Medications
Clearly, medications play larger and more important roles in many of our lives. They can be wonderful and contribute to our well being. Or, if not taken properly and in accord with physician directions, they can be deadly. Failure to take medications can have disastrous results. Simple changes in medications can lead to a higher incidence of falls. Connected for LifeSM members will have tools to assist in medication adherence that will be accessible by caregivers and those receiving care.
Medication and Aging
Caregiver Advocacy
How can a family member or a caregiver contribute to the sharing of information necessary in many of the complex situations that arise in treatment of an older person--for example, designing a new regimen that will correctly treat the mix of old and new problems and avoid causing additional ones?
One solution would be for older adults to designate a person to serve as caregiver advocate. The advocate will agree to become familiar with the older person's medications and the reasons for their use. This person need not provide hands-on caregiving (although these roles may be combined) but, rather, will be a source of information about the older adult.
Important facts health care professionals need to know include the complete list of medications being taken, allergies, and recent symptoms or behavior changes. Unlike the health care representative named in a health care power of attorney, who may live far away, the caregiver advocate should be someone in frequent contact with the older person. If the caregiver advocate is empowered to be part of the health care team, it would result in more effective communication, better medication management, the achievement of optimal therapeutic outcomes, and improved quality of life.
Medication-Related Problems
Medication-related problems in older people arise in four basic areas:
appropriateness, effectiveness, safety, and compliance.
Medication Appropriateness
* Unnecessary medication therapy. This is a problem that includes medication use without a valid medical indication, medication use when non-drug therapy is more appropriate, multiple medication use for a condition for which one single medication therapy is indicated, and medication use to treat an avoidable adverse medication effect associated with another medication. The problem occurs commonly with the use of antibiotics, with certain gastrointestinal medications, and often with certain sleep medications or medications that affect the central nervous system.
* Need for additional medication therapy. Additional medication required can include medication therapy to treat a previously untreated condition, additional medication therapy to augment the effectiveness of medication to treat a condition optimally, or medication therapy to prevent development of a new medical condition. In the older population, incontinence, heart failure, and depression are grossly under treated, and vaccines are still dramatically underused, even though we know that immunization saves lives, reduces morbidity, and saves money.
Aging, Medications and Mental Health
Among the first signs that a drug may not be working properly in an older person is a change in mood, energy, attitude, or memory. Too often, these alterations are overlooked, ignored, or chalked off to "old age" or senility. Older people may themselves feel that their blue mood is caused by something external such as the death of a friend or simply by boredom. Nothing could be farther from the truth. Virtually every heart medication, blood pressure drug, sleeping pill, and tranquilizer has been known to trigger depressive symptoms.
When a psychological symptom appears in an older person, examine his or her medication or drug use first. Consider, too, factors like alcohol intake, poor nutrition, and hormone imbalance. And never dismiss the possibility that a real psychological problem has developed and may itself require medication. Any older person with feelings of hopelessness, worthlessness, unexplained crying, thoughts of suicide and similar symptoms could be among the five percent of the elderly who have a treatable, reversible depression.
Medications Mistakes
6 Tips to Avoid Medication Mistakes
1. Find out the name of your medication. Rather than simply letting your doctor write a prescription and send you on your way, be sure to ask the name of the medication. "This way you'll notice if the pharmacy gives you something different," says Cindi Fitzpatrick, BSN, a registered nurse and a consumer safety officer in FDA's Center for Drug Evaluation and Research. "Also, every time you receive a refill, look at the medication before you leave the pharmacy to make sure it looks the same as what you had before. Is it the same color, size, shape, and texture? Is the packaging the same? If anything about the medication seems different, ask the pharmacist about it."