cause side-effects, quite a few commonly used drugs are known to make thinking, memory and balance worse in aging adults. Ask yourselves if the drug seems to be serving its purpose. If it’s a drug to manage a symptom such as pain, consider how the symptom seems to be doing. If the doctor hasn’t reassessed the symptom lately or if the symptom is still bothersome, you’ll want to discuss with the doctor.
If there are alternatives to taking the drug. Especially when it comes to treating symptoms, there are often non-drug alternatives that can and should be considered. For instance, physical therapy can help treat some forms of pain or pelvic floor exercises and timed toileting can reduce incontinence.
In general, the risk of side-effects and problems goes up with higher doses of medication. Consider asking if a lower dose is possible for any of the medications.
But don’t stop the medication on your own, as that can be dangerous too.
If taking medications on schedule is an issue, ask the doctor or pharmacist for help simplifying and streamlining the daily medication plan. For drugs taken several times a day, there may be a once-a-day option, so ask.
Make sure the pharmacy label says why you are taking the prescription. This is particularly important for older adults who are taking multiple medications, to ensure that they know what each medication is for and how to take it properly. It can also help caregivers police whether their loved one is being given too many medications to treat the same issue, or whether a less scrupulous provider has prescribed a drug for a purpose it wasn’t intended to treat.
Ask your provider if the dosage is age-appropriate. Because of the way our bodies metabolize various drugs as we get older, seniors can be more sensitive to some drugs and less sensitive to others. They are also more likely to experience adverse effects. Double-check with your pharmacist or doctor to ensure that the dosage on the prescription is age-appropriate, and ask if it’s advisable to start with a lower dose and taper upwards.
Minimize the number of providers and pharmacists you use. Keeping the number of doctors and pharmacies to a minimum is better for you and better for the providers who must coordinate care. The primary-care provider, the caregivers, specialists and you must maintain good communication with each other to prevent or minimize problems. Use only one pharmacy to obtain all medications, this adds another level of review to help ensure appropriate dosage and reduce the risk of adverse drugs effects and interactions. Have the pharmacist make a note in your file to review the interaction of drugs each time you pick up a prescription, then ask if they did the review.