Granny's on drugs - seniors and overmedication

 Medicine sometimes snatches away health, sometimes gives it.

Ovid 

                      Taking medication (photo: Baudouin, flickr creative commons)

People over the age of 65 are the largest consumers of prescription and nonprescription medications in the United States. Seniors in many parts of the world are similarly overmedicated. As of 2007, statistics showed that 30 percent of all prescription related deaths (in the U.S.) took place in elderly people and 20 percent of all hospital admissions for aging patients was related to medicine-related problems. This growing problem is referred to as overmedication and, within the medical community, as polypharmacy.

What is Polypharmacy?

Polypharmacy simply means when someone is prescribed more medications than are indicated by "good" medical practices and more than can be safely used. 

                Aging (photo: LHG Creative Photography, flickr creative commons)
 

Why are Elderly Patients More Likely to Be the "Victims" of Polypharmacy?

• Fewer clinical trials with older people
• The aging body metabolizes medications differently than younger people
• Elderly people have declines in liver and kidney function, which also changes the way the body metabolizes medications. 
• Seniors have more chronic health conditions and specialists may prescribe medication without being aware of all the medications a patient is on. 

What are some consequences of Polypharmacy?

• Drug reactions and side effects that send someone to the hospital or even cause death
• Falls related to dizziness, reduced muscle strength, and drowsiness
• Side effects, such as dizziness, dry mouth, depression, insomnia, nausea and diarrhea
• Changes in quality of life: elderly people who are taking too many prescriptions may no longer enjoy hobbies or  participate in regular activities. 
• Taking too many medications can be costly, depending upon the type of health care someone has (or doesn't have!)
• Younger family members or others may gain access to potentially addictive drugs such as Oxycontin.

How can you tell if your aging parent/spouse is being overmedicated?

•  Have you noticed changes in your loved one's behavior?
• Does your loved one still enjoy the things they used to enjoy?
• Has your loved one been falling more or had more than one significant fall recently?
• How many medications is your loved one taking regularly? (Some experts suggest that taking more than 6 medications at a time is enough to set off alarm bells.)
• Does any one doctor know all of the medications that your loved one is taking?

 What can you do?

The situation may seem overwhelming, but there are actually quite a few simple things that can make a big difference to your loved one's well-being. If you have the time, you can do further research and inform yourself with as much information as you have time to uncover. 

Here are a few places to get started:

• Find out what prescription and nonprescription medications your loved one is currently taking. (This may not be easy, but without finding out what medications they are taking, it will be impossible to proceed. If your loved one resists sharing this information, go slowly, gently repeat the request, and explain why it is so important to make sure they aren't taking medications that may be dangerous to their health.)
• Once you determine what medications your loved one is on, write them down on a list and copy the list: one list for you, one list for your loved one that they should keep in a convenient location to take to the doctor or hospital whenever they go.
• Buy your loved one a pill box and make sure they use it!  Better yet, help them fill the pill box and if you live with them, or nearby, make sure they take their medications on a regular schedule.

                  Pill box (photo: Kristen Beck, flickr creative commons)

• If your loved one's family doctor doesn't seem well informed or cooperative on the issue of overmedication, encourage your loved one to transfer to a geriatric physician or a family doctor (GP) who is informed about the issue of polypharmacy. 
• At least once a year, schedule a "brown bag appointment" with your loved one's doctor. This is exactly what it sounds like: help your loved one put all of their medications - prescription and nonprescription - into a bag (brown or otherwise) and take them to their doctor, so that the doctor will know exactly what medications they are on.
• Become informed. A good place to start is with the Beers Criteria (Medication List), a source developed by professionals that lists medications that are not recommended for seniors. 

For more on this important topic see:  (Over)medicating the Elderly or watch the video below. (It's long, but well worth watching.)