Seniors usually take medications for chronic conditions, such as high blood pressure, arthritis or cholesterol. Half of the people older than 65 years use 5 or more prescription and over-the-counter medications per week, and 12% use 10 or more, one survey showed. Sometimes, those medications—or the interaction among medicines—may do them more harm than good. Do you know these facts about assisted living? “Drug-related problems are common in the elderly and include drug ineffectiveness, adverse drug effects, overdosage, underdosing, and drug interactions,” pharmacists J. Mark Ruscin and Sunny Linnebur note. Adverse drug reactions (ADR) among ambulatory people 65 and older take place at a rate of about 50 events per 1000 person-years. The risk for developing an adverse drug reaction that requires hospitalization is approximately 10.7% for seniors, compared with 5.3% for the general population. Adverse drug reactions are mostly preventable. ADR hospitalization rates are 17% for seniors, compared to 4% for younger people, more than 4 times higher.
Is Medication Causing Your Parent’s Symptoms?
The most common symptoms of adverse drug reactions are mental status changes, dizziness or fainting upon standing, mood and behavior changes, constipation or diarrhea, dry mouth, blurry vision, drowsiness, hallucinations, memory impairment and difficulty urinating. Symptoms of drug-related problems may range from mild to life-changing. Mild symptoms may include sleepiness, diarrhea, confusion, compulsive gambling, increased sexual behaviors, and weight gain or loss. More severe symptoms may include:
- Failure to treat the symptoms for which medication was prescribed
- Parkinsonian tremors. Observation of these symptoms may lead doctors to prescribe Parkinson’s drugs, which may cause additional problems
- Prolonged (and painful) erections
- Hallucinations
- Falls
- Development of breasts in men
- Extreme sensitivity to sunlight
- Suicide
- Sudden death
Family members who have been taken in by stereotypes of aging may conclude that their parent’s behavior is just a symptom of aging. However, any changes in behavior should be noted, reported to a medical professional and monitored.
Symptoms of Medication-Related Allergies
Allergic reactions may occur within hours of or as long as weeks after taking a new medication. Minor symptoms include flushing, itching, rash or a drop in blood pressure. Contact your doctor for advice. If your parent develops blisters, hives, swelling, wheezing, light-headedness, vomiting or shock, take them to the emergency room immediately.
What Causes Medication-Related Problems?
- Drug Ineffectiveness may result when a doctor is concerned about side effects or when patients can’t afford to or don’t properly take drugs. As a result, the medication is not effective in treating symptoms.
- Adverse Drug Effects are a particular problem for older people because they usually take several prescriptions and their bodies use drugs differently than younger people.
- Overdosage occurs because the bodies of older people use drugs differently than those of younger people. Drug interactions, usually caused by patients who fail to report all medications and supplements or to follow instructions, may also cause overdoses.
- Underdosing may be an attempt by the physician to prevent unwanted drug interactions or to reduce the patient’s cost. Drugs that are often underprescribed for seniors include those used to treat depression, Alzheimer’s disease, pain, heart failure, heart, atrial fibrillation, hypertension, glaucoma, and incontinence. Opioids and beta-blockers are often underprescribed, and immunizations are not always given as recommended.
- Drug Interactions may result when the drug used to treat one disease makes another disease worse. However, the most common form happens when people take two drugs, but their doctor is not informed about one. A frequent situation occurs when a person purchases an over-the-counter supplement or medication and takes their regular medication without informing their doctor beforehand.
How Can You Prevent Medication Problems?
Inappropriate drug prescription for older patients is a nationwide issue. “(T)ypically, about 20% of community-dwelling elderly received at least one inappropriate drug. In such patients, the risk of adverse effects is increased…In one study of hospitalized patients, 27.5% received an inappropriate drug,” remark pharmacists Ruscin and Linnebur. To minimize the risk of drug interactions, make a list of all vitamins, supplements, over-the-counter drugs, creams, and prescription medications your parent takes, as well as the caffeine and alcohol they consume. List what they take on a daily basis, such as 500 milligrams of vitamin C or a couple of beers. Take the list to all your parent’s doctors and ask staff to ensure the doctor knows about all of them. Update the list as needed. Ensure your parent’s medical history is accurate, too. Genetics, health and lifestyle all play a part in determining how medications work inside the body. Many pharmacies keep a list of medications prescribed for customers. Ask if they have a patient profile form. Pharmacists will monitor your parent’s medications, too. Determine whether your parent is taking medications prescribed by the doctor. If not, inform their doctor. Each year, check your parent’s medicines and dispose of outdated over-the-counter and prescribed medication. Do NOT flush them down the toilet. Instead, scratch out all identifying information on labels and put the container in a plastic bag. You can then dispose of it the way you do other trash. Because you are your parent’s first line of defense, if your parent begins to act oddly, ask: “Has there been a change in medication?” It’s just as important to ask your parent if new medication is actually helping their symptoms. Pharmacists Ruscin and Linnebur explain, “Lack of close monitoring, especially after new drugs are prescribed, increases risk of adverse effects and ineffectiveness.” Thanks to technology, you can check for possible drug interactions online here. The American Geriatrics Society Beers Criteria Update lists drugs that are “potentially inappropriate” for seniors here. If your parent is prescribed one of these drugs, ask their doctor why.
Lack of Adherence Reduces Drug Effectiveness
Up to 50% of seniors don’t take the medication prescribed by their doctors. Their excuses include not being able to afford the drugs to not believing the drugs are working. They may not remember when to take the medication, lose the bottle or be able to open the bottle. The study noted that calendar charts, blister packs, and compartmentalized trays helped seniors take their medications. New devices that may also help include boxes with digital alarms and apps.
Medication Reminders at The Arbors
At The Arbors Assisted Living Residential Communities, we prefer to use a human touch with residents. Our staff members remind residents, then document when residents take their medication. We also keep a sharp eye for changes in behavior that may indicate medication interactions. If your parent is having difficulty with medications or other activities, we can help. Contact any of our 8 locations.