Medication Management for Seniors

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As we age it is  common to have an  increased need for daily medications. It is typical for seniors over 65 to be taking 5 to 6 different medications per day. Almost 20% of elders (65 years or older) take 10 or more   medications.(1) For seniors, the management of medications can be a challenge. Remembering to take medications, which ones, and when is often too overwhelming for them to handle on their own.

              In addition to seniors, it is reported that nearly 75% of all Americans do not take their medications as prescribed. Improper medication management at home causes approximately 125,000 deaths per year, and 10% of all hospital admissions are medication related. For those over 65 the number escalates, 30% of hospital admissions are directly related to non-adherence of prescribed medication. Many seniors have family members who help with their medication regimen. This often includes filling medication reminder devices or pill dispensers. These dispensers can range from highly sophisticated electronic devises to simple Sunday through Saturday plastic holders. Filling them is one thing, knowing when to take the medications, and remembering to take them is another.

What can be done to help with this problem? At Abundant Blessings Homecare, Inc. we have seen the problems with medication management in many different situations. We have adopted a plan of action we would like to share and recommend. This plan is listed below.

1. Best practice is accountability. To have a caregiver with you to prompt and remind you to take your medications at the appropriate time and to document is ideal. This person can be a family member or a private duty homecare aid. The key is to have someone there anytime medications are to be taken.

2. Utilization of automated medication dispensers. There are many manufacturers offering programmable dispensers which will alarm (both visual and/or audible) when it is time to take medications. One even alerts a call center which in turn calls the client and/or up to three people if the medications are not removed from the dispenser after a set amount of time lapse. The limitation to these dispensers is that they need to be filled weekly. We have reviewed many dispensers of this type and are now selling at a discount and recommending various models from MedReady, Inc. which can be seen and purchased at our website.

3. For any situation which leaves seniors living a distance from family, or when there is no one to fill medication dispensers on a weekly basis, we recommend bubble packs or blister packs. These are available from many pharmacies in the area. They consist of clear little pouches containing each day's pills, sorted according to the day of the week and time of day they should be taken. Bubble Packs are filled and

sealed by the pharmacy and all medications which are to be taken at any given time are together in one pouch. Bubble packs help eliminate confusion as to when and what pills to take. No one needs to fill a weekly dispenser; the bubble pack acts as a prefilled dispenser. A caregiver may still be needed to remind and prompt. Studies indicate that One 14-month study indicated that patients' medication compliance had risen from 61% to 96%.

4. If none of these suggestions are taken, we would  recommend at minimum utilizing basic weekly Sunday through Saturday medication dispensers. These can be obtained at any pharmacy. They are very simple to use, yet help tremendously with medication compliance.

One last consideration is regarding safety and theft prevention. Often seniors have many service people working in and around their homes, from Home Health Care Nurses, Physical Therapists and Home Care Aids, to landscapers and cleaning companies. Our policy with our Clients is that any medications not in use or in a dispenser must be locked up. In some situations, even family members may be tempted to steal certain medications. Locking them up prevents theft, deters misuse and eliminate any pointing of blame when medications are missing. If you would like to talk to us about help with your or your loved ones medication management we are available 24/7. Anyone who is considering altering their medication management, or that of a loved one, should consult with their physician first. As health care reform progresses, the goal is that clinicians will share medication management responsibilities following the patient-centered medical home model of care.(2)

(1)        Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases. JAMA. 2005;294:716-724.

(2)        Feldstein AC, Smith DH, Perrin N, et al. Improved therapeutic monitoring with several interventions. Arch Intern Med. 2006;166:1848-1854.

Summer Safety for Seniors

Summer has finally arrived here in New England. With summer comes days of high temperatures which can be dangerous to seniors and others who are affected by the heat. So as you enjoy the long lazy days of summer, remember to take precautionary measures to protect those you love from heat related illness. The following is an article from the Red Cross website with tips on helping seniors to beat the heat.

"Summer Safety & Preparedness Guide for Seniors

As our bodies age, skin and fat tissue, the body's insulators, tend to thin. Because of that change, seniors regulate temperature less efficiently, putting them at greater risk than others from heat-related health problems. Signs of dehydration or heat exhaustion are less pronounced in seniors, who:

  • Tend to perspire less than younger people—so their bodies don"t shed heat as easily as they once did.

  • May lose some of their sense of thirst and not feel thirsty until severe dehydration has set in.

  • May take high blood pressure and heart disease medications that remove salt and fluids from the body. These medications, coupled with heat, can cause a senior to become dehydrated—leading to confusion, organ damage and even death.

The following tips can help seniors beat the heat.

  • Slow down. Strenuous activity in extremely hot weather adds strain to the heart. If you must be active, choose the coolest part of the day—usually between 4:00 a.m. and 7:00 a.m.

  • Take regular breaks when engaging in physical activity on warm days. If you think that you, or someone else, show signs of heat-related illness, stop your activity, find a cool place, drink fluids and apply cool compresses.

  • Stay cool. If you don’t have air conditioning, spend time at an air-conditioned shopping center, senior center, library, movie theater, restaurant or place of worship.

  • Plan outdoor activities in the cooler early morning or evening hours

    • Stay in the shade. A covered porch or under a tree are good choices.

    • Wear a wide-brimmed hat and umbrella to protected yourself from sun overexposure

    • Use U/V skin protection

  • Stay cool in your home. If you must be at home without air conditioning:

    • Stay in the coolest part of the house—usually the lowest floor.

    • Close curtains or shades on sunny windows to keep out heat and light.

    • Use portable and ceiling fans, and/or battery-operated hand-held fans and misters.

    • Install outdoor awnings or sun screens.

    • Use wet washcloths or ice cubes wrapped in a washcloth to pat your wrists, face and back of the neck.

    • Take cool baths or showers.

  • Stay hydrated. Carry water or juice with you and drink continuously even if you do not feel thirsty. Avoid alcohol and caffeine, which dehydrate the body.

  • Eat small meals and eat more often. Avoid foods that are high in protein, which increase metabolic heat. Sandwiches, salads, fresh fruit and vegetables are good choices.

  • Avoid using salt tablets unless directed to do so by a physician.

  • Dress for the heat. Wear lightweight, light-colored clothing. Light colors will reflect away some of the sun's energy. Wear a hat or use an umbrella as well.

  • Discuss with your doctor how medications and/or chronic conditions may affect your body's ability to manage heat.

  • Take the heat seriously. Rapid heartbeat, dizziness, diarrhea, nausea, headache, chest pain, fatigue, clammy skin, mental changes or breathing problems are warning signs that you should seek immediate medical attention.

Frail seniors who live alone should be looked in on often during hot weather by family members, neighbors or friends."