This month’s column needs a preface about the January Aging Matters column, which revisited Adult Family Homes.
A reader residing in a Kitsap County AFH pointed out that the phone number I’d listed for the long-term care ombudsman, Gayle Helseth-Kenison, was incorrect. The correct number, which I’d transposed, is (360) 337-5714.
The ombudsman program as I described it is still in place and can be a resource for you if you are researching boarding-home options (AFHs and assisted living facilities). Please accept my apologies for the error.
Overmedication
This month’s column topic was suggested to me by a friend in Hansville. Overmedication can mean either a proliferation of medications or a dosage that is too high.
Polypharmacy — meaning administration of more medications than are clinically indicated — is a common issue for the elderly because of several factors, largely driven by the number of ailments that can affect an elderly person. A 2006 EzineArticles.com story, “Overmedication in Seniors,” reported that at age 65, 66 percent of people have two or more chronic conditions requiring prescription medications, and by age 80, 70 percent have several chronic conditions, such as heart disease, high blood pressure, diabetes, arthritis, depression, etc.
Complexities related to the number of medications taken include increased likelihood that the patient forgets or otherwise fails to take all of the medications properly. For example they might forget to take the medication at the right time or with or without food. The author, a nurse, maintains that only 30 percent of the elderly take medications correctly.
Chances of drug-drug interactions and cumulative drug side-effects also rise in the case of large numbers of medications. Further, as the number of medications prescribed rises, patients are also increasingly at risk of failing to list the over-the-counter medications that they are taking when talking with physicians. That omission can lead directly to over-dosing.
Some significant proportion (20 percent or 35 percent, depending on the article you read) of older adults’ hospital admissions are attributable to non-compliance with medication regimen, or under-medication, or over-medication. A further proportion of the drug-related admissions are attributable to falls.
What to do?
If you or someone you care for is experiencing increasing prescription medications, the first priority is to determine whether the older person needs assistance with administering the prescriptions.
If the elderly person is open to your involvement, you can find out whether the patient knows the purpose, correct dosage, and timing of each medication, as well as side effects. If the patient is unclear about these facts, you can offer to help with lists, pill boxes, and other devices.
In my experience it is essential that someone — you or some other trusted person — accompany the patient to physician appointments to help listen to the physician, ask questions if necessary, make notes, and ensure follow-up.
An objective advocate or companion can be invaluable in keeping the information straight. I’ve also taken medications or a list of them to a pharmacist to find out whether there are potential duplications and/or unanticipated interactions.
My mother’s physician was extraordinary in that she frequently invited collaboration in reducing medications my mother was taking. Sometimes it’s not so easy to accomplish that, but if a patient has multiple health issues, as the statistics suggest is becoming commonplace, it could be helpful.
Story after story indicates that what is sometimes diagnosed as dementia is in fact a result of polypharmacy, and patients can improve their cognitive and physical functioning by systematically withdrawing the excess medications.
Reach columnist Bobbie Moore at elliottmoore@comcast.net.
