Medication Management

Improper drug use is a major problem of the aging population. Because the elderly often suffer from a number of chronic conditions they are likely to take more medications than younger people. As a result, they run a greater risk of drug overdoses and side effects.

Elderly people may have trouble reading the instructions that come with their drugs because of failing eyesight. They may see several different doctors and not tell them about medication already prescribed, leading to overdoses or dangerous combinations of drugs. An elderly person taking many drugs may have trouble keeping track of which pills to take at what time and under what conditions. Without a system, people may forget to take their medicines, or take too much.

The physical condition of the aged person adds to the problem. The elderly do not absorb drugs as readily from their intestinal tract; their livers are less efficient in use of drugs; and their kidneys are less effective in getting rid of chemicals.

Also stiffness of joints may prohibit opening medicine bottles with childproof caps. Alone or in combination, improper drug use by the elderly can cause heart palpitations, confusion, blurred vision, dizziness, lethargy, delirium, insomnia, nausea, symptoms of dementia, bleeding problems, rashes, anemia, shortness of breath or other drug related ailments.

Tips to avoid drug-related problems

• Give and receive clear information when visiting the doctor about what medications the patient is taking and what the     medications should do.
• Organize a system for taking medicine.
• Recognize a medicine's negative side effects, and know what to do.
• Periodically have a pharmacist review all medicines, prescriptions and non-prescriptions.

Family caregivers questions for the doctor

To diagnose health problems and prescribe the proper medicine, a doctor needs information. At your parent's next visit:

• Bring all the medicine your parent is using or bring a written list of all of them, including non-prescription drugs such as aspirin, laxatives, vitamins, herbal remedies, etc.
• Bring a list of question to ask the doctor about any medicine he/she may prescribe such as:
  • What is the name of the medicine?
  • What should it do?
  • How should it be taken? How often? With or without food?
  • Any food or medicine that should be avoided?
  • What side effects should be watched for?
  • Are there any side effects that should be reported to the doctor?
  • Is this a generic drug? If not, is there a generic substitute?
  • How should the medicine be stored?
  • Are there any special cautions with this medicine?

Suggestions for family caregivers

Be sure your parent:

• Knows how and when to take his/her medications
• Takes medicines only as directed
• Takes medicine in a well-lit place
• Throws away old and outdated medicines
• Does not exchange medications with relatives or friends
• Does not transfer pills/liquid medicine from original container
• Knows where to store medicines
• Carries a personal medication record card

Other suggestions for caregivers

If medications are taken in the same dosages daily, use a daily pill container. Each morning put the day's pills in the proper section. Then, see that the pills in the appropriate spaces are ingested at the correct time.

If some prescribed medications are to be taken every other day, or in different dosages on different days, a weekly container system could be helpful. Some drugstores have small medicine holders with a different compartment for each day of the week. At the beginning of each week you would put pills in the proper compartment and then take them on the correct day.

Remember drugs need to be kept from moisture, heat and light, so storage containers must meet these requirements.

Caregivers can get a public health nurse or a personal care aide to help organize medications.

Many medications come in liquid form for elderly who have trouble swallowing. Some drugs can be masked or pulverized and mixed with honey to facilitate swallowing.

If times prescribed for drug administration are inconvenient, ask physician or nurse to rearrange dose. (How early or late a dose can be given depends on the type of drug, how often it must be taken, and whether it may be taken before, with or after a meal.)

The easiest way to remember when to give or take a pill is to tie procedure in with meals (before, with, after) or other activity such as bedtime, wake-up time, or nap time.