Medications have the potential to harm senior health
For most older adults, taking medication is essential for managing serious health conditions and improving quality of life.
But it’s important to be aware that medications can also cause harm, especially for seniors.
Are you confident that all the medications your older adult is taking are necessary for maintaining or improving their health?
Do you know if any drugs are causing or worsening certain symptoms?
Dr. Leslie Kernisan, an experienced geriatrician, discusses top issues about how medication can affect older adults.
In her full article, Dr. Kernisan explains 6 common medication problems in seniors and 6 ways to minimize the problems drugs can cause.
We summarized the key points from her article and share additional tips and perspective.
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6 common medication problems in seniors
1. Side effects that worsen thinking and balance Many common medications cause side effects that affect thinking and balance.
These include:
Anticholinergics – a class of drugs that are widely used for conditions like overactive bladder, trouble sleeping, itching, allergy, nausea, nerve pain, depression, and more
Sedatives / tranquilizers – usually prescribed for sleep issues or anxiety
Medications that affect memory, increase fall risk, or cause confusion
2. Symptoms that don’t improve Sometimes symptoms don’t get better even after starting a new medication.
When doctors start an older adult on a drug to treat a certain health condition, they’ll choose a specific dose.
But they typically don’t follow up to find out if adjustments are needed to properly treat the symptoms.
When this happens, older adults end up taking medications that aren’t working and that could interact with other drugs.
And, they’re spending money on the meds, but aren’t getting any benefit.
3. Drug interactions When multiple drugs, vitamins, or supplements are taken, they can interact with each other and cause problems.
For example, warfarin is a commonly-used blood thinner that can interact with antibiotics as well as with other drugs.
4. Drugs having a stronger effect than intended Older bodies process medications differently than younger bodies. Because of that, sometimes a drug will have a stronger effect than expected.
For example, a blood pressure medication could lower blood pressure more than it should, causing dizziness or lightheadedness that increases fall risk.
Similarly, a diabetes drug could end up lowering blood sugar too much, causing falls or faster cognitive decline.
5. Difficulty scheduling and taking medications On average, people over 65 take 14 – 18 prescription medications a year. That’s a lot to manage, especially when drugs need to be taken at different times of day.
Getting medications mixed up, missing doses, or taking too much or too little of a drug can cause serious health issues.
6. High cost of medications Prescription drugs are expensive, even with coverage from Medicare Part D plans.
If an older adult doesn’t have the budget to cover the medications they need, they may skip doses or not fill prescriptions.
6 ways to minimize medication problems in seniors
1. Check the Beers List The Beers List for Potentially Inappropriate Medication Use in Older Adults is a list of medications that are more likely to cause problems for seniors because older bodies process drugs differently.
The Beers List helps doctors be aware of potential side effects so they can use greater caution when prescribing drugs to older patients.
Check your older adult’s medications to see if anything they’re taking is on the Beers List. But DON’T make any changes if you see that your older adult is taking something on the list – that’s very dangerous and there could be a good reason the doctor chose that specific medication.
What is recommended is contacting their doctor to discuss the pros and cons of the medication, if the dose is appropriate, and if there are potential side effects or interactions that you should watch for.
Another helpful list from the American Geriatrics Society covers 10 medications that seniors should avoid or use with caution – see it here.
A pharmacist can also help spot potential risks with your older adult’s medications.
Advertisement 2. Make a complete list of all medications, vitamins, and supplements being taken and understand why they’re needed Keep a full list of all drugs that your older adult is taking That includes prescription medications, over-the-counter (OTC) medications, vitamins, and any supplements.
For every drug, find out the reason why your older adult is taking it and how it helps them Don’t be afraid to ask the doctor or pharmacist to explain.
Ask the doctor if all their medications are still needed They should eliminate or modify anything that isn’t working well or is no longer needed. A drug could have been started and then forgotten about – even though it should have been discontinued long ago.
Consider if the drug is still doing its job For example, is a painkiller effectively relieving your older adult’s pain? If the doctor hasn’t recently reviewed the symptoms and the drug, be sure to discuss it with them.
Ask the doctor if there are non-drug alternatives that can be tried For example, drugs for depression or anxiety could be reduced in dosage or eliminated with the help of regular therapy or counseling sessions. Physical therapy or certain exercises could reduce pain and reduce the need for painkillers.
Ask the doctor if a lower dose could do the job The risk of side effects and drug interactions increases with higher doses. So, if lower doses could work just as well, they should be considered.
3. Check for drug interactions Ask the doctor or pharmacist to check the entire list of drugs (including OTC, vitamins, and supplements) for potential interactions.
Or, check the list yourself when you prepare for a discussion with the doctor. Find out how here.
If you discover a potential concern, let the doctor know right away. DON’T stop the medication or change doses on your own – that can be very dangerous.
4. Get help with medication costs If your older adult’s prescription medications are straining the budget, explore different ways to lower the cost.
For example, working with the doctor to identify medications that aren’t effective or aren’t needed means reducing the number of medications that are needed.
We’ve also got 7 tips to help lower drug costs and 5 options for drugs that aren’t covered by Medicare.
5. Simplify medication schedules If your older adult’s medication schedule is getting too complex to manage, ask the doctor or pharmacist about options for simplifying their medication needs or routine.
For example, maybe certain medications are no longer needed and can be safely discontinued.
Or, there might be a once-a-day dose that works just as well as taking the drug 3 times a day.
And, in some cases, perhaps a non-drug alternative could reduce or eliminate the need for a medication.
6. Keep the doctor fully informed and up-to-date You see your older adult more often and know them and their routine far better than their doctor could.
When your older adult sees any of their doctors, make sure they review the full list of drugs (including OTC, vitamins, and supplements).
One doctor often won’t be aware of drugs prescribed by another doctor – you might be the only person who has the full picture.
Also, it’s important to let the doctor know if your older adult hasn’t been taking certain medications or if they tend to forget or skip doses.
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By DailyCaring Editorial Team Image: Whole Home Fall Prevention Task Force
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