> Health and Disease > Aging

Preventing Medication Mishaps in Seniors
by author Joey Shulman, DC, RNCP

People are living longer than ever before. For example, a Canadian born in 1960 can expect to live 20 years longer than one who was born in 1900. Birth rates have also declined, leaving a growing part of the population over 65. It is estimated that by 2031, 20 percent of the population will be seniors; of these, the most rapidly growing age group will be 85 and over.

 

Over the Hill?

With the surge in preventive health care, including exercise, nutrition, and supplements, a new type of senior has emerged. Although seniors are technically classified as 65 years and older, many people in their seventies, eighties, and even nineties maintain busy and active lifestyles–a far cry from being considered “over the hill”!

Yet there are still unique health-care concerns that specifically affect our aging population. A significant number of seniors face the reality of chronic or acute illnesses, including heart disease, stroke, cancer, and digestive disorders. In addition, seniors are more susceptible to an increased number of falls resulting in bone fractures and hospitalizations.

Medication Mix-Ups

“Did I take my little white pill or not?” I often hear my grandmother ask. With a basket full of pills and nutraceuticals, along with a schedule that includes taking certain pills with food and others at different times of the day, my very sharp grandmother can occasionally become perplexed. Unfortunately, medication mix-ups are a major concern in seniors.

The use of multiple medications, referred to as polypharmacy, is common in the aging population. In fact, research shows the average senior takes four prescription medications daily and fills 18 prescriptions a year. Another study suggests that individuals spend more than 50 percent of their lifetime health expenditures after the age of 65. Topping the lists of drugs prescribed to seniors are laxatives, sleeping pills, anti-anxiety medications, heart medications, anti-ulcer drugs, anti-angina drugs, and blood pressure medications.

Problems arise when a number of medications are prescribed, often by different doctors, without each being considered or explained in detail. Drug interactions, medication side effects, and the misuse of prescribed medications are all concerns that can have detrimental effects on a senior’s health.

Physiological Changes

In addition to confusing regimens of multiple medications, seniors’ bodies change as they age. These changes alter absorption, digestion, and elimination of medications ingested.

Stomach acid declines and digestion slows, so drugs are broken down at a slower rate.

Due to decreased functioning of the liver and kidneys, the body’s ability to rid itself of medication is also slowed by up to 50 percent, increasing the risk of side effects and toxicity. In seniors, the heart pumps at a slower rate and delays the elimination of drugs from the body. Both muscle mass and the percentage of water in the body also decrease, while fat increases. Because toxins and medications are stored in fat, they remain in the body for a longer time.

Avoiding Misuse

In order to prevent adverse reactions from occurring due to medication misuse, side effects, or interactions, specific guidelines should be in place whenever a medication is prescribed. When followed, these guidelines will prevent unnecessary health consequences from occurring in the first place.

When seniors are given prescriptions, it’s important for them to speak to the pharmacist or physician in detail about when and how to take the pills properly. For example, certain pills must be taken with food, while others need to be taken on an empty stomach.

The physician needs to know about all of the medications or supplements that are being taken. One guideline for seniors is to bring to the doctor’s office a detailed list of every medication or supplement they are currently taking. Alternatively, they can bring in all of the bottles for the physician to review for potential drug interactions, side effects, or expiry of any of the medications.

Dr. Joey Shulman, DC, RNCP, is author of Winning the Food Fight: Every Parent’s Guide to Raising a Healthy, Happy Child (Wiley, 2002) and The Natural Makeover Die (Wiley, 2005).

Source: alive #276, October 2005