Top Eight Medication Pitfalls for Seniors

Provided by: Home Instead Senior Care
www.homeinsteadottawa.ca

 

Seniors on multiple medications begin a slippery slope that can lead to disaster if their medications are not properly managed, according to a representative for the Canadian Society of Consultant Pharmacists (CSCP). Pronica Janikowski, Professional Development Coordinator of the CSCP says: “A senior with four health problems – an eye condition, hypertension, cardiac issues, and diabetes – could be taking eight different medications, and sometimes there are side effects and they take medications for the side effects too.”

Janikowski says that in addition to prescription drugs, many seniors take herbal remedies, over-the-counter laxatives and pain medications.

“People are not aware of what medications their senior parents are taking and what services are available to them,” she says. “They often don’t find out until they’re in the middle of a crisis. They should be proactive and check what their parents are taking before a crisis happens. This is why seniors need a friend, a family caregiver or a professional caregiver to look out for them. They need an advocate who goes with them to the doctor to make sure that any changes in medications are followed correctly.”

Home Instead Senior Care’s^® Caring For Your Parents: Senior Emergency Kit^SM can help older adults and their families track medications in an effort to prevent problems. This toolkit provides family caregivers with everything they need to be prepared for an emergency. Common types of medication-related problems include:

1. Untreated conditions – The patient has a medical condition that requires drug therapy, but is not receiving a drug for that condition.
    
2. Drug use without indication – The patient is taking a medicine for no medically valid condition or reason.
    
3. Improper drug selection – The patient’s medical condition is being treated with the wrong drug or a drug that is not the most appropriate for the special needs of the patient.
    
4. Subtherapeutic dosage – The patient has a medical condition that is being treated with too little of the correct medication.
    
5. Overdosage – The patient has a medical problem that is being treated with too much of the correct medication.
    
6. Adverse drug reactions – The patient has a medical condition that is the result of an adverse drug reaction (ADR) or adverse effect. In the case of older adults, ADRs contribute to already existing geriatric problems such as falls, urinary incontinence, constipation and weight loss.
    
7. Drug interactions – The patient has a medical condition that is the result of a drug interacting negatively with another drug or a food.
    
8. Failure to receive medication – The patient has a medical condition that is the result of not receiving a medication due to economic, psychological, sociological or pharmaceutical reasons.

For more information, visit the Canadian Society of Consultant Pharmacists at www.cscpharm.com. Check out www.SeniorEmergencyKit.com to learn more about the management tool, or contact your local Home Instead Senior Care office.

Give and Take: What you and your senior loved one should know about medications

Safe medication management involves give and take between the patient, his or her doctor and pharmacist.

Seniors can benefit from an advocate, such as a family member or friend, to make sure they are asking a doctor or pharmacist the right questions. CAREGivers^SM from Home Instead Senior Care^® are often called upon by family members to accompany an older adult to the doctor, serving as a second set of eyes and ears.

Pharmacists are another important source for medication information. They can answer questions about the medications being prescribed, but cannot discuss diagnoses. Consider the following from Home Instead Senior Care and the Canadian Society of Consultant Pharmacists (CSCP) site at www.cscpharm.com.

What a Senior Needs to Share With a Doctor:

• Tell your doctor about all the medicines you are already taking. This includes prescription medicines and the medicines you buy without a prescription, such as aspirin, laxatives, vitamin supplements, and home remedies. It’s helpful to take along a written list or go to www.SeniorEmergencyKit.com and fill out a medication tracker form to take along.

• Tell your doctor what is important to you about your medicines. You may want a medicine with the fewest side effects, or fewest doses to take each day. If you have trouble swallowing, you may want a liquid form of medicine. You may care most about cost (there may be a generic drug or another lower-cost medicine you can take), or you may want the medicine your doctor believes will work best.

• Tell your doctor if you have any allergies to medications or if you have had any troubling side effects from medicines.

• Tell your doctor if you have any illnesses or problems for which another doctor or health professional is treating you.

• Tell your doctor if you are not taking your medicine as directed. For example, some people may stop taking their medicine, take a lower dose, or skip doses if they are having side effects. Your doctor needs to know about any changes in your treatment plan. Do not let guilty feelings or embarrassment keep you from telling your doctor this important information.

What a Senior Needs to Ask a Doctor About a Prescription:

What is the name of this medication and why do I need it?

What is this medication supposed to do?

What is the correct dosage?

How does this drug interact with other medications I am taking?

How do I take it – with or without food?

When do I take it – a.m. or p.m.?

What are the benefits and risks of the medication?

What are the side effects of the medicine, and what do I do if they occur?

What food, drinks, other medicines or activities should I avoid while taking the medicine?

How often must the doctor check the medicine’s effects? For example, checking your blood pressure if you are taking a medicine to lower it, or having a laboratory test done to make sure the levels of medicine in your blood are not too high or too low.

