Elderly Medication

Information, Resources and Recommendations

Elderly medication plays an important role in health and can improve, extend and save lives if used properly.

If they are not used properly, they can cause serious problems.

Elderly often run into difficulties when medications have been prescribed by different doctors or different pharmacies are used.

This decreases the information each professional has when considering how all the medications work together (or don't work together!).

They may only be aware of the medications they themselves have prescribed or dispensed.

Seniors are often over medicated for this very reason. So it's important to be involved and help your loved one manage their medications.

Ask Questions

Learning as much as possible about medications is one of the best ways to avoid mistakes. Don't hesitate to ask questions or express concerns about medications or how multiple medications interact.

Make sure to remind your loved one to ask questions concerning their medications such as:

• For a new prescription:
  • The name of the drug
  • Why it was prescribed
  • When and how it should be taken
• If you're unsure that the medication is being used correctly or unclear about its effects or purpose, ask your pharmacist or doctor.
• For multiple medications: ask your pharmacist to make a schedule for when and in what order to take the medications
• Keep a written record of all the medications that your loved one is taking, including vitamins, non-prescription and herbal supplements.
• Encourage them to keep a copy in their wallet.
• Remind them to bring the list whenever they see their physician or pharmacist, or bring your copy if you go with them
• Use only one pharmacy
• If there is ever a bad reaction or an allergy to a drug, or there are changes in medical conditions, be sure to inform the doctor and pharmacist and ensure this information is on file
• Ask the pharmacist if there are changes in the color, size, markings or dose of the medications
• You can always prepare a list of questions for your family member to take to their appointment with the doctor of pharmacist and encourage them to write answers down if it will be difficult to remember. Or you can accompany them and write the answers down for them. If the answer is confusing, ask the doctor or pharmacist to explain it again. Tell them you don't understand.
• Read the patient information brochure that should come with prescriptions

Some questions for your local pharmacist when starting a prescription:

• Why am I taking this medication?
• Can it be used safely with the other medications I already use?
• When should I take this elderly medication, in what amount and for how long?
• Are there any special directions for taking this elderly medication?
• Do I take it on an empty stomach or with food?
• How will I know if this medicine is working?
• Will I need any tests such as blood tests or X-rays to ensure the medication is working like it should be?
• What side effects could I experience?
• What should I do if I miss a dose?
• What should I do if I use too much by accident?
• Will this medicine make me drowsy?
• Should I avoid any drinks, foods, other substances or activities while using this medicine?
• Can I drink alcohol while taking this?
• Does the medication require refrigeration?
• Can I get my medication in a container that is easier to open?
• Is there another form of this medicine that would be easier to swallow?
• Is there any chance I might become addicted or dependent on this elderly medication? How can I avoid this?

Tips and Information For Taking Medications at Home

• Check the labels each time you use a medication to make sure it's the right medication for the right person and that it is still being taken in the proper way at the proper time
• Take medicine at regularly scheduled times each day. You can do this by associating your medications with a regular activities such as mealtimes (if your medications can be taken with food), going for a walk or getting a phone call each day
• Take the recommended dose exactly as prescribed even if you are tempted to use more to feel better quicker
• If you forget to take your medication, don't double the next dose - call your pharmacist or doctor for advice
• Don't share your medications and don't use others medications
• If there is more than one person in the home, highlight the person's name and dosing instructions; use a different colored highlighter for each member of the family
• Usually medications should be taken with a full glass of water unless the doctor or pharmacist recommends otherwise. If the prescription recommends "plenty of water", you likely need more than one glass
• If your medications are to be taken on an empty stomach, take it one hour before meals or two hours after food with a full glass of water
• Gravity can help the elderly medication reach your stomach - stand or sit upright for at least five to ten minutes after taking it
• If it is to be taken with food, a piece of bread, cracker or banana can help it get to your stomach faster
• Some medications that should not be taken with food should also not be taken with milk or other dairy products
• Alcohol can add to the effects of medication, making you drowsy
• If you are starting a new medication that may cause drowsiness, it is important to avoid activities that require alertness, ie. driving, until you find out how the drug will affect you
• Never take medications in the dark, many pills look and feel alike
• Finish all medicine as directed - even if you start to feel better! Don't save any for future use unless your doctor tells you to.

Side Effects and Adverse Reactions

Most drugs can cause some side effects. A side effect is something that happens when your medication affects you in a way it is not supposed to. These are usually mild and short term; in some cases these side effects can cause problems. Your pharmacist or doctor can help you understand potential side effects and how long they might last.

Adverse reactions are more serious than side effects but are rarer. Examples of both side effects and adverse reactions are listed below.

• Be sure to have a good idea of what to expect from medications - how soon one might experience results and what the potential side effects are If unexpected symptoms are experienced, contact the pharmacist or doctor.
• The physician may want to change the medication or the dose if the side effects are too troublesome.
• The elderly can be more likely to experience side effects or find them bothersome. This is because as people age, often liver and kidney functions decline which affects the way a drug is broken down and removed from the body.
• Some side effects that more often effect seniors are dizziness, falls, drowsiness, dry mouth, nausea, diarrhea and insomnia.
• Adverse reactions are more serious but fairly rare. These may include a severe allergic reaction with difficulty breathing; skin rash; itching or swelling; feeling faint and having a racing heart; severe nausea or severe diarrhea; or severe depression.
• If you think your loved one is having a reaction listed above or you have any other concerns, contact their doctor or pharmacist immediately.

