Older adults are at an increased risk for problems related to the use of prescription drugs, over-the-counter medications, and herbal or other alternative medicines. According to the February 2019 Kaiser Family Foundation Health Tracking Poll, 89 percent of seniors report taking prescription medications, including 54 percent who report taking four or more. The sheer number of drugs the average senior takes contributes significantly to problems associated with noncompliance, drug interactions, adverse drug reactions and the misuse of medications.
Physiological changes in the body associated with aging also make the elderly more susceptible to the undesirable effects of drugs. In fact, there are some medications that should not be prescribed to older adults at all because they are more toxic than comparable drugs.
Even when used as prescribed, drugs may cause urinary problems (incontinence), gastrointestinal problems (constipation, diarrhea, nausea and vomiting), cognitive impairment, changes in mental health (depression, delirium), dizziness, changes in sleep patterns, injuries (hip fractures), breathing problems, skin rashes, bruising and bleeding, and neurological problems. However, medication misuse, whether it is intentional or purely accidental, can have a devastating impact on a senior’s health.
Among the elderly population, adverse drug reactions are thought to cause between 10 and 30 percent of all hospital admissions, some of which prove fatal. Fortunately, there are several ways to help an aging loved one manage their medications responsibly and avoid drug-induced medical problems.
- Make sure the senior’s primary care physician is aware of all medications they are currently taking. Keep an up-to-date list or even bring the bottles and containers to each medical visit. Be sure that any specialists they see report back to their primary physician to ensure coordination of their care.
- Ask prescribing physicians to provide written instructions for taking each medication and written descriptions of any possible side effects. Remind your loved one to report any unusual symptoms to their physician.
- Make sure your loved one understands when and how to administer each medication. If you cannot accompany them during a medical appointment, call the physician or office nurse for these instructions.
- Ask your loved one if they are able to comfortably open and close their medication containers. You might want to purchase a pill box that is easier to open and organizes pills for easy dosing and tracking. Some pharmacies even offer pre-sorted medications that come in easy-to-open blister packs. However, if your loved one has trouble remembering when they’ve taken their medication and keeping their pill box straight, a locking medication organizer might be wise to prevent them from reorganizing their doses.
- If possible, try to use only one pharmacy to fill all medications so all your elder's prescription information is easily accessible. With this complete list, the pharmacist can screen for any drug interactions and answer any questions about the combined use of prescription and nonprescription drugs. Also, many pharmacies provide customers with a toll-free number or hotline for advice.
- If a senior does not consistently take their medications correctly on their own, then consider implementing a prompting system. Medication reminders can consist of a simple phone call from you, another family member or volunteer, an electronic prompt, or a personal visit.
- Regularly go through all medications in the home to properly dispose of any that are out of date or no longer part of your loved one’s regimen.
It is important to understand that managing medications is one of the instrumental activities of daily living (IADLs). Instrumental ADLs provide an effective measure of a senior’s ability to live alone. If you have determined that your loved one is capable of taking correct dosages of medications at the right times, even with some help, safe and independent living may still be possible. If the ability to independently manage medications declines and aids like medication boxes and reminders are not proving effective, it is time to consider increasing supportive services.