Overmedication – An All Too Common Problem

too many pills

by Kim Keller

“Overmedication of the elderly is an all too common problem, a public health crisis that compromises the well-being of growing numbers of older adults.  Many take fistfuls of prescription and over-the-counter medications on a regular basis, risking serious and sometimes fatal side effects and drug interactions.”

So states science and nutrition writer Jane Brody in the April 16 edition of The New York Times, in an articled entitled “Too Many Pills for Aging Patients.” This is a topic that’s near and dear to my heart.  My own parents have suffered greatly from medication side effects, such as debilitating nausea, shortness of breath and sleeplessness, and their adverse reactions have included severely impaired cognitive ability, aggressive behavior and acute anxiety.  (The difference between a side effect and an adverse reaction is that the former is expected and the latter is not.)  Far too often the drugs produced more turmoil than healing.  And then the cycle intensifies when more drugs are added to counter the unpleasant side effects.  In fact, the situation with my dad was so serious that drug-safety awareness became one of the driving forces in the creation of In Care of Dad.

Sadly, my parents’ struggles are all too common.  In Brody’s article, she shares a story about her 92-year-old aunt who was hospitalized and nearly died because of a series of medication complications.  Her aunt’s extended hospital care, Brody points out, ended up costing Medicare a significant amount of money.

Brody explains that “more than 40 percent of people over age 65 take five or more medications, and each year about one-third of them experience a serious adverse effect, like a bone-breaking fall, disorientation, inability to urinate, even heart failure.”  Isn’t that alarming?   Those statistics cover nearly 5 million Americans a year!

So, what can you do to minimize risk?  Here’s what Brody reports:

  1. Keep an updated list of all types of medications, including over-the-counter drugs, vitamins and herbs.  Note any previous adverse reactions to drugs, along with any chronic medical conditions.  Review this list with each and every one of your loved one’s health care providers.
  2. Discuss possible side effects with each doctor who prescribes medications.
  3. Refer to the Beers Criteria, which identifies potentially inappropriate medications for people over 65.  The Criteria is named after geriatrician Mark H. Beers, whose team published in 1991 the first list of medication warnings for the aged.  The list was recently updated, naming 53 drugs that should be (a) avoided all together because of a high risk of adverse effects or limited effectiveness, (b) avoided with certain types of diseases or disorders because the drug could inflame the problem, and (c) used with caution.  If your loved one is taking a drug that’s mentioned on the Beer’s List, then discuss this with the appropriate doctor.  The list is just a guide and should never preempt doctor’s orders.

These simple tips could make a significant difference in the quality of your loved one’s care.  My family learned the hard way that many doctors are just not aware of the special medication considerations for patients over 65.  But Jane Brody is, and her recommendations are essential for reducing potentially dangerous complications.

Kim Keller is the co-founder of In Care of Dad.  She lives and works in New York City.

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