Senior Care and Medication Management
Nearly half of seniors do not take their medications when or how they were prescribed. There are mistakes on dosages, methods of delivery, time of delivery, what they should be taken with, and even if they should still be taken. Compounding the issue, most seniors over the age of 65 are taking between 8 and 13 different medications. Put these numbers together and it is no wonder that problems with medication management are one of the leading reasons seniors end up in the emergency room, and is the number one reason seniors end up back in the hospital after being recently discharged. According to a study published in "Pharmacotherapy", nearly 70 percent of hospitalized seniors suffered from at least one
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Most seniors over the age of 70 cannot name all of the medications that they are taking. They may remember that they need 2 red pills, one yellow one, and two of the little white ones, etc, but they can't tell you all of the names. With the crazy names of the medications and the mix of names between generics and name-brand, who can blame them? Yet, if there is a problem, doctors, first responders, emergency room personnel, etc, need to know exactly what they are taking, how much and when. A good medication management plan addresses this.
Logging why the medications are taken. Too often, medications are prescribed for a condition and the refills just keep on coming. Their condition may have been cured, a new medication may have been ordered, or another physician may have ordered a pill that conflicts with one that is already being taken. Senior care personnel can make sure the medication log reflects what is taken, why, and help check for duplications, contraindications, etc.
Know who and Where. Most seniors see many different physicians. Who ordered the medication? Why did they prescribe it? If somebody needs to check on a refill or ask for an alternative, who would they contact? Senior care personnel can help keep this list up to
It can be determined that the elderly seldom get drugs illicitly. As stated earlier, they usually get drugs by seeing multiple doctors. In addition to this, they stockpile prescribed medications over time, or getting medications from family members. This only contributes to the problems of the elderly. Often times, family members are reluctant to address the issues their elderly family member face.
When doctors prescribe medication for their patients, a local retail pharmacy is most likely to be utilized to fill the order. However, there is a growing population of older Americans that are no longer able to live independently and must reside in nursing homes or assisted living facilities. In order for this vulnerable population to receive their medications, a different kind of pharmacy is needed, these are known as LTC, long term care pharmacies. Within these specialized pharmacies there are highly trained employees called CPhTs, certified pharmacy technicians who are overseen by state licensed
Inappropriate prescribing commonly occurs in adults aged 65 or older, who have a higher prevalence of chronic disease, disability, and dependency (Page II, Linnebur, Bryant, & Ruscin, 2010). Exposure to inappropriate medications is associated with increased morbidity, mortality, and health care utilization (Page II, Linnebur, Bryant, & Ruscin, 2010). Below is a list of measures that concentrate on the prescribing of correct medications in the hospital
Senior citizens are the people who are most likely to take multiple medications due to the occurring chronic conditions as the aging process continues. Given the several medicines they take, they are ironically the age group that is very much sensitive to medication side effects, both therapeutic and negative.
How much knowledge do we have about the medications that we are prescribed from our physician? We don’t always as patients get to much knowledge about the medications from our doctor and we rarely ask the pharmacist about any concerns, and how many of us really have taken the time to read the description of the medications that is stapled onto the medication bag. I must confess I am not very good about that myself.
