Medication Management in Aging: Tips to Consider
The ability of an individual to properly manage his or her prescriptions and other supplements will in a large part direct the course of how independent an aging person can be.
Non-adherence to complex medication regimens is a major cause of nursing home placement of frail older adults.
In the United States, an estimated 3 million older adults are admitted to nursing homes due to drug-related problems at an estimated annual cost of more than $14 billion. Older adults are the largest users of prescription medication, yet with advancing age, they are more vulnerable to adverse reactions to the medications they are taking. Approximately 30 percent of hospital admissions of older adults are drug related, with more than 11 percent attributed to medication non-adherence and 10–17 percent related to adverse drug reactions (ADRs).
Older adults discharged from the hospital on more than five drugs are more likely to visit the emergency department (ED) and be re-hospitalized during the first 6 months after discharge. Nursing interventions that assist older adults in managing their medications can help prevent unnecessary, costly nursing home admissions, hospitalizations, and ED visits, as well as improve their quality of life.
While anyone can assist in setting up and arranging the loved one’s medicines, a licensed nurse in an assisted living or memory care community is the only legally permitted individual to actually administer, or hand over the medication to a patient who is not capable of self—administration, as determined by a physician. (Data from Agency for Healthcare Research & Quality, NCBI 2008)
Fortunately, many newer drugs are more targeted with lower side-effect profiles than their original ‘parent’ agents (antidepressants & anti-anxiety agents for example). Anyone however could have an atypical or idiosyncratic response to a single drug or in combination. A diligent physician and pharmacist will regularly inquire as to how the meds are managed and by whom.
As a pharmacist for over 25 years, I strongly advised patients and their caregivers with complex regimens to stick to one pharmacy for all their prescriptions, and keep their doctors informed on delayed or premature refills, duplicate therapy, and related concerns. When a senior can participate and engage in their drug therapy, the direct impact on their sense of autonomy, recovery, and overall well-being is tremendous.