Caring for the Elderly: Tips About Medications
The right medications can be life saving. However, if an elderly individual fails to follow physicians orders on dosing, they can be ineffective or even a threat to their health.
Medications and the Elderly
The small physical problems that we begin experiencing in adulthood have a tendency to expand and become more problematic as we age. That stiffness turns to pain and even reduced mobility. The failure to stop smoking has resulted in some difficulty with breathing and maintaining a more active lifestyle. So on and so forth. Of course as we get older, there are other things that may come along which are even less expected. High cholesterol, osteoporosis, heart disease, diabetes, and other problems may show up and begin to gradually exert more control over our lives.
As these issues come to the surface, many older individuals find that medications become an important part of life. At some point, they can become overwhelming in fact. So many medications to remember and such a large volume to ingest.
I'm not a physician, nor am I a pharmacist or nurse. I can offer no advice regarding medications and their usefulness, interactions, or anything else. I also don't feel qualified to discuss alternatives to the pharmaceuticals that are prescribed by most physicians. However, I am someone who is involved in caring for elderly parents and wanted to offer some suggestions regarding steps that can be taken to improve the chances that such an individual will be able to comply with a medication schedule and be as safe as possible with them. These suggestions are based only on my personal experience with my aging father and mother and are not medical advice.
Difficulty Ingesting Oral Medications
Pill size can be a problem for some people. There are of course a number of options if an elderly individual encounters pills that are simply too large for them to swallow. Pill splitters are one option that's inexpensive and simple to use. Of course, it's important to split the pill in a manner that indeed makes it small enough that it won't get lodged in the throat. Taking them with enough liquids can help with this as well. It is possible to split a very large pill such that it's left with a sharp edge which makes it more painful if indeed it does get stuck. Pill crushers or pulverizers are another option which can eliminate this problem.
Some pills are available in other forms and if you're caring for an elderly individual who is having difficulty, you can inquire with the physician or pharmacist about this. Compounding pharmacies are particularly useful in this regard as they work to convert medications into a form that will better suit the needs of any individual. However, even if this isn't available, some medications may be available in smaller, coated capsules which make ingestion easier, or in a liquid form. Sometimes the medication itself can be switched and administered by an entirely different route as you can see below.
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Wing grips allow for easy crushing of hard to swallow pills
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Going a Different Route With Medications
My father had difficulty swallowing large pills, crushing was useful for him. My mother on the otherhand could swallow a pill the size of a walnut and never complain. However, she simply had difficulty ingesting the large volume of medications she had to take on most days. Finding a way to get her to consistently take all of her medications and to avoid becoming too full to eat anything, required us to check with the physician about other routes for taking the necessary drugs.
Because of her low nutritional intake, my mother needed supplemental B12. Luckily, one of her options was to get this via a once a month shot versus continuing to take it in pill form each day. In fact, her body seemed to make better use of the supplement when taken this way versus in pill form.
Some of her other medications were also able to be delivered by alternate routes. Instead of a daily pill, she switched one of her medications to a patch and another was administered as a once a year IV infusion. This switch not only reduced the number of oral medications she had to ingest but also reduced the number of medications she had to remember to take.
Her arthritis medication was shifted to one which could be delivered by nasal spray although it was still a daily dose. A word of caution here however: if the medication will be self administered you need to be sure that the individual can dispense a nasal spray properly so that they get the full intended dose. It can be difficult to operate the dispenser if there is tremor or other weakness.
Remembering to Take Medications
If you're caring for an elderly individual who is living independently and will be self administering their medications, being able to consistently remember them is critical. No medication is effective if the therapeutic level of it is not achieved and maintained. This means that it must be taken in the prescribed dosage, on the prescribed schedule; not just when it's remembered.
When my father was alive, we simply made a chart and my mother and he recorded on it each time he took a given pill. My mother was his reminder. Now, years later, my mother is alone, and there is no one else there to act as her back up memory.
There are a number of products on the market that can help organize pills, act as a reminder, and even dispense pills so that there's no confusion about whether or not a pill scheduled for earlier in the day was taken. They range from simple containers to electronic devices that include an auditory reminder and visual alarm. They're even capable of dispensing up to 25 to 30 pills in a single day. Many of these require filling as infrequently as every two weeks, allowing a friend or relative to refresh it periodically if necessary.
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The Up-To-Date List of All Medications
Another thing I have learned is the importance of knowing all of the medications being taken and their dosage. My mother now keeps an updated list of all of her medications in her purse. Anytime we visit the doctor, they need to know of any changes. This is particularly critical if more than one physician prescribes drugs for the individual. Obviously, this information would also be important in an emergency.
Of course medical alert bracelets and wallet cards can be a good idea for many individuals. These are often used for diabetics and patients on Coumadin, a "blood thinner". There are also medical alert signs that can be found online to put on your front door to alert any rescuers. A complete list of medications and so forth can the be kept on the refrigerator or medicine cabinet for their reference. Medical alert systems are also available which not only summon help in an emergency, but often also keep a record of medications and medical information which can be used by rescuers.
When keeping the list of meds, be sure to include over the counter medications, vitamins, and supplements. While there may be items such as these that are taken without a physician's order, it's important to understand that there can still be drug interactions that occur or side effects which can result with these over-the-counter supplements.
Know the Danger Signs and Watch For Them
If you're caring for an elderly loved one, the only other medication tip I can give is to be sure you read up on any drugs they're taking. Acquaint yourself with the precautions, side effects, and any mention of drug interactions. Asking the physician about this is important, but talking to the pharamacist is sometimes easier, as getting time to talk to the physician when you aren't at an appointment can be difficult.
Any time a new medication is started, it's wise to monitor how the individual is responding. Are they having headaches, stomach upset, heart palpitations, loss of appetite/weight loss, swelling, dizziness, nausea, or anything else? It's important to keep tabs on things for a while. Of course, it's also possible that things can go fine for quite some time and only much later have problems arise when things seem to get out of balance. Medications can exceed their therapeutic level over time and need to be changed. Keep the doctor appraised! For elderly individuals who live far away, regular checks by the physician or a nurse are a good idea. Once a year visits aren't frequent enough in my experience. Periodic nursing checks via a home health agency or even checking of vitals through automated systems (telemetry) are also ways of keeping tabs on elderly individuals who live alone.