They continue taking drugs that may be unnecessary or unsuitable. According to Gayathri J. Dowling, Susan R. B. Weiss and Timothy P. Condon, authors of “Drug Abuse and the Aging Brain”, the dynamic nature of the brain suggests that drug abuse in older adults may have unique consequences that influence drugs’ effects in the brain. The abundant amount of medication found in the everyday lives of elderly patients is alarming and can do much more harm than good. The U.S. Department of Health and Human Services stated in a 2014 action plan that older adults account for 35% of all hospital stays and more than half of those visits are marred by drug-related
Polypharmacy, which is the use of multiple medications and/or the administration of more medications than are clinically indicated, which is very common in elder adults. Polypharmacy has many bad effects on the body of an elder. Taking medicine is already risky but taking more than one medicine especially different kinds can hurt the body. Taking many medicine can cause “Poor health, depression, hypertension, anemia, asthma, angina, diverticulosis, osteoarthritis, weight gain, diabetics mellitus, and use of 9 or more medications are the health risk associated with polypharmacy” (Hajjar, Cafiero, & Hanlon ,2007). These can occur because taking many medicines at the same time especially if the doctor does not direct you to do it that way, the medicine can
Are any of you are aware of the terminology of any medication taken or do you all simply take the medication because it was prescribed by a doctor? it is undeniable that drugs do save lives, but few prescription medications are completely free of risks or side effects. Naturally, the more drugs that are taken at the same time, the greater the risk of adverse interactions and potentially devastating side effects. This problem of “overmedication” is increasing to almost epidemic proportions among the elderly. For example, a recent Washington Post article that described an 83-year-old grandmother who wished to remain anonymous. The woman had been hospitalized for an asthma attack. In the hospital, she was prescribed
A list of all of the prescribed medications and over the counter medications that the patient is currently taking needs to be wrote out. Included in the list needs to be the route, side effects, when to take the medication, who prescribed the medication, and why they are taking the medication. Patient education is important for patients who are taking multiple medications. It is important for them to understand what the medication is doing for them, how and when to take it, and the possible side effects to be looking for. There have been a few systems or tools to help in the prevention of polypharmacy. The Beers Criteria, Screening Tool of Older Persons Potentially inappropriate Prescriptions (STOPP), and Screening Tool to Alert doctors to the Right Treatments (START) are all used in hospitals today (Alpert and Gatlin, 2015, page 6). However the Assess, Review, Minimize, Optimize, and Reassess tool was developed more recently to help consolidate recommendations in a tool that is easily implemented to address polypharmacy (Alpert and Gatlin, 2015, page 6). Nurses and other healthcare providers are encouraged to use these tools in a proactive way to help prevent the effects of polypharmacy in the elderly population. As healthcare providers it is our responsibility to help improve the quality of life and ensure that we are doing
Undoubtedly, the human body naturally begins to decline as a person ages. This decline can easily increase the amount of medication an individual is prescribed. Often it is difficult for older individuals suffering with cognitive impairment to remember medication names, dosages, or the medication’s purpose. These individuals are at a higher risk for medication errors, adverse
It has led to an increase of emergency department visits, hospital readmissions, and even death in the elderly. According to the Nursing Manual of the Saskatoon Health Region, there are policies to provide correct medication administration “to ensure patient safety when preparing and administering all medications” (2014). For this to be successful, all health care professionals must understand the reason for the medication being given, the therapeutic effect, any side/adverse effects, and assessments to be completed prior to administration (2014). The Saskatoon Health Region also states that “if sending medications home with the patient, ensure the patient understands how and when the medication is to be taken” (2014). As stated above, this was one reason for polypharmacy in the geriatric population to have harmful outcomes. It is the responsibility of the health care provider to educate the patient with proper medication teaching (indications of the medication, proper dosage, and any adverse effects that could occur). If all of these aspects were performed and shared with the patient, it could drastically decrease the negative effects of
Due to increased medication usage in the geriatric population, the importance of preventing an adverse drug reaction is crucial. In understanding reasons behind why patients may not follow medication schedules, health care providers can work towards achieving the therapeutic outcomes that are desired. The article presented by Frances, Thirumoorthy, and Kwan (2015), discusses the importance of medication adherence as well as how to address potential barriers in the geriatric population.
Adverse drug events occur in fifteen percent or more of the geriatric population that come to offices, hospitals, and long term care facilities. Nearly fifty percent of older adults take one or more
Medication therapy management plays a huge role in the healthcare world. In the United States we see an enormous problem dealing with the mismanagement of medications given to patients.
A list of PIMs was developed and published by Beers and colleagues for nursing home residents in 1991 subsequently expanded and revised in 1997, 2003 then 2012 to include all settings of geriatric care [4]. Avoiding the use of inappropriate and high-risk drugs is an important, simple, and effective strategy in reducing medication-related problems (MRP) and ADEs in older adults. However, the use of PIM is common; according to Popovic et al., 62.4% of ageing patients were received at least one medication with risk outweighs the benefit [4].