Older Canadians may be taking too many unnecessary drugs. Are you among them? I’m not! Does your primary care physician know how many drugs you’re actually taking on a daily basis? My doctor knows how many I’m taking; just the ones he’s prescribed, and only ONE on a daily basis — a thyroid medication. Pain management medications for issues related to aging with cerebral palsy are taken ‘as required’.
According to the Canadian Institute for Health Information, 1 in 4 Canadian seniors is prescribed 10 or more drugs. In 2016, about 1.6 million seniors (representing approximately 1 in 4 Canadians age 65 and older) were prescribed 10 or more drug classes. I’m having an OMG moment, people.
How many of those drugs are actually necessary, or prescribed for a condition that no longer exists? Did their treating/prescribing physician forget to tell them they were no longer required after the condition resolved? Or was a dependence created and the doctor kept on prescribing them at patient request. Sadly, patient-directed prescribing happens and it’s a problem.
Upon release from hospital, how many seniors are sent off with a brown bag full of drugs, to be taken along with what’s currently on board, as part of their daily regimen? Where’s the monitoring? Can the patient remember which is to be taken with food and which is to be taken with extra water. It’s all so confusing, and not getting it right can be dangerous if not fatal.
As well, seniors/elderly taking anti-psychotic drugs without sufficient follow up to determine continued efficacy are at risk and treating physicians must accept some of the responsibility. Men and women in this age group still living on their own need to be followed. Nursing home and other similarly housed individuals also need to be assessed if they’re taking such medications.
Some drugs may actually be setting the stage for dulled senses and accelerate the risk of falls — a vicious cycle begins. A serious fall results in a hospital admission to treat the injury, perhaps with an extended stay, creating the potential for contracting any number of airborne infections. Sometimes, one layered on another. Hospital stay extended. Pneumonia settles in; more medications. Sleeplessness — sleeping pills. Anti-anxiety medications are often part of a hospital stay, with some patients continuing to take them or seek them long after release. That warrants investigation. Sadly, what started out as a minor situation at home, with a direct link to over-medication, leads to a death in hospital from a condition totally unrelated to the initial falling incident. Time for a change of approach.
I’m pleased to know use of antipsychotics and benzodiazepines in long term facilities has declined since 2011; it can’t be lost on health care professionals that those drugs seriously impact quality of life for the aging person and that there needs to be more focus directed at establishing other ways of assisting seniors in care facilities adjust to their circumstance. Government funded research programs to explore drug use is redundant. Why not direct funds to resources that physically and mentally stimulate elderly in care, making their days more palatable. Imagine being essentially parked in a chair all day in front of a television, surrounded by a number of similarly aged people, some of whom having lost the capacity to engage.
There is much to be done. Doctors say it is not uncommon to encounter patients taking more than 20 drugs to treat acid reflux, heart disease, depression or insomnia or other disorders. My head is spinning. Why so many ‘doctor drugs’, as I call them? There needs to be a place for nutrition education, physical therapy, occupational therapy. Mental health counselling amongst seniors needs to be given much more attention. Constructive communication is critical if clinicians are to effectively treat their senior and geriatric patients in a manner that contributes to improved quality of life.
Overuse of prescription drugs amongst the elderly can be a gradual thing; taking a drug to lower blood pressure causes swollen ankles, so a diuretic is added to the mix. The diuretic lowers potassium, so another drug is layered on to treat that. Oh, and then there’s the nausea caused by the drug treating potassium deficiency. Mental confusion sets in because of the drug used to treat the upset stomach. The cascade effect.
I call upon all doctors in this province and across the country to conduct ‘brown bag’ medicine reviews. Going over the list of daily medications, who prescribed them and why is like a good housecleaning; getting rid of what’s not needed and perhaps downward adjusting dosage and strength of certain medications that may be interfering with quality of life.
Networking with local social service agencies to connect seniors to community would be a perfect prescription.
Carla MacInnis Rockwell is a freelance writer and disability rights advocate living outside Fredericton, NB with her geriatric Australian silky terrier and a rambunctious Maltese. She can be reached via email at carmacrockwell@xplornet.ca
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