Do I need a refill and how do I get one?

Is there written information I can take home about the medication? (Most pharmacies have information sheets on your prescription medicines.)

Seniors who are seeing multiple doctors are at increased risk of medication problems. Try to ensure that older adults have one doctor overseeing all of their medications. Also, look for an independent pharmacy or a specialist in geriatrics, geriatric pharmacotherapy and the unique medication-related needs of the geriatric population.

The Warning Signs: How medication problems can hurt older adults

Seniors and family caregivers should look for warning signs that would indicate a problem with a medication. “When there is a change in medication, you should watch for changes in behaviour,” said Pronica Janikowski, Professional Development Coordinator of the Canadian Society of Consultant Pharmacists. “The person may be confused or dizzy and this can lead to a fall. Sometimes changes in medication can also make them drowsy, so if they are suddenly sleeping all the time or experiencing a change in appetite, it could be a sign to watch for.”

Medication-related problems can cause, aggravate or contribute to common and costly geriatric problems including:

• Confusion
• Delirium/hallucinations
• Depression
• Dizziness
• Falls
• Incontinence
• Insomnia
• Loss of coordination
• Malnutrition/dehydration
• Memory loss
• Psychiatric problems

In the lives of seniors, these issues can then lead to decreased quality of life, emergency room and doctor visits and hospitalizations, hip fractures, loss of independence and even death.

For more information about how a Home Instead CAREGiver^SM can keep seniors safe at home, visit www.SeniorEmergencyKit.com         and contact your local Home Instead Senior Care^® office. To find a Home Instead Senior Care office near you, visit www.homeinstead.com.

Toolkit Helps Family Caregivers Be Ready for the Call

The Home Instead Senior Care^® network’s Caring for Your Parents: Senior Emergency Kit^SM, information management tool can help ensure that family caregivers have fast and easy access to important information about their loved ones in case they get an emergency call.

The Home Instead Senior Care network worked with Humana Points of Caregiving^® to develop the tool as a resource to give family caregivers ready access to a senior’s doctors, pharmacy and insurance company, medications and dosage details, as well as allergies and other important information.

This toolkit will provide family caregivers the following information about their senior in a centrally located file:

• Checklist of important contact names and information
• Medication Tracker
• Allergies and Conditions Worksheet
• A Doctor Visit Worksheet
• A Senior Health Tracker Magnet to place on a loved one’s refrigerator
• A Wallet Card for seniors to carry when they are away from home

The file also will give seniors and their family caregivers one location to house important documents or copies of information such as:

• Health Care Proxy
• DNR Order
• Advance Directives such as Living Will and Durable Power of Attorney
• Insurance Policies
• Will and Testament
• Copy of Medicare/Medicaid Card
• Anatomical Gift/Organ Donation Card
• Valuables Designation List

The toolkit is part of the organization’s Answering the Call^SM program designed to help family caregivers be ready for a call that their senior loved one has had an emergency. To learn more about these resources, go to www.SeniorEmergencyKit.com.

Resources including Mission Medicine (if appropriate to the market)

www.homeinstead.com – The Home Instead Senior Care^® network is the world's largest provider of non-medical in-home care services for seniors, with more than 900 independently owned and operated franchises providing in excess of 40 million hours of care in 16 countries including Canada.

Visit www.SeniorEmergencyKit.com to learn more about the management tool, or contact your local Home Instead Senior Care office.

www.pointsofcaregiving.com - Humana Points of Caregiving® is your complete caregiving community, with expert information, advice, and tools to help you make caregiving decisions with confidence, including 24/7 access to telephonic consultations with trained caregiving advisors. For more information, call 1-877-260-7277 (TTY: 711) Monday through Friday, 8 a.m. to 8 p.m. Eastern time.

www.cscpharm.com – The Canadian Society of Consultant Pharmacists is a chapter of the American Society of Consultant Pharmacists, an organization of 1,500 North American consultant and senior care pharmacists who are specialists in geriatrics, geriatric pharmacotherapy and the unique medication-related needs of the geriatric population.

http://www.canadiangenerics.ca/ – The Canadian Generic Pharmaceutical Association has represented the pharmaceutical industry – manufacturers, distributors, suppliers, etc. – for more than 50 years and plays a vital role in the country’s health-care system by providing safe and effective alternatives to brand-name medicines.

www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/safe-secure-eng.php – Health Canada offers a variety of resources and detailed information to ensure seniors are taking medication properly and minimizing risks.

www.phac-aspc.gc.ca/seniors-aines/publications/public/medication/med/med-01-eng.php – The Public Health Agency of Canada has compiled a medication kit to help seniors use medication safely.

www.learnaboutrxsafety.org – Medicine Safety is a website from The Center for Improving Medication Management & the National Council on Patient Information and Education that provides more information about the safe use of prescription and over-the-counter medications.