Medication management for seniors: Making sure the cure isn’t worse than the disease
According to recent data collected by Health Canada, seniors represent 17% of the population but are more than 40% of prescription users.
The numbers are similar for the United States: people older than 65 represent 12% of the US population but they account for 34% of prescription medications and 30% of over-the-counter medication use.
That’s a lot of medications, and we need to take seriously the potential risks. Several medication-related issues affect seniors in particular. These are side effects, drug interactions, and management challenges. Let’s take a look at how to handle these challenges!
Some drugs can make balance and thinking worse.
As we age, our ability to digest and absorb medications can change too. Some people may see big differences in how well drugs work as they get older; others may not. How quickly we absorb a drug can affect how strongly we feel its side effects. This means if you’re a person whose absorption rate or speed has changed a lot over time, you may find yourself with unexpectedly strong side effects, even if taking a drug you’ve used before.
Two kinds of side effects are especially important to watch for. The first is balance. If you’re taking a medication that affects your balance, it can have serious consequences, such as falling and breaking a hip. Seniors who break a hip face higher rates of death in the first year after a hip fracture (between 14 and 58%).
Some medications can also affect brain function. We also call this cognition. Medication side effects can negatively affect how we learn, think, understand, plan, and remember. Seniors may experience memory loss leading to confusion. A number of over-the-counter sleep aids and painkillers can also contribute to altered brain function.
Two groups of drugs to watch out for are medications used to lower blood pressure and those used to reduce blood sugar. If these drugs are absorbed too quickly, or the dosage is too high, the drugs may work too well and lead to balance or cognition trouble.
Other drugs to be careful of include those given to manage overactive bladders, anxiety and sleeplessness. Many specialists in seniors’ health recommend reviewing a person’s medications on a regular basis and reducing or eliminating them whenever possible to avoid troubling or dangerous side effects.
What you can do: Talk to your pharmacist about any changes you notice as a result of taking a new medication or a change in dosage for a long-term prescription.
Drug interactions are unpleasant and dangerous.
Although we don’t require a prescription for over-the-counter-medications, they are still real drugs, and we need to use caution, especially if we are taking them in combination with one or more prescription medications. The biggest concern here is how drugs interact with each other. Some drugs can reduce or nullify the effects of another drug’s performance while others can make side effects worse.
Drug interactions can also occur with certain foods or beverages. For instance, alcohol can cause dizziness or drowsiness, and it can also change your heart rate—speeding it up or slowing it down.
These interactions can affect how a senior manages their daily activities such as driving, walking, or cooking, leading to increased risk of injury or other harm, sometimes quite serious.
What you can do: Your pharmacist can guide you in what to avoid when taking a medication that can interact poorly with food or other medications. Don’t hesitate ask questions about contraindications anytime you fill a new prescription or consider a new over-the-counter medication!
Make a list of all the drugs you are taking, including over-the-counter medications, and keep a copy with you at all times. Include notes for each item on your list about any contraindicated drugs or foods so you never forget what to avoid.
You may also find it useful, as much as possible, to buy all your medications from a single pharmacy. You can ask your pharmacist to look at your prescription record to see if there’s anything you need to watch out for.
Juggling lots of different medications can lead to mistakes.
Most seniors are dealing with at least one chronic condition and many may be dealing with two or more. Managing multiple prescriptions is a chore for most of us, but for seniors, declining brain function or deteriorating memories can increase the risk of taking too little or too much of the medication. If you miss a dose often, it may also affect how your condition responds to treatment. If you take too much, you may change how other drugs work.
What you can do: Talk to your pharmacist about managing your prescriptions safely. They may be able to provide you with special blister packs organized by day and week so you can keep track of when and how much of each drug you have to take.
In short, be proactive about your pharmacare!
It’s okay to ask your health provider questions about the medications you’re prescribed. If you are a senior, or if you’re helping a senior manage their care, here are some other things you can do to manage medications properly:
- Understand why you are taking the medication, including prescriptions, over-the-counter medications, vitamins and supplements. What conditions do you have? Are there alternatives to managing your health issues?
- Keep track of how you’re doing. Are your symptoms better or worse? Do you have new symptoms? How and when will your doctor reassess your medication?
- Don’t make changes in how you take your prescriptions (frequency, dosage and so forth) without consulting your doctor or pharmacist. If you are worried about the cost of certain medications, ask your pharmacist if a generic, cheaper version is available.
Prescription and over-the-counter medications are intended to make our lives easier and our health better. But they’re strong substances that have serious effects on our bodies. With a little care and management, you can make sure you get all their benefits while minimizing the specific issues that are most likely to arise for seniors.