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EmailMedications: Staying on top of them all
Modern medicine offers many options to treat the various ailments that are associated with aging. In order to reap the benefits and to avoid any unwanted side-effects, it is extremely important that medications are taken properly.
Often family caregivers are concerned that their loved one is on too many drugs.
In 1997, Dr. Paula Rochon, senior scientist with Baycrest Geriatric Health Care System in Toronto, and her research team published a study in the British Medical Journal (BMJ) that identified a problematic prescribing situation that they described as the “prescribing cascade.”
For example, the “prescribing cascade” can occur when people who have chronic illness take medications which may cause particular side-effects. The side-effects are then treated with other medications, and so on.
“Because adverse drug effects may often look like a new medical condition, it is important to rule that out first before adding further medications,” explains Dr. Rochon. “Some of the common ways that adverse drug effects present in the elderly are confusion, oversedation, or falls that result in injury.”
Family caregivers play an important role in helping with the medication challenge. If you are concerned, collect and bring all of your loved one’s drugs to his/her family doctor for a thorough review. This includes all prescription drugs and over-the-counter medications, vitamins and herbal medications, as well as anything only taken on occasion.
The doctor can assess everything being taken and determine if any medication needs to be removed, added, or the dose adjusted. This is an opportune time to determine whether certain medications might be interacting with each other and causing any adverse side-effects.
If your loved one is admitted to hospital, bring a list of all of the medications he/she is taking and ask for a list of all medications upon discharge. Often patients are put on medications while in hospital that can be stopped once back home.
Finally, if your loved one is in a nursing home, it is important to be aware of a class of drugs called anti-psychotics. These are sometimes prescribed in nursing homes to calm agitative and difficult behaviours related to dementia. These sedative drugs should be used only after other approaches have failed because they are associated with side effects such as falls. It is important to talk to the nursing-home doctor before anti-psychotic medication is prescribed to ensure that it is necessary and that non-pharmacological options have been explored first.
“Good communication between you and your relative’s doctor, as well as between the doctor and any other doctors in the health-care system who might prescribe medication to your loved one, will help ensure that he (or she) is on the most appropriate and safe medication regimen,” says Dr. Rochon.