How many medications does your loved one take every day? If they’re anything like the average older adult, it’s probably at least four, and nearly 40% of seniors take five or more prescriptions each day.
As you may already know, medications can be a double-edged sword for seniors. Although each prescription was created to treat or manage a specific problem, each medicine also comes with its own risks and side effects — and when not used appropriately, effectively, and safely, medications can have devastating consequences.
If you’re a family caregiver, chances are you’re helping your loved one manage their medications. You might be attending doctor appointments and asking the doctor and the pharmacist about dosages, frequency, and possible side effects. Perhaps you’re putting together a pill case each week for a loved one and making sure they understand how to use it. You might even be tracking the names, amounts, and dosage frequencies for all medications your loved one takes, including over-the-counter drugs and herbal supplements.
It’s likely that your knowledge of your loved one’s medications is greater than that of your loved one themselves. That’s why you play such a critical role in helping to identify when a medication-related problem is occurring.
Here’s a look at five common medication-related problems and how family caregivers can help prevent them.
Medications and the ways they’re used have changed considerably over the years. Not only are the drugs far more complex, but consumption of them is increasing as well. Yes, there’s a pill for that, but does your loved one really need to be on it?
Research has shown that the more medications a person takes, the greater the risk of experiencing a medication-related problem.
One way to prevent what is known as polypharmacy is through communication. Here are some questions to ask the doctor or pharmacist for each medication:
Your loved one might not only be taking a bunch of medications, but they might also have numerous prescribing doctors. A recent study found that most older adults have at least two specialty care doctors, and nearly one-third of them visit at least five doctors each year.
One medication-related problem that can occur due to poor communication is that a senior ends up taking a medication that is unnecessary given their current medical problems. For example, if your loved one is discharged from the hospital, drug regimens that were started and needed only in the hospital may be unnecessarily continued by the discharging prescriber. Another example, your loved one receives combination therapy when a single drug would be equally effective.
To help avoid this medication-related problem, make sure you have a clear understanding of what to expect — and when to expect it — when your loved one is taking medications. Drug reconciliation refers to a formal process of reviewing all prescribed drugs at each transition of care and can help eliminate errors and omissions.
Perhaps the most common medication-related problem among older persons is when the correct medication is prescribed, but the dose is too high. This often happens because physical changes of aging can alter the way our bodies process and react to medications. For example, the ability to eliminate medication from the body becomes less efficient with aging due to reductions in kidney and liver function. A “normal dose” of a medication can be an overdose for many older persons.
On the other hand, another medication-related problem occurs if your loved one has a medical condition for which too little of the correct medication has been prescribed or too little is taken. When the correct medication is prescribed and the dose is too low, the benefits of the medication can be minimal or none at all, and may result in serious unpleasant effects through poor treatment.
If you believe a drug dose may be too low or too high, contact your loved one’s primary care provider or pharmacist.
Drug-to-drug interactions are common because older adults often take many drugs. An adverse drug reaction happens when your loved one is receiving a medication considered to be unsafe based on:
For example, a common drug interaction involves blood-thinning medications that can thin the blood even more when combined with aspirin and some other pain relievers.
The best way to avoid adverse drug reactions is to ensure that all health care providers have a current list of all medications, vitamins, and dietary supplements your loved one is taking and to document all symptoms and address them with a medical professional.
Up to half of older adults do not take drugs as directed. Your loved one might be confused about why and how to take the medication, or maybe they find it inconvenient to take the medication. Perhaps they perceive that the medication has caused or will cause some adverse event. Financial and physical constraints may also make purchasing drugs difficult.
Yet for medications to be safe and effective, they must be taken at a particular dosage, at specified times, and for a specific period of time. Pharmacists and nurses can help by providing education and reviewing prescription instructions with your loved one, and you can help your loved one stick to their regimens with some organizational devices such as pillboxes and medication reminders.
Keeping an up-to-date medication record is one of the best ways to reduce the risk of medication problems. When new medications are added or medications are discontinued, you can communicate this to all of your loved one’s health care providers by giving them a copy of the list. You can also keep an ongoing record of any adverse reactions to medications they have experienced.
This Emergency Medical Information Worksheet is a great way to compile information on medical diagnoses, doctors’ appointments, questions, and medication history. Download it, print it, and fill it out.
Once completed, provide copies to other family members so you can all be prepared no matter what happens. Also, keep a copy in a prominent location and make it easily identifiable. Remember to update it regularly.