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A client of mine recently presented me with her pretty basket of pill bottles. "I never miss one," she reported with a smile. "I am very careful with my medications."
With reading glasses perched on her nose, she picked up Bottle 1 and said, "This is for my blood pressure and I take this twice a day." Check. She pulled out Bottle 2, and said, "This one I am not sure of." The label was from the local vet clinic, and the "patient's" name looked like one of a pet. My heart sank.
The label triggered confusion, and she teared up. She was upset with herself. She realized that she needed help, and she consoled herself by telling me stories about her beloved but long since departed cat.
The Canadian Safety Council's Drug Safety for Seniors report, tells us that around two-thirds of seniors are taking more than five prescription medications a year, with one in 20 seniors taking in excess of 15 daily medications. Statistically, those who take multiple medications are at a greater risk of errors and drug interactions.
These statistics do not even include over-the-counter medications, which can be deceptive tricksters in the drug mix. Add a dollop of confusion, plus a dash of metabolic uniqueness, and therein lies the perfect recipe for potential harm.
Double dosing is the most common medication error among the elderly. When it comes to hypertension or diabetic medication, the consequences can be fatal. Health Canada reports that about 4,000 hospitalizations in Canada each year are related to acetaminophen overdose. With so many products containing acetaminophen (both prescription and over the counter), it is confusing even to those of us who know what to look for. And that is only one compound.
Pro-active vigilance can decrease our loved one's risk of harm from medication. Here are five ways to meddle effectively.
Review medications
Ask your pharmacist to review your medications with you twice a year (if your medications are the same), and every time any new medication is added. This will educate you on potential side effects and drug interactions.
Use one pharmacy
Use only one pharmacy for all of your medications. The pharmacist cannot check for drug interactions if everything you are taking is not in their computer system.
Use a reminder system
Medications are hard to remember to take at any age. Anyone on any regular medication should think of using a reminder system. A dosette (readily available at any drugstore) or, better yet, a pharmacist-loaded "blister pack" will reduce the chance of double dosing or omission errors.
Get organized
Keep all medication in a designated spot, with a written list of everything that is being taken. Include dosages, and times, and take the list to all of your health-care appointments. This will help your health-care professionals make informed decisions, and will help to prevent errors.
New meds means high alert
Medication can directly affect our daily functioning. Confusion, excessive drowsiness, delirium, insomnia, incontinence, falls and fractures, and changes in memory and speech can all be flags that medication-related problems may be occurring. Report any changes to your health-care professional, and alert them to the new medication. Although medications can be life-saving, they can also have a dark side. One of my clients was recently hospitalized for days while big-gun tests were done to diagnose her new-found dizziness. Her son mentioned her new medication to the right doctor, at the right time – and it turned out to be the culprit. Her discharge was organized and back at home she happily went into recover.
Happy and safe is how we want our elder loved ones to be, and medication vigilance is one of the highest leveraged activities that can get you there.
I hope that it is a long time before I see kitty's glaucoma pills in the daily medication mix again.
Renée Henriques is a registered nurse, and the owner and managing director of ComForcare Home Care Toronto-Central, which provides personal support services