The older we get, the more health challenges we face. In particular, people older than 85 often have multiple complex conditions. Polypharmacy, defined as taking five or more medications at the same time, becomes more common. It’s important for seniors and caregivers to know how to organize and monitor medications to avoid improper dosages and drug interactions.
Elderly medication management can be complex. But this guide will help you and your loved ones safely and effectively manage daily medicines.
Understanding the Need for Medication Management
When it comes to medication management for the elderly, you may face several challenges. Caregivers tasked with monitoring medicines may encounter loved ones or patients who:
- Need help remembering when to take their medications
- Dislike taking pills or other medications
- Worry about a medication’s side effects
- Have trouble following detailed instructions
- Can’t easily tell certain pills apart
- Don’t trust that the medication is working
As you plan out a medication regimen, it helps to understand what’s being taken and why. Common medications prescribed to people 65 and older include:
- Antihypertensives, used to manage high blood pressure
- Statins, used to lower cholesterol
- Antidiabetics, including metformin and insulin, used to control blood glucose levels
- Anticoagulants and antiplatelet agents (blood thinners), used to prevent blood clots
- Bronchodilators and inhaled corticosteroids (inhalers), used to manage chronic obstructive pulmonary disease (COPD) and asthma
- Bisphosphonates, used to prevent and treat osteoporosis
Failure to take medications as instructed could lead to negative health consequences, hospitalizations and, in some cases, death.
But just taking them as prescribed isn’t the only issue that requires management. It’s important to know the essential details about each medication being taken.
Keeping Track of Medications
Creating a medication list is a good idea. A chart or spreadsheet with categories is even better. These should include:
- Medication name and purpose
- Strength and dosage
- Any special instructions
- Number of refills left
- Prescribing doctor's name and phone number
The National Institute on Aging offers a worksheet as does the Family Caregiver Alliance to help you get started. Consider creating a file on the history of each prescription and keeping it somewhere easily accessible.
Being Aware of Medication Safety
Even though medications may be prescribed and taken as directed, that doesn’t automatically make them perfectly safe. Adverse reactions to other drugs or foods, inadequate medicine for the diagnosed issue and outdated regimens are all issues to watch for when managing medication for the elderly.
Drug Interactions
Older people are at higher risk for medication errors and adverse drug reactions. Keep in mind that drugs that may be just fine when taken alone may not be safe or as effective when combined with other substances. Some interactions can cause unwanted and serious side effects.
Ask your loved one’s health care provider and pharmacist about:
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Drug Interactions: When two or more drugs react with each other, causing unexpected side effects or impairing the effectiveness of one or more medications — including over-the-counter (OTC) medications.
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Food Interactions: Certain foods can interfere with medications either by reducing their effectiveness or causing adverse reactions. For example, foods high in vitamin K, such as kale, can reduce the effectiveness of the blood-thinner warfarin, leading to an increased risk of blood clots.
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Alcohol Interactions: Older people may be more affected by alcohol. Mixing alcohol with medicines is never a good idea. It can affect coordination and balance, increasing the risk of falls. It can also affect breathing, result in gastrointestinal bleeding, lead to liver damage and cause dangerously low blood pressure in some cases.
The prescribing physician and the dispensing pharmacist are the key people who will help you be aware of these interactions. Medications generally come with warnings about interactions, and the internet makes it easy to look them up, but polypharmacy can be complicated. Pharmacists in particular can be a great resource to ask for a holistic review that all medications can be taken as intended.
Prescribing Cascades
Another significant challenge when taking multiple medications is a prescribing cascade. This happens when a side effect of one medication is mistaken for a new medical condition and is treated with additional medication.
Not addressing the original side effect can mean introducing a new medicine that isn’t needed. And it may have its own side effects and drug interactions.
To avoid a prescribing cascade, bring an updated medication list (with prescribed and OTC medications) to all medical visits so providers have a complete view of current drug treatments. When a physician suggests a new medication, it never hurts to double-check and ask if any current ones could be causing the problem and if the new one may cause future problems.
Regular Medication Assessment
When you’re taking various medications for various conditions, it can be easy to slip into autopilot mode. You may dutifully line up medicines every day and take them as directed — but it’s important to revisit what’s being taken, why and whether it continues to be effective or necessary.
This is another reason to keep an updated medication list and bring it with you to every health care visit, whether it’s for a check-up, point-in-time treatment or specialty consultation. Review medications with the prescribing provider regularly and talk through whether they continue to be needed and whether the dosage remains effective.
Using Medication Management Methods
Once safety issues are assured, you can focus on adherence. Simplifying medication schedules and aligning dosing times with routines can reduce confusion and improve consistency.
Here are some tips for making medication routines easier:
- Pill organizers that group doses by day and time can help seniors and caregivers keep track of medications.
- Blister packs that allow you to push individually sealed tablets through the foil can make it easier to see whether a pill was taken.
- Store all medications in one location.
- Consider taking medications at mealtimes, bedtime, etc. Associating taking medication with regular daily activities can help establish a routine.
- Mail-order delivery, 90-day supplies and medication synchronization can make it easier to fill prescriptions all at once, just a few times a year.
Considering Technology’s Role in Elderly Medication Management
Technological advancements have led to various medication management support devices. However, entering information accurately is key to making the most of these tools. It’s also important to note that no technology is foolproof. Even if you set up a medication schedule, you should still ensure a caregiver or medical professional can provide supervision and adherence, especially for complex or changing medication regimens.
Some of these tools and devices include:
- Wearable devices such as smartwatches let users manage their medications by scanning pill bottles, importing information and setting up a dosage schedule and reminders.
- Health apps can monitor and manage medication schedules, set reminders and track adherence.
- Smart pill bottles track when medications are taken and can send notifications if a dose is missed.
- Automatic pill dispensers can be programmed to open only at designated times, reducing the risk of taking the wrong medication or dose.
Finding Caregiver Support
Caregivers may find challenges in managing medications for others. They may feel heightened pressure if they’re caring for someone with a life-threatening health condition that depends on a medication regimen.
It’s important to ask for help if you’re feeling overwhelmed. Support is always available. Some options include:
- The Family Caregiver Alliance offers information and programs to help and support caregivers.
- The Caregiver Action Network provides education, peer support and resources for caregivers.
- National Alliance for Caregiving offers resources to guide new and experienced family caregivers.
Medication Safety Starts With Informed Management
Effective medication management is essential for seniors' health and well-being. By understanding the medications your loved ones are taking, regimens and safety issues, caregivers can ensure medications are taken correctly and safely. Creating routines, using tracking tools and consulting with health care providers can help you manage your or your loved one’s health effectively. If you ever start to struggle or feel overwhelmed, remember you can seek out a support group or ask medical professionals for additional tools, guidance and resources.
Stay on Track with BrightStar Care®
BrightStar Care® team members are prepared to help with elderly medication management. Whether you're looking for in-home care services or assisted living for your loved one or a reliable medical staffing partner for your organization, our experienced local care team members are ready to be of service. Find a location near you, contact us online or call 866-618-7827 to learn more about how BrightStar Care® offers A Higher Standard®.