Medication: Special Concerns in Dementia and Alzheimer’s Patients
Many older adults must take several medications each day as they strive to keep their health in balance and remain independent. As many as 10 percent of people over age 65 take five or more prescription drugs, requiring them to juggle potentially dozens of pills every day. Painful arthritis may make opening a pill bottle seem as difficult as crushing a stone. Failing vision might prevent some older adults from reading key warning labels or instructions.
While a medication organizer, pill bottle opener or magnifying glass can help to overcome some medication-taking obstacles; we cannot prevent the normal aging process. Both the liver’s ability to inactivate drugs and the kidney’s ability to [get rid of] drugs slow with age. A doctor must lower the dosage of certain drugs to prevent over-medicating and avoid causing side effects, Beers warns.
Several key factors put older adults at greater risk for reactions to medication such as falls, confusion or drowsiness, and medication-related hospital admissions. Both you and your doctor must work together to minimize potential pill-related pitfalls.
Tips For Medication Use By Older Adults
The more medications someone takes the greater the risk for a drug reaction, particularly with increasing age. Furthermore, it is not unusual for doctors to prescribe the same dose of a medication for both a 200-pound athlete and a 90-pound older adult with chronic illnesses. Weight and size do matter. Muscle (lean body) mass drops with aging as the body stores more fat cells. Body size, percent fat, and how lubed and primed the kidneys are can significantly affect dosing of popular drugs such as antibiotics (cephalosporins, penicillins, quinolones), heart drugs (digoxin, atenolol, ACE inhibitors), and even the household pain reliever acetaminophen. Taking medication comes down to a risk versus benefit analysis and a few basic guidelines:
- Be certain your doctor periodically reevaluates all medications you take for possible dosage adjustments, drug-drug reactions, drug-disease side effects, and if a drug can be safely discontinued.
- Hume advises older adults to always ask if a drug can make them drowsy or dizzy and if there are ways to reduce those effects.
- Tell your doctor about any over-the-counter medications you take as well as herbal remedies. These may interact with prescription medications or have side-effects.
- Each time you renew a prescription, be sure you receive the same generic product. Different formulations of a medication can actually contain up to 10% more or less of the active ingredient.
- When you get a new prescription, clarify with your doctor how long you must use that medication and how it should be taken.
- Beers advises patients to use their pharmacist as a resource for reviewing all medications to check for interactions. This strategy is particularly useful if your doctor seems rushed when going over your medication.
- Be prepared with the right tools for the job. Purchase a pill splitter if you take only half a pill, as long as your pharmacist says that drug can be split. A large magnifying glass can be useful for reading directions or warnings in small print. Many inexpensive pill bottle openers can help those who have difficulty opening child safety caps. In fact, if you tell your pharmacist you cannot open safety caps and you have no children prancing around your house, the pharmacist will use a cap that opens with less effort.
- Consider buying one of many pill-dispensing gadgets to help you develop a system for properly taking all your medication. Check your local pharmacy or search the Web.
- Consider signing up for one of many available Internet services that send medication-taking reminders. Reminders can be in the form of telephone calls, emails, or a beeper.
Micha Shalev MHA is the owner of Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 Randolph Road in Worcester. The facility is holding two FREE support group meetings a month for spouses and children of individuals with dementia and/or Alzheimer’s disease. He can be reached at 508-853-8180 or by e-mail at firstname.lastname@example.org or view more information online at www.dodgepark.com