Medication is a regular component of life for many seniors, partly because they live with one or multiple chronic conditions. That medication may have many roles, like reducing pain, preventing deficiencies, reducing disease complications or treating a health condition.
Yet, seniors are often taking far too many medications, some of which are completely unnecessary. The pattern means that some seniors may be on 10 medications, or more, to treat various conditions.
Some of the medications are used to treat side effects of other medications, creating a complex challenge.
Why So Many Medications?
The precise reason for so many medications will vary from case-to-case. Even so, there are some common threads.
In many situations, the pattern will be partly associated with common medical practice. Prescribing medication is often an early step when treating a health problem. Furthermore, many alternatives to medication (such as lifestyle interventions) are not well-funded or supported in the current healthcare system.
Another issue is the way that patients will often see different doctors. Reasons vary, such as changing medical practices, moving house, a previous doctor retiring and seeing a doctor in a hospital or emergency room.
While doctors will normally have access to the patient’s history, they may not have the same level of understanding as the previous doctor. This can contribute to problems.
The new doctor may also be unaware of why all of the previous medications were prescribed. This is particularly common if the medication was prescribed for an off-label use. In many cases, it may seem easier and safer to simply leave previous medications alone.
That pattern strongly contributes to overmedication. After all, some of the previous medications may have been prescribed for a time-specific need or a problem that no longer exists.
The layering of medications is particularly common when seniors are hospitalized.
One final reason is the side effects of medications.
The side effects of medication can often be substantial and the cause isn’t always obvious. As a result, patients are frequently prescribed medication to deal with the side effect.
The same sometimes occurs even if the problem is known to be a side effect. For example, blood pressure medication can lead to water retention, which is treated with a diuretic. The diuretic may have its own side effects, which are then treated with another medication and so on.
The end result is a large range of medications that are all related to treating a single problem. Yet, there are other medications and approaches that could be used in treating the initial health challenge (like high blood pressure) and would not create the same medication cascade effect.
Why Is This A Problem?
Over-medication is a serious issue, especially for seniors. As people age, the ability to metabolize medications decreases. This can increase the risk of side effects. The side effects can also compromise health in many ways, such as increasing the risk of falls.
Other issues include the following:
- Drug interactions. Many medications interact with one another. This is something that doctors will be careful about. However, as the number of medications increase, interactions become more difficult to predict and it’s easier to miss some potential interactions. This is particularly significant if more than one doctor is involved.
- Side effects. Each medication will have some risk of side effects. With many medications, the side effects can be dramatic. In some cases, the side effects may make a person feel worse than the underlying problem did.
- Medication management. Many seniors struggle with medication management and for good reason. The medications often need to be taken at different times of the day, which complicates matters further. Medication management systems, apps, and spreadsheets can help but they don’t solve the problem entirely.
- Health risk. Managing medication well is critical, as not taking medication correctly can place people at risk. Some medications are particularly likely to send people to the hospital when mismanaged. Other medications may have more subtle effects, ones that are difficult to detect.
- Risk of death. Issues with excessive medications aren’t just theory. The practice has been linked to various deaths, partly due to the way that medications interact with one another.
Caregivers may also find medication a problem for stubborn family members. Some seniors will be resistant to the idea of taking medication, especially if it comes with side effects. This issue often becomes more significant as the number of medications increases.
To make matters worse, there’s only so much you can do as a caregiver. You aren’t able to physically force the senior to take medication and such an approach would damage your relationship with them anyway.
What Caregivers Can Do
There is no simple solution to this problem, as you won’t normally have the background to know which medications are critical and which are not.
One key approach is to be more involved in the medication process. This includes finding out exactly what each medication does, how it helps and whether there are any non-medication alternatives.
It’s also important to find a doctor who is willing to listen. Some people see no problems with prescribing as many medications as they feel are needed, while others seek to minimize prescriptions. If the doctor’s goals are similar to your own, you’re likely to have an easier time at reducing medication load.
Leave a Reply