Geriatric Aging: A Case Study

I am going to focus on a particular and an effective intervention for fall prevention in aged care facilities, which is medication review. According to Australian Commission on Safety and Quality in Health Care (2009, p. 72), almost all of residents in aged care facilities are prescribed one medication and more than 60% of residents are prescribed 4 or more medications, 47% taking psychoactive drugs regularly, 11% taking sedatives regularly and 21% taking antidepressants regularly. Polypharmacy is highly common in aged care facilities in this country and has been proven as one of the main factors for falls (Baranzini et al. 2009, p. 228). Certain types of medications are strongly associated with the negative outcomes, such as diuretics, antiarrhythmics,

Falls are highly common amongst the elderly, particularly those who lack mobility, are in hospital, or are living in a nursing home. When an elderly person falls, their activities of daily living may be impacted due to injuries sustained from the fall. It is essential that precautions are put in place to prevent falls in all settings. This essay will discuss the statistics surrounding falls, prevention strategies, and the impacts of a fall on a patient’s ability to complete activities of daily living.

Four articles were chosen with the first article being: Psychotropic medications, including short acting benzodiazepines; strongly increase the frequency of falls in elderly, written by Atrid Strien, Huiberdina Koek, Rob van Marum, and Marielle Emmelot-Vonk. The

However, they also increase overall mortality and increase their cognitive impairment. It was seen that those on the medications were more prone to falls, leading to hip fractures. Withdrawal from the medication actually reduced the residents fall risk as well as increased their verbal fluency (Jordan, 2014). So despite all of these warnings and known risks doctors are still determining that the pros outweigh the cons and are prescribing these drugs to dementia patients. It would appear that pharmaceutical companies play are huge role in contributing to this problem. These companies are improperly promoting their drugs to be used for these groups of people (Levinson, 2011). Elderly are already a vulnerable population and these pharmaceutical companies are preying on them simply for financial

One in six Canadians have a chronic disease, with these chronic diseases being especially prevalent in the elderly population, individuals 55 years of age or older. Elderly populations have four times the rate of chronic disease compared to the overall population (Government of Canada, 2017). In fact, population aging was stated as one of the three most prominent elemental determinants of chronic disease development, along with globalization and urbanization, by the World Health Organization (WHO) in 2005. One major form of chronic disease is osteoporosis, with related expenditures totaling over $2.3 billion per year (Tarride et al., 2012), contributing to the ever-increasing health care costs in Canada. However, many chronic diseases such

“polypharmacy as the use of five or more prescription medications—is common among seniors and can lead to reduced compliance with medication regimens and problems with drug–drug interactions” (2012, p.428). Elderly patients are mostly at risk to polypharmacy issues due to aging effects on how the body tolerates medications, and also, as a result of taking more medications than younger patients. Reason et al., continues to demonstrate that the use of prescription increase with age and in association with multiple morbidities in the elderly patients. Medications such as over the counter drugs, herbal preps, and home remedies are widely used by older adults. These medications have a higher risk of causing adverse drug reaction especially with

Polypharmacy is very prevalent in the elderly, due to multiple diagnoses that require medication management. Polypharmacy can be very dangerous in many different ways. There are so many drug-drug, drug-food, drug interactions that could occur with every drug. When a patient is taking over 10 medications it is hard to understand every interaction that could occur with each medication. In a patient with polypharmacy, medication reconciliation is extremely important for patient safety.

It is important to maintain patient’s cognitive status by stimulating her cognitive status and social activity thru leisure activities that improves memory and cognitive skills (crosswords, puzzles, bingo, cards, etc.). Likewise, enhancing the patient’s physical activity will improve brain function by increasing the oxygen delivery and cerebral blood flow of the brain resulting to decrease the risk of dementia. Due to her co-morbid illnesses and subsequent falls, it is important to use the Hendrich II fall risk model to help me identify her risk for fall. My patient’s age, co-morbid illnesses, multiple drugs, and renal insufficiency, this will make my patient at risk of polypharmacy. It is important for healthcare professionals to be more vigilant of the possible effects of her medications and before prescribing new medications to the patient. Likewise, patients and their caregivers must be educated about their medication and the possible side and adverse effects, so they have the knowledge when to seek help when

