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Crookston Times - Crookston, MN
  • Medicine and the elderly

  • I recall my Grandpa George eating a spoonful of jam after taking his morning pill. What I don’t recall from those days back in the ‘70’s, was the” in your face presence” of the big drug companies.
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  •     I recall my Grandpa George eating a spoonful  of jam after taking  his morning pill. What I don’t recall from those days back in the ‘70’s, was the” in your face presence” of the big drug companies.     
        Advertisements now seem to be everywhere ranging from adds touting medications you can’t even buy without a prescription;  to notifications of where you  can call an attorney  when things go wrong.  It sure seems far more complicated now, than trying to pick between the strawberry or raspberry preserves.      
        Medication use in the elderly requires thoughtful diligence.  Statistics reveal that on average, seniors take 4-5 prescription drugs and 2 over the counter (OTC) drugs per day.  There are more medications available today to treat various maladies; having multiple medications, notably more than 5, is called polypharmacy.     
        It is important for seniors and their families to take an active part on the health care team so as to avoid an adverse drug event (ADE) from medications.   
        Elderly people are at greater risk for these ADE’s.   As we age, physiological changes occur making the body more sensitive to the effects of medications.      
        How we absorb these medications, metabolize and distribute them through the body and then clear them out through our kidneys is quite different in elders.  In addition, older brain receptors can sometimes be much more sensitive to pain or mood modifying medications; causing drowsiness, confusion and sometimes even agitation.   
        It is not unheard of to see elders with a cascade effect of prescriptions.  This is when a person gets side effects from a medication, and then the prescriber finds another medication to treat those problems and soon, things mushroom to a pile of pills and a person who just doesn’t feel well.   
        So what is a person to do?  First, have a good partnership with a health care provider who is knowledgeable, especially about those medications that should be avoided in elders (there is an actual list called the Beer’s Criteria).    
        Your provider should listen and care, looking for the big picture during your appointment.  Some may want a “brown bag” approach (where you bring in all your pills to show your doctor) to see exactly what you are taking. They may prescribe lab work to monitor for medication effects or side effects on the body.   
    Page 2 of 2 -     Second, know your medications and take them right.  Seek help if you need assistance with pill set-ups.  Take them as directed to minimize problems, like with food or without, etc.   Know the side effects.      
        Be cautious with vitamins and herbals and make sure your provider knows what you are on as some can interact with other medications quite horribly.   I myself have cut down considerably on supplements.         
        There is nothing like just making sure you are eating healthy  food; with a strong focus on fruits, vegetables,  whole grains (and avoid processed foods as much as possible)  to get your nutrients.     
        Medication therapy has certainly improved the lives of many.  Careful and judicious use of pharmaceuticals is important to avoid unnecessary adverse effects, especially in the elderly.   Know yourself or your loved one and be alert to changes possibly brought on by new or current medications.      
        It is funny how the little things bring you back to a cherished time in your life.  I don’t ever take a little spoon of jam without going back in time, thinking of Grandpa taking that morning pill and remembering the sights, smells and love around my grandfolk’s kitchen table.    
        I wish you healthy living.      
        It is critical to maintain a good  partnership with your medical provider, one who is mindful and caring of your unique clinical “picture.”    
        Jill Brown, RN,C CN-E, is quality management coordinator at the Villa St. Vincent.

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