Walk into the average senior citizen’s home and you’ll likely find a pill box filled with multiple pills of varying sizes and colors. Seniors consume 40% of all prescription drugs manufactured in the United States, and they also purchase 35 % of the over the counter medications.
The reasons for this vary, from over-medication to control of chronic diseases and multiple conditions. The result is often confusion. The average 65 to 69 year old takes 14 prescriptions per year, while those individuals aged 80 to 84 consumer 18 prescriptions per hear.
Not all of those pills are medically necessary. According to the Journal of the American Geriatric Society, about 15 to 25 percent of medication use in seniors is unnecessary or inappropriate. Of that number, the medications over prescribed most often are antihistamines, laxatives, antispasmodics and anti-depressants. These medications can cause side-effects that might simply look like symptoms of a disease like dementia, including blurred vision, incontinence and falls.
Many times seniors get medications from various doctors, or have prescriptions filled at various pharmacies. As a result, the medications they think they’re taking to get better make them worse. In fact, adverse drug reactions are responsible for 28% of hospitalizations among older adults. And 36% of all reported adverse drug reactions involve an elderly individual.
Beers conducted a study that looked at the number of medications that needed to be taken before the risk of an adverse interaction occurred. Turns out it’s not a large number. When someone takes more than four medications, their risk for an interaction goes up 100 percent.
Learning medication management tips, and managing medications is critical to reducing the risks of adverse reaction. What medication management really involves is making sure the medications being taken are medically necessary. Secondly, medication management involves making sure those that are needed are taken properly.
Some ways in which people don’t adhere to a medication schedule include failing to fill a prescription or a refill, skipping does, taking more than prescribed, taking medications at the wrong time, with the wrong food or liquids, taking expired or damaged medications or not using medical devices properly.
Cost can be a factor, too. When a family is paying $300 a month for a medication like Aricept, used to treat symptoms of Alzheimer’s, there is sometimes a financial incentive to take fewer of the pills. However, Aricept is a medication that needs to be tapered off.
When a loved one has dementia, medication management can be extremely difficult. Family members and caregivers need to be involved, or if out of town, the use of a nurse care manager may be the best alternative. As for home care medication management, under California law, home care aides are not allowed to administer medications or organize pill boxes. An RN or LVN is allowed to organize pill boxes, as long as they are employed by a licensed home health agency. Most home care agencies do not have this license, so be wary if they offer to organize pill boxes for your loved one. Some home care agencies claim that their on-staff nurse can organize or administer medications. This is not true. A home care agency nurse can provide evaluations, but only a nurse who works for a licensed skilled nursing agency can organize pills.
Once pill boxes are organized, home care aides can provide reminders to people who can self-direct taking those medications.
Family members can organize pill boxes and there are ways to do this effectively. We recommend using a medication chart that is brought to each doctor’s appointment and pharmacy appointment. It’s important to visit a physician once a year for the purpose of evaluating medications, doses, and deciding whether any changes should be made.
It’s also a good idea to get all prescriptions filled by a single pharmacy. This is the best way to get a red flag of potential drug interactions.
Finally, also be sure the family knows how to dispose of medications properly. This is another question for a pharmacist. Don’t keep old or unnecessary medications. They too can pose a danger in terms of potential drug abuse, or by adding to the confusion of an elderly person already taking up to 18 pills daily.
