Have you noticed that pillboxes are getting larger and larger?
It is estimated that “most seniors take, on average, 4.5 drugs at any one time and have three times more adverse drug reactions than younger adults.” 1 The challenge of managing multiple prescriptions is called polypharmacy, and despite what the term might imply, it is not up to the pharmacy alone to monitor and coordinate all of an individual’s medications.
In order to ensure that adverse drug reactions are avoided and medications are taken as directed, there are many things a proactive patient can do.
*Recognize that as we age, our body’s response to a medication can change. A dose that was appropriate at one time may need to be adjusted to have the same efficacy. If you feel that a condition is becoming more troublesome, or that a medication is causing new side effects, report the changes to your doctor.
*Write down all prescriptions, dosages, and the conditions they treat on a sturdy index card and keep it in your purse or wallet. (Some clinics provide these prescription record cards; ask your provider.) It is wonderfully helpful to have an up-to-date record on hand no matter what provider you are visiting. If you would like assistance in creating this record, ask your Cascade Companion Care caregiver to assist you.
*Some medications must be taken with food, or must be administered at a specific time before or after a meal. Other medications must not be taken together with certain foods, such as grapefruit or milk. These dietary guidelines are not just suggestions; they are vital to ensure that the medicine is absorbed properly. Check the prescription label and accompanying information for any dietary directions and follow them carefully.
*Even seemingly harmless vitamins, over the counter medications, herbal supplements, or other natural remedies can significantly alter the effect of your prescription medications or cause unwanted interactions. The bottom line is to be sure to include everything you take on your record and discuss them whenever a new medication is added to your regimen. (Many pharmacies will print out a list of possible interactions based on your record or even a “brown bag” full of your various medicines.)
*If you suffer from arthritis, ask your pharmacist for easy to open containers. (Just be sure to keep all easy to open medications on a high shelf away from any visiting grandchildren!)
*If you have visual limitations, it can be very difficult to read prescription labels and pamphlets. If your pharmacist is not able to provide instructions in large print, ask your Cascade Companion Care caregiver to transfer the directions to a large format schedule or calendar.
*Memory changes can make it difficult to remember complicated dosing schedules. This creates a serious risk. It can be very dangerous, for example, if a patient forgets to take a prescribed dose, or doubles up on a dose that they didn’t remember taking earlier. Mild memory loss may only require a clear, posted schedule with check off boxes for each dose. However, more significant memory loss may necessitate that a designated helper handles medication reminders. This is a service that many Cascade Companion Care caregivers provide. There are also all kinds of high tech pillboxes on the market that include sensory reminders such as vibration, flashing lights, alarms, pop out dispensers, and locking compartments that only open when a dose is scheduled! George Jetson would approve!
*Finally, discard expired or discontinued medications, whether prescription and over the counter. To keep them out of the water supply and your local landfill, many pharmacies and clinics now provide medication safes where you can deposit unneeded medicines safely.
1Working with Seniors: Health, Financial and Social Issues, Society of Certified Senior Advisors, 2009.