Are Our Aging Parents Taking Too Many Pills?
Did you ever ask your aging parents how many prescriptions they are taking?
The answer could surprise you. Sometimes there are so many pill bottles, no one is keeping track of all of them. Parents’ memory loss, too many drugs to track easily, lack of money to pay for them and other factors can mess up the best of medical intentions when prescriptions are written.When I worked as a visiting nurse many years ago, it was not uncommon for me to go into an elder’s home and find shoeboxes of pill bottles, some duplicates for the same drug, with different doctors prescribing them. Some of the medications were incompatible with each other. My job was to notify the various MD’s of the problem and instruct the aging person what to stop taking and what to keep taking. The problem, sometimes called “polypharmacy” still persists.
Doctors are often in a hurry and seniors may be too intimidated to insist that their list of medications be reviewed. Worse yet, when various medications are available to treat a particular condition, the drug representatives have visited the doctors’ offices and offered free samples of the most expensive ones. Those may not the only choice and they are not what the elder can afford, but those expensive items may be what are most often prescribed.
What’s the answer to this?
We think an underutilized resource is the neighborhood pharmacist. It may be someone from a chain drug store or from any other kind of pharmacy, but the pharmacist, unlike the MD, will take the time to compare medications. The pharmacist can offer suggestions as to less expensive alternatives and brands. It’s their role to explain what the medication does, explain the side effects and help the person understand the importance of taking what is ordered.
“The pharmacist can be the patient’s advocate with the MD” says Susan Gordon, licensed Pharmacist for 15 years with CVS in Tampa, Florida. “The pharmacist can give the elder or adult child advice about less expensive options the MD does not know about. The MD may not know what it costs to fill the prescription he/she has just given to the senior.”
The Medicare drug benefit is limited and many medications are not covered. Elders like my 89 year old mother in law, Alice, have to pay a lot out of pocket each year for drugs they need to take. For our aging parents on fixed incomes, expensive medications are not in the budget. If we encourage them to find one reliable source of information about what affordable alternatives are available, there is a better chance that they will take what is prescribed for them.
Even though elders may like to shop around for the best drug prices, the advantage of a “home pharmacy” can be the prevention of filling duplicate prescriptions for the same drugs. It can also be an ed
I encourage the use of one place for storing data about all our parents’ prescriptions, where the pharmacist can be a reassuring source of information about not only what elders must pay for out of pocket, but side effects, drug incompatibilities and prescriptions for the same condition from different doctors they see. Says Pharmacist Gordon, “With a home pharmacy, the patient can ask about all the meds they are taking, regardless of where they got the prescriptions filled”.
An alarming number of hospitalizations are related to failure to take medications as prescribed or taking medications incorrectly. Though our aging parents are already a responsibility for their adult children who are involved in their lives, it is reasonable to ask them about their pills and where they get them, especially as they start to show signs of declining health.
I work with many adult children who tell me that their aging parents won’t take medications their doctors have ordered even if they can afford them. Whether they take the prescribed meds or not is the parents’ choice and no one can force them. Anyone has the right to decline treatment. But, we can encourage, support and try to make it easier for aging parents to comply with what the doctors want them to do to treat their conditions. We do so in the hope of enhancing their quality of life.
Our respectfully watching over their medication regime and encouraging the use of one place for getting their prescriptions filled can literally be a life saver.
Until next time,
Carolyn Rosenblatt,
The Tough Question: Move In With Your Aging Parent?
The Tough Question: Move In With Your Aging Parent?
We hope you are enjoying the beginning of spring and this time of renewal. Mikol and I have recently moved our offices to new, brighter and better space and we’re feeling very renewed! Wouldn’t you agree that there is nothing like disposing of junk and unwanted items to give you that free feeling?
So, here’s a situation to share with some of you who may be wondering about your own aging parents.
It comes up here a lot at AgingParents.com. This could be you!
Victoria has had a struggle with deciding how to best care for her Dad, 86. She moved him from his home to assisted living, but she’s beginning to think that was a mistake.
Over the last six months, there have been numerous errors at the assisted living facility. Dad is spending $7500 a month there. First they got his medication mixed up and created a mess. Then, they sent Dad to the wrong doctor. Finally, Dad fell and they called 911, but “forgot” to tell the paramedics about the fall. He went to the emergency room for what was reported as “the flu”.
They’re supposed to check him out all over and take x-rays. As the ER folks didn’t know about a fall, they did none of that. He was released. It was lucky he had no fractures. They would have missed them entirely.
Now she is asking herself: should I move in with him and take care of him myself, with helpers at his home? When dad was cared for at home before, she didn’t live nearby. Now, she has moved back to dad’s home area.
Victoria is tired of getting upset with the assisted living staff. Frustration is at the breaking point.
The main reason Victoria moved dad to assisted living was for socialization. That’s not working. He spends a lot of time in his room alone.
Now she needs to look within. Is she willing to undertake the daunting task of caring for dad as his dementia advances and he may become more of a behavior problem? Will caregivers at home solve the problem, or will he be still too isolated there, even if she is with him in the evenings?
At AgingParents.com, we come across this question often.The concept of assisted living works very well for some people, particularly those who are able and willing to interact with others. It can facilitate friendships, offer activities, balanced meals and transportation to various things like doctor’s appointments. We went over the pros and cons with Victoria. One option was to try a different assisted living facility.
But, things can go wrong at assisted living too. There is no direct nursing care, even if a nurse is on staff to supervise the caregivers. The assisted living facility license does not permit “nursing care” from its employees. Perhaps Victoria’s dad needs more care than he is getting there. If Victoria is available to supervise the at-home caregivers on a daily basis, she can be assured of what is going on and she can stop the mistakes the facility keeps making.
After two sessions and a lot of discussion, Victoria did decide to move dad back to his house and to hire caregivers through an agency to care for him during the day. She’ll move back into his house with her husband and supervise the care. We advised her to supplement his care with adult day services, which will be a place to go for social connections, activities and some meals. The total cost for the caregivers at home and adult day services is about the same as assisted living, but Victoria will have much more control.
If this scenario could be about you and your aging parent, consider how Victoria is getting through it. She tried her options. She sought professional advice when one option did not work. She has been careful in considering the personal price of caring for dad herself. She is supplementing her home care plans with using adult day services to get dad out of the house every week. She is at peace with her choice.
We say, kudos to Victoria. She is working at the job of caring for aging parents in a very intelligent and well thought out way. We wish for you the same peace of mind, whether you move a parent in with you, choose a care facility, or some combination of help.
If the decision-making is making you crazy and you don’t know where to turn, consider getting a free complimentary strategy session at AgingParents.com. It’s a start.
Meanwhile, we both send you our best.
Until next time,
Carolyn Rosenblatt and Mikol Davis,
Aging Parents.com
Managing Conflict During the Holidays
Webinar on Managing Conflict During the Holidays
Hello, again. Carolyn and Mikol here.
Are holiday family gatherings stressing you out?
Learn some proven ways to combat stress from Carolyn and Mikol, psychologist, nurse-lawyer team.
Webinar on Managing Conflict During the Holidays
Our free, 30 minute webinar is packed with solid advice to help you prevent that headache you always get this time of year.
Whether it’s all the work, specific people or your aging parents that get to you most, we’ve got some strategies to help you handle it better than ever before.
Make this season one you go through in a calmer, smarter way because you have a plan in mind. Learn it now-you’ll be glad you did.
Click here to sign up for either of 2 viewing times.
If this is a problem you are having, remember that AgingParents.com is there to lend you a hand. A brief strategy session to size up your problem is complimentary. Click HERE
May you