The Complicated Landscape of Seniors and Medications

Oct. 10, 2022 – When the time got here for Ginny Erickson-Ebben’s aged mom to maneuver right into a senior residing facility in 2018, all the household agreed the perfect place was close to Erickson-Ebben. The climate was heat the place she lived in Texas, and Erickson-Ebben lived only a mile down the highway from the ability. She additionally had the time to assist together with her mom’s care. While fortunately and willingly taking over these duties, she didn’t notice what a giant job she’d signed up for. 

Ebben did have bodily assist from a caretaker on the facility, however she was not licensed to handle drugs – Erickson-Ebben’s mom took 20. Even for a vivid, middle-aged girl like Erickson-Ebben, the treatment administration was an advanced process. 

“I was ignorant of how overwhelming the job would be,” Erickson-Ebben admits. “There was a nurse at the senior living facility who stopped in once a day to check on my mother, but otherwise the job fell to me, and it was stressful.”

Erickson-Ebben developed a system to maintain every little thing straight. She made common journeys to the pharmacy to select up the drugs, after which, as soon as every week, fastidiously counted out the meds and positioned them in her mom’s pillboxes, separated by morning, afternoon, and night doses. “It was scary at first, because I didn’t know what pill did what, but after a month, I learned them all and knew what I was doing,” she says. “But I was always worrying about what would happen if she missed a pill or if she took the wrong one at the wrong time.”

Like many seniors, Erickson-Ebben’s mom had a bunch of illnesses and diseases, and managing the prescriptions to maintain all of them in verify is a large enterprise. Recently, the American Medical Association took steps to assist with the issue, issuing a brand new coverage known as “Reducing Polypharmacy as a Significant Contributor to Senior Morbidity.” 

Reducing Polypharmacy 

The physician who championed the brand new coverage is Louisville, KY-based Tom James III, MD. He’s been involved for a while in regards to the sophisticated image of sufferers – particularly seniors – taking a number of drugs. 

“There’s an inverse relationship between the number of prescriptions a patient takes and their longevity,” he explains. “Of course, patients who are sicker are on more medications, but while all drugs are tested for their side effects, they’re not tested in combination.”

As a end result, says James, each affected person taking a number of drugs turns into their very own particular person take a look at website. Compounding the difficulty, he says, is the truth that in medical faculty, medical doctors obtain coaching for including drugs, however not subtracting them. 

Another compounding challenge is the truth that, like Erickson-Ebben’s mom, many senior sufferers have a number of medical doctors treating them directly. Today’s trendy medication signifies that, typically, medical doctors don’t actually have alternatives to debate their mutual sufferers in individual. 

“It used to be that we’d chat in the doctor’s lounge, often comparing notes on a patient,” says James. “Now we often put information into electronic charts, but don’t talk face-to-face.”

What’s generally misplaced, says James, is an opportunity for a number of medical doctors to be on the identical web page a few affected person’s drugs. “Medication profiles often don’t catch all the drug interactions,” says James, “because the tools we use are not discriminatory.”

This spills over into over-the-counter meds and dietary supplements, too, which may generally work together with prescribed drugs. All in all, many aged sufferers are in danger for the problems of over-medication.

Erickson-Ebben discovered it important that she and her household analysis the drugs her mom was taking, and why. “You have to advocate for the patient,” she says. “Unfortunately, if there’s a reaction to a medication, you need to research that, too.”

In the case of Erickson-Ebben’s mom and her 20 drugs, if one induced a rash, it was troublesome to know which. “You can’t just take them off one medication,” she factors out. “Talk to the doctors about your concerns, and don’t let them be dismissive of patients just because they’re elderly.”

Creating a Safety Net 

The new AMA coverage goals to create a community of caretakers to teach sufferers in regards to the vital results of all drugs, in addition to many dietary supplements. It encourages pharmacists, medical doctors, and different caretakers to show sufferers to convey lists of all up to date drugs/dietary supplements to every level of care. 

The concept is to “get patients thinking in terms of becoming the victim of too many medications,” James says. “Ask questions when you need answers.”

Many medical doctors have restricted time with sufferers today, so advocacy is essential. “If there’s an adult child or home-health nurse in the picture, they should review the medication list at least twice a year with the patient’s primary care physician,” says James. “Too often, if a doctor didn’t write a prescription on the list, he or she won’t mess with it. So we hope a pharmacist might catch the potential interaction.”

Erickson-Ebben’s household particularly selected to work with one hospital system, hoping there can be good coordination between medical doctors. But that did not occur. “The doctors didn’t always communicate well with each other,” says Erickson-Ebben. ”We discovered that every specialist was centered on their specialty solely.” 

This is an element of the present hole in care, one which James hopes to start resolving with the brand new AMA coverage. In the tip, he says, the present system depends an excessive amount of on the “I hope this will work,” strategy. “We need to go beyond the resolution and add in an educational approach, too.”

The new AMA coverage is an efficient first step on the highway to bettering well being take care of seniors, and James hopes to maintain shifting the needle. “There’s universal agreement that there’s a problem,” he says. “There’s not yet a universal agreement on the approach.”