Why medication management is critical for older adults

(Aging Untold) — Older adults managing multiple health conditions face serious risks when medications aren’t taken correctly.

Seniors 65 and older visit emergency rooms more than 600,000 times each year because of medication misuse, according to the Centers for Disease Control and Prevention.

“You need to take inventory,” Dr. Rhea Rogers, a board-certified physician, said. “You need to know what all medicines you’re on and have a list and not just the prescription medications, but also the list of over-the-counter medications, especially supplements, because they actually can interact.”

Polypharmacy poses risks

Rogers said older adults don’t metabolize medicines as quickly as they used to, creating higher risk for drug interactions.

“This polypharmacy, so to speak, is a real phenomenon,” Rogers said. “And so you can see people with falls and dizziness and confusion and all that. And you don’t really know what medicines they’re really on.”

Polypharmacy is defined as the practice of administering many different medicines.

Rogers said physicians need to go through medication lists carefully with patients and reevaluate their medical conditions.

“I’ve had instances where people have been put on certain medications and they’ve never been looked at again,” Rogers said. “And their conditions change. So that’s very important as well.”

Sam Cradduck, a gerontologist, said her mother was left on a blood thinner for two years after a heart attack and heart surgery when she should have been off the medication after six months.

“Two years later, she’s bleeding out and having issues because she should have been off the med in six months,” Cradduck said. “And it was it was a culmination of errors.”

Rogers said statins prescribed for high cholesterol are often left on too long.

“If your cholesterol gets too low, you start having memory issues,” she said.

Specialized pharmacists available

Amy O’Rourke, an aging expert, said people should take advantage of senior pharmacy specialists if available in their area.

“There’s pharmacists that specialize in older adults and their medications,” O’Rourke said.

She said people 65 and older take an average of 18 to 20 prescription drugs a year, plus supplements.

Some pharmacies will sort medications and put them in pill packs by dose, Cradduck said.

Hospitalizations create confusion

Cradduck said the biggest problem she sees occurs when there is a hospitalization and the hospital changes medications.

“The hospitalist comes in and jacks all the meds around,” Cradduck said. “They’re still in the pill containers at home, they’re still in the medicine cabinet, sends you home with an entirely new list. And then you’re trying to make those adjustments.”

She said to build a system now that is going to catch any mistakes.

O’Rourke recommends that caregivers go into the hospital with a list of medicines the patient is taking, look at the medicines at the hospital, and then match those two lists to make sure the patient is back on the medicines that work for them.

Tips for medication management

Cradduck recommended using a single pharmacy so pharmacists know all medications a patient is taking and they can catch potential interactions.

Weekly pill organizers help keep people on track, even those without cognitive issues, she added.

O’Rourke said if an older person has a system for their medicines that works for them, let them continue using it.

“The little pill by the bedside, and then there’s another pill by the orange juice glass and another pill by the coffeepot,” O’Rourke said. “And they remember to take their medicine. Well, allow that, because at least you know it’s successful.”

Rogers also recommended that caregivers sit down with patients and understand why they’re taking each medication and talk to the provider.

“Sometimes what happens, they end up having two medications for the same problem,” Rogers said.

Cradduck offered advice for people who visit the home of an older adult who is taking medication. Those who have small children should look for hidden pills in couch cushions, she urged.

“Because that turns into a really bad day in a real big hurry,” she said.