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Doctor's Thoughts

Medication Safety for the Elderly

Medications play an expanding role in health care as we grow older. People are increasingly likely to develop more than one chronic illness with advancing age. Appropriate medication can help seniors live longer and lead active lives. However, this medication use by older adults should be monitored closely to alleviate safety concerns.

With an ever increasing number of prescription medicines available and a growing population of older adults, the potential for medication-related safety problems are on the rise. As people age, a majority of those people will be prescribed more than one kind of prescription medication. In the case of seniors, many will take three or more. This increases the risk of drug interaction, mix-ups and potential for side effects.

Older adult bodies process and respond differently to medication when compared to younger people. This is due to the effects of aging. Age-related changes in the liver, kidneys, central nervous system & heart can expose vulnerabilities in elderly people; making them susceptible to overdose and side effects. Furthermore, age-related challenges such as memory loss or poor eyesight can make it harder to follow medication instructions. Financial issues may also prevent some seniors from filling prescriptions.

Drug interactions:

A drug-drug interaction occurs when two or more medicines react with one another, causing unwanted effects or rendering either medicine’s effects, more or less potent. Such interactions may also be caused by alcohol, nutritional supplements or herbal products in addition to non-prescription and prescription medications.

A food-drug interaction may occur when medicines react with foods or beverages. For example, grapefruit juice should not be taken with certain blood pressure lowering medications. Dairy products should be avoided with some antibiotics and antifungal medications.

Sometimes, a doctor can add a new medicine for symptom treatment to counteract side effects of another medicine (as opposed to the condition itself). This is known as “prescription cascading” and it can be problematic if a patient sources several different types of medication (polypharmacy) by visiting multiple health care professionals and/or clinics for care consultations.

Advice for patients and caregivers:

  •  If you are visiting a doctor, clinic or other health care professional (for the first time or follow-up), it is very important that you bring an up-to-date list of all the prescription and non-prescription medications you take, including herbal or dietary supplements, topical medications along with key facts about your medical history.
  •  If your doctor prescribes medication, make sure you understand the name of the medicine (trade name and generic); how, when, and for how long you should take it; any precautions or warnings about the medicine; side effects to watch out for, and what to do if they occur.
    -Ask what the medicine is intended to do and whether you will need any lab tests to monitor your treatment
    -Ask how long you need to take the medicine for and whether you should stop taking it once you feel better
  • If you take more than one kind of medicine, know the side effects that each can cause and make sure all your health care providers know what you are taking. Ask your doctor if you can stop, reduce the dosage or change any of your current medications (instead of adding another to the mix).
  •  Beware of effects from non-prescription medicine. Always seek advice and read the drug facts.
  • Seniors should consider asking for help from their family, caregiver, doctor or pharmacist; if they:
    -Live alone
    -Take 3 or more medications, including non-prescription medicine and herbal or dietary supplements
    -Have memory problems or are not as sharp as they used to be
    -Get prescriptions from more than one doctor
    -Fill prescriptions at more than one pharmacy
    -Use both online and community pharmacies