Why is managing medications in older adults important? Older adults consume 40% of all prescription drugs in the United States, and 35% of the over the counter medications, and some studies show up to a quarter of those medications are not necessary or beneficial.
Most seniors juggle doses of three to eighteen pills each day, often taking them for years without an updated review or consolidated medication profile.
The reasons for the large consumption of medications 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 more than 15% of hospitalizations among older adults. A National Institutes of Health study in 2019 showed that 40% of those hospitalizations were more likely preventable with better managing of medications in older adults.
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.
Here are five simple tips for managing medications in older adults:
When an older loved one has dementia, managing medications 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.
When managing medications, a home care RN or LVN are appropriate for organizing pill boxes for clients, after an RN completes a medication profile to record all medications, including over the counter medications, in one plan. The medication profile should be double checked by the client’s primary care physician for accuracy.
Home care aides can provide daily medication reminders to help clients stay on the medication schedule.
It’s also a good idea to get all prescriptions filled by a single pharmacy. This is a good way to red flag of potential drug interactions. The software used by most home health agencies will also highlight risky medications.
Finally, unused or expired medications should be disposed of properly. There are drop of areas in most police department offices, plus ways to safely put old medications into the trash, never the toilet or drain. 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.
Taking these steps may reduce the risk of hospitalization over medication errors, and add to the quality of life of your older loved one.