The pharmacokinetics and pharmacodynamics of many commonly used drugs vary significantly across all age groups. Adverse Drug Reactions are one of the major concerns in the elderly. Adverse drug reactions, especially those that may be preventable, are among the most serious concerns about medication use in elderly in clinical setting. The incidence of adverse drug reactions in patients more than 60 years old compared with younger patients (age less than 30 years) increased by two or threefold. The ageing process is associated with physiological and pathological changes. It then makes individuals at a higher risk of multiple morbidity and treatment-related complications. Predisposing factors to adverse drug reactions which have been noted including

Falls are a major problem in elderly population in the United States living in nursing facilities. Statistics from Agency for Healthcare Research and Quality (AHRQ) show that approximately 800,000 seniors fall each year and 1 in 3 of those will fall twice or one more time in a year. (Agency for Healthcare Research and Quality, 2012). Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling. Healthcare providers can help cut down a person’s risk by reducing the fall risk factors

Polypharmacy is the use of many different drugs concurrently in treating patient who often has several health problems. The growing geriatric population consumes the largest proportion of all medication than of other population groups. In Canada alone, one in three older adults takes more than 8 different drugs each day, and some take as many as 15 or more (Lilley, 2011). Polypharmacy can lead to what is known as the “prescribing cascade”, in which older adults develop adverse effects from one or more of the medications taken and the health care provider then prescribe another drug. The risk for drug interactions, adverse effects, and hospitalization is far greater in this situation. Acknowledging polypharmacy in a patients and

The word “fall” does not usually strike fear into the hearts of most people, but it should. Falls are all too common in the geriatric population, and they have devastating consequences. American Geriatric Society. (2016) falls are the leading cause of injury and death in adults 65 years and over. A person who falls may sustain severe injuries such as hip fracture, or head trauma. Falls have cost the US health system more than $19 billion and is predicted to increase to $54.9 billion by 2020. Falls are prevalent among elderly patients living in a Long Term Care Facility. According to Lee, A., Lee, K.-W., & Khang, P. (2013), argues that falls are the common and devastating problem among elderly clients causing a tremendous amount of morbidity,

To prevent falls, patients should be taught simple interventions that decrease their risk of falls. This applies to their stay in the hospital, as well as when they go home. While planning what the patient should be taught, the nurse should consider the risk factors and circumstances surrounding the patient’s needs (Quigley 2015). Medications are one of the risk factors to consider. The elderly, in particular, are more sensitive to a drug’s effects (Savita et al 2015). Many medications cause dizziness or orthostatic hypotension, while others like antidepressants have a sedating effect. (Savita el al 2015). Patients should be instructed to move slowly when going from a sitting to a standing position. It is a good idea to teach them to stand for at least one minute before beginning to walk. They also need to understand which medicines have a sedating effect, so they could plan their activities around their medicine regimen.

Accordingly, it was noted the repercussion of taking countless drug medications could result to multiple outpatient/ urgent care visits or hospitalization. A systematic review by Hamid, Ghaleb, Aljadhey, and Aslanpour (2013) identified “old age and polypharmacy” as risk factors to hospital admission caused by ADR’s and /or adverse drug events. It was attributed to people who are elderly and

Polypharmacy is generally defined as the use of multiple prescription and/or over-the-counter medications simultaneously. “The incidence of risk for adverse drug events, reactions, and interactions increases proportionately with the number of drugs taken, such that the use of five or more compounds increase risk for adverse drug events to more than 50% while the use of seven or more drugs results in a risk of more than 80% (Heuberger, 2012).” Having multiple prescribers, different filling pharmacies, medications taken with no clinical indication, and having multiple dose schedules increases the likelihood of polypharmacy (Edlund, 2012). Adverse drug events arise when the effects of a drug are altered by the co-administration of another drug or food substance, causing drug-drug interactions and/or food-drug interactions (Brewer, 2013). These drug-drug and food-drug interactions have been recognized as substantial components that increase the likelihood of morbidity and mortality in patients (Cheng, 2005).