Preventing Medication Mishaps in Seniors

People are living longer than ever before. For example, a Canadian born in 1960 can expect to live 20 years longer than one who was born in 1900. Birth rates have also declined, leaving a growing part of the population over 65. It is estimated that by 2031, 20 percent of the population will be seniors; of these, the most rapidly growing age group will be 85 and over. 

Over the Hill?

With the surge in preventive health care, including exercise, nutrition, and supplements, a new type of senior has emerged. Although seniors are technically classified as 65 years and older, many people in their seventies, eighties, and even nineties maintain busy and active lifestyles–a far cry from being considered “over the hill”!

Yet there are still unique health-care concerns that specifically affect our aging population. A significant number of seniors face the reality of chronic or acute illnesses, including heart disease, stroke, cancer, and digestive disorders. In addition, seniors are more susceptible to an increased number of falls resulting in bone fractures and hospitalizations.

Medication Mix-Ups

“Did I take my little white pill or not?” I often hear my grandmother ask. With a basket full of pills and nutraceuticals, along with a schedule that includes taking certain pills with food and others at different times of the day, my very sharp grandmother can occasionally become perplexed. Unfortunately, medication mix-ups are a major concern in seniors.

The use of multiple medications, referred to as polypharmacy, is common in the aging population. In fact, research shows the average senior takes four prescription medications daily and fills 18 prescriptions a year. Another study suggests that individuals spend more than 50 percent of their lifetime health expenditures after the age of 65. Topping the lists of drugs prescribed to seniors are laxatives, sleeping pills, anti-anxiety medications, heart medications, anti-ulcer drugs, anti-angina drugs, and blood pressure medications.

Problems arise when a number of medications are prescribed, often by different doctors, without each being considered or explained in detail. Drug interactions, medication side effects, and the misuse of prescribed medications are all concerns that can have detrimental effects on a senior’s health.

Physiological Changes

In addition to confusing regimens of multiple medications, seniors’ bodies change as they age. These changes alter absorption, digestion, and elimination of medications ingested.

Stomach acid declines and digestion slows, so drugs are broken down at a slower rate.

Due to decreased functioning of the liver and kidneys, the body’s ability to rid itself of medication is also slowed by up to 50 percent, increasing the risk of side effects and toxicity. In seniors, the heart pumps at a slower rate and delays the elimination of drugs from the body. Both muscle mass and the percentage of water in the body also decrease, while fat increases. Because toxins and medications are stored in fat, they remain in the body for a longer time.

Avoiding Misuse

In order to prevent adverse reactions from occurring due to medication misuse, side effects, or interactions, specific guidelines should be in place whenever a medication is prescribed. When followed, these guidelines will prevent unnecessary health consequences from occurring in the first place.

When seniors are given prescriptions, it’s important for them to speak to the pharmacist or physician in detail about when and how to take the pills properly. For example, certain pills must be taken with food, while others need to be taken on an empty stomach.

The physician needs to know about all of the medications or supplements that are being taken. One guideline for seniors is to bring to the doctor’s office a detailed list of every medication or supplement they are currently taking. Alternatively, they can bring in all of the bottles for the physician to review for potential drug interactions, side effects, or expiry of any of the medications.

Some seniors, and people a lot younger than seniors, feel overwhelmed by all the information they get at the doctor’s office. There’s no need for embarrassment; this is a common occurrence. Bringing a loved one to the appointment with a pen and paper is a good idea; it is always best to have an extra set of ears listening to the details. Some physicians will also allow the use of a hand-held recorder during the visit.

It’s important to be prepared with a set of questions to ask the doctor when new prescriptions are given. (See sidebar for some suggestions.) When side effects from new medications or new dosages are even suspected, seniors should consult their doctors immediately.

Calendars or charts that clearly outline when and how medications and supplements need to be taken are useful–maybe even lifesaving–references. These should be placed near where the medications are going to be taken, such as the door of the fridge. All medications should be kept in the same place in the home (someplace cool and out of the sunlight). A yearly inventory of all medications is important, as is getting rid of any that have expired.

Preventive Health for Seniors

Although these recommendations are important for seniors to be aware of, the ultimate health goal is to take fewer medications in the first place–whether prescription or over-the-counter. Regardless of their age, seniors need to be active participants in their health and health care. Preventive health care is not just for those in their younger years; it can make old age exciting and filled with energy and optimal health.

In terms of lifestyle choices, it’s important to maintain an optimal body weight. Excess weight is typically associated with disease processes such as high blood pressure, heart disease, stroke, and cancer. Exercise, whether it is walking, golf, swimming, light weights, or yoga, is essential; the joints in the body lubricate themselves through movement. Don’t smoke. If you do smoke, quit. Smoking is the number-one age accelerator.

Diet and digestion play a role, too. Drink a minimum of six glasses of water per day. Many seniors don’t pay enough attention to their water intake and become dehydrated. Load up your diet with disease-fighting substances called phytochemicals. These are found in fruits, vegetables, and soy. Blueberries, tomatoes, and broccoli top the list in terms of antioxidant strength.

Nutritional supplements should not be overlooked. As you age, your stomach acid and digestive enzymes decrease. If you are experiencing digestive disturbances, speak to your local health food store or a holistic health-care practitioner about supplementing your diet with a hydrochloric acid (HCl) and enzyme combination. Supplement with a daily multivitamin, vitamin E, fish oils (2-3 grams), and vitamin C to maintain proper immune system and brain function. If you are male, supplement with saw palmetto daily to maintain prostate health. If you are female, consume a moderate amount of high quality soy products for their weak but beneficial estrogen-like effects.

You Won’t Have to Lie About Your Age

As Lucille Ball once said, in her final years, “The secret to aging well is to live honestly, eat slowly, and lie about your age!” My wish for all is that our days are long and filled with health, laughter, and vibrancy. By being medication smart, leaning on others for help when necessary, and following a preventive health care approach, seniors can live an active and fulfilled life.

Medication Mishaps

According to Health Canada, medication risk factors in seniors occur when

• medications that may be inappropriate for a senior’s health needs are prescribed
• medication is not taken exactly as prescribed (non-compliance)
• prescription medications are combined with over-the-counter drugs, alcohol, or other drugs
• prescription medications are taken without a prescription
• multiple-medication interaction results from inappropriate prescribing

Health Canada also estimates that

• seniors consume between 20 and 40 percent of all prescription medicines
• between 18 percent and 50 percent of all medications used by seniors are used inappropriately
• between 19 percent and 28 percent of hospital admissions for patients over 50 years of age occur as a result of medication problems
• 60 percent of these admissions are attributed to adverse reactions and 40 percent to noncompliance.

Questions to ask the doctor when getting a new prescription:

• What is the name of the medication?
• What is it used for?
• How long should I take it for?
• What are the side effects?

Few in the health care industry are paying attention to the fact that our senior population will nearly double over the next 25 years. This will represent an astronomical overall increase in health-care costs, as the senior population uses more than 50 of all health-care dollars.