Storing

• Keep medications in the original container with the cap closed
• Keep medications in a dry, cool place out of the sunlight. Do not keep them in the bathroom as the heat and moisture could damage them.
• Keep elderly medications out of sight and reach of children or pets.
• Don't store medicine with food or household products. Refrigerate only if the label states to.
• Check expirations dates. Don't use prescription, over-the-counter drugs, herbal supplements or vitamins past their expiration dates.
• Do a "medication" spring cleaning yearly. Dispose of medicines that are old, no longer in their original container, or that have changed color, smell or taste. This includes nonprescription elderly medication such as cough/cold, pain, first aid, vitamin and herbal products.

Disposing

• Take all the medicines that have been cleaned out back to the pharmacy for safe disposal
• If you don't know if a medicine is still good, ask your pharmacist
• Don't throw medicine in the garbage Ð children or animals may get into it
• Don't flush medicine down the toilet Ð itÕs not good for the environment

Pharmacists can be a Valuable Resource

• Advice on managing headaches, other minor ache and pains, ulcers, heartburn, stomach upset
• Reviewing medication records and overall health to be sure people are getting the most from medications being taken
• Advice and information about non-prescription medications, vitamins and natural health products
• Providing extra assistance with prescriptions such as bigger print on the label or advice on organizing daily medication regime to suit lifestyle
• If opening elderly medication is a problem, they may be able to provide a different type of container
• If swallowing medication is difficult, they may be able to make suggestions
• If remembering to take elderly medication is a problem, ask for some ideas to help keep track such as pill boxes, calendars or blister packs

Medications and the Hospital

If your loved one has time to plan prior to going into hospital:

• Ask the pharmacist for a list of all the prescription elderly medication including dosage and when it should be taken. Add to the list any non-prescription drugs, herbal and natural health products and vitamins.
• Bring the list to hospital and give it to the admissions staff to place in the chart
• Ask whether the medications taken before hospital admit should continue to be taken while in hospital
• When you are ready for discharge, ask to speak to the hospital pharmacist if there have been any changes to medications or medication regime. Ask if medications started in hospital should be continued and if the medication prior to hospital admission should be continued.
• Contact your pharmacist and doctor to inform them of the new medications after your hospital stay

Medication Tips

• Place the elderly medication in a visible area so it's readily available at the time it should be taken, ie. on the counter where meals are eaten (only if there are no children or pets to worry about and there are no specific storage instructions)
• Incorporate the medications into normal daily routine. They could be taken immediately before or after another daily activity such as eating a meal, doing a household chore, having a daily nap or going to bed at night.
• Ask your pharmacist about reminder devices such as calendars, mini-alarms, blister packages (plastic, sealed bubbles), pill boxes or containers.
• Some areas have telephone service reminders or some people have home support come and assist seniors with medication management. Some families phone and remind their loved one at the appropriate times during the day.
• For complicated elderly medication regimes, pill boxes with various compartments (for meals, days or weeks) can help. These are also helpful for people who have trouble opening pill bottles.
• Pre-filled pill boxes or bottles without child-proof caps can be requested.
• Some medication aids are available with Braille or raised characters.
• Do a "brown bag checkup" once a year. Put all the medications and over-the-counter products in a bag and take into the doctor or pharmacist. The bag should include both prescription and non-prescription drugs, herbal supplements or products, vitamins, dietary supplements, and topical treatments such as ointments and creams. This will help avoid medication mistakes and cut down on unnecessary medications.
• Accompany seniors to doctor's appointments if they might need help understanding or remembering what the doctor tells them. Write the information down.
• Keep track of possible side effects or drug interactions and inform the physician or pharmacist immediately if any unexpected symptoms are experienced

Medication Review

You can ask your loved one the following questions to help determine if a medication review with the doctor and pharmacist might be indicated:

Do I have trouble:

• Understanding the instructions on my medications?
• Reading the label on my elderly medication?
• Opening the medication bottle?
• Swallowing my medications?
• Remembering to take my medications?

Do I want to know more about:

• The elderly medication I am taking?
• Where to store my medication?
• How and when to take different kinds of medications?

Do I:

• Share my medications with family and friends?
• Sometimes change the amount of medications I'm taking?
• Take non-prescription medication, vitamins or herbal supplements without talking to my pharmacist or doctor (especially when I'm also taking prescription drugs)?
• Drink beer, wine or liquor with my medications?
• Keep old bottles of medication, just in case I need them?

Do I know:

• The names of the medications I'm taking?
• What I'm taking them for?
• What to do if I miss a dose?

Do I feel that:

• My medication is making me sick?
• My elderly medication is not working?
• I am taking too many medications?
• My medications are not working well together?

Do I:

• Have more than 3 medical conditions?
• Take medications 3 times a day or more?
• Take 5 or more different medications (including both prescription and non-prescription)?

If your loved one answered yes to a number of these questions, it may be time to review elderly medication with you doctor and pharmacist.

How to Set-up A Weekly Pill Box

A weekly pill box can come in a variety of shapes and sizes. They are available at most pharmacies and health care suppliers, sometimes for free. They are typically plastic boxes with dividers to delineate the different days of the week.

Some have the boxes labeled with times, others use meals (breakfast, lunch, etc). Some are for one week while others are for the whole month.

Sit down with your parent and come up with a system for labelling the boxes. Use colours and large print labels.

Blister Packs

More and more pharmacies are blister packing medications for their elderly clients. Each package typically holds a weeks worth of medications arranged by both the day and time to take the medication.

This is a great solution and I recommend this service to many clients. Also, some pharmacies are not charging for this service and it is much easier for clients to know if they have taken their medication or not.

It is also easy for you to see if they have taken their medication.

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