Blogcritics The critical lens on today's culture & entertainment
Prescription medications are an increasingly common part of our everyday lives and a key contributor to longer lifespans and increased quality of life. But for many seniors, prescription medications pose an unrecognized risk as well. Caretakers, family members, and doctors all can play a role in helping to keep older people safe, and that starts with getting organized.
Ask Questions
There are plenty of tools and initiatives meant to keep seniors safe from medication mistakes, but ultimately the best thing you can do is to start with the basics: make a list of all the medications an individual takes and carefully note the directions. And if you don’t understand the directions, make sure to ask the doctor or pharmacist.
As the professionals at John Muir Health note, medication safety is a shared responsibility. If you’re part of the care team for someone who can’t adequately participate in his or her own healthcare, it’s your job to clarify all directions for dosing and storage, and all information about potential interactions.
It’s perfectly normal if you’re not sure what questions to ask, so don’t hesitate to ask for guidance. Poison Control recommends using the same pharmacy to fill all medications since its computer system should automatically flag potential interactions, but to get a thorough assessment you should also inform the pharmacist of any herbal supplements or over-the-counter drugs the individual is taking.
Learn About Risks
For certain medications, such as opioids and benzodiazepines, addiction is a serious risk – but because elders aren’t viewed as likely addicts, doctors are prone to less vigilance when prescribing them these medications. Unfortunately, there’s no evidence that seniors are at a lower risk for addiction, and in fact, neurological deterioration can make them more vulnerable.
About 15% of patients leave the hospital with an opioid prescription, so ask the doctor how long that prescription should be continued. Without proper oversight, many patients end up in a loop wherein the doctor keeps renewing the medication. Half of that 15% are still taking opioids three months after discharge. In addition to risking addiction, opioids can increase grogginess, confusion, and depression, all common issues in seniors. If symptoms can be managed differently or patients weaned off the medication, that’s preferable and should be discussed with the doctor.
Monitor Other Caregivers
One reason seniors are so vulnerable to unsafe medication use is that they can no longer take their medications independently and may be subject to the whims of careless or abusive staff. In the UK, the Care Quality Commission (CQC) found high rates of turnover, insufficiently trained staff, and lack of medication oversight among caregivers for the elderly – and the situation is similar in the US where many caregivers are poorly paid women and minorities with few protections and dangerous jobs.
If you’re concerned that something is awry with a loved one’s care, there are a few things you can do. One of the first things to do is to check medication bottles, both to make sure that all drugs are accounted for and to verify that other patients’ medications aren’t mixed in.
You should also be aware of the risk that caregivers and other family members may steal medications from patients, particularly opioids and benzodiazepines. With the US in the grip of an opioid abuse crisis that’s overwhelming the foster care system, causing infants to be born addicted, and forcing professionals to reconsider harm reduction methods, it’s worth considering the possibility that a caregiver could be using your loved one’s drugs as an alternative to doctor shopping. Know the signs and monitor available medications.
Get Trained
Because medication safety is such a pressing concern on a national scale, take steps to improve your knowledge of proper administration and storage practices. Medicare offices hold regular fairs to help seniors and their caregivers assess medication safety and interactions and prepare you with questions to ask your provider. These events can be good starting points if you want to improve home care practices.
Professionals at Medicare trainings and similar events may also talk to you about the importance of medication reconciliation, the process through which practitioners review an individual’s complete drug list. This typically occurs upon admission and discharge, but especially during a hospitalization you may request that it be done more regularly. Since not all medication errors happen on prescribing – some are connected to administration or dosage – using reconciliation technology can reduce the likelihood of a drug error later in the course of treatment.
Prescription medication may be improving our lives, but it also poses distinct risks, especially for an aging population. As a caregiver, it’s important to step up and prevent mistakes and medication abuse. Your loved one’s life depends on it.
The most efficient thing a patient can do is to have a medications review at least yearly. A medications review is aimed at eliminating unnecessary medications or finding alternate ways to treat the medical condition. i.e. diet, exercise or life style changes.
The next important aspect is to understand the appropriate dose via discussions with the primary care physician and the local pharmacy. Sometimes, divided doses are more helpful.
When taking a medication for the first time, the wisest thing to do is to begin with a small dose and phase in the full dose. In this way, adverse reactions are identified quickly and major damage may be avoided.
There are serious side effects to taking too many medications. The most dangerous is blood toxicity from the Stevens Johnson Syndrome which is a serious adverse reaction to the medications taken as a whole. That’s why a periodic medications inventory is so critical.
Patients should understand the differences between a generic form of the medication and the original brand. Sometimes, generics are produced in places where there are few restrictions on manufacturing pharmaceuticals and/or quality control standards are minimal or non-existent.
People who take a lot of medications should have a more frequent blood/urine chemistry to measure the impact of the medications both individually and taken as a whole. Again, the purpose here is to remove unnecessary medications which have either an adverse impact or a negligible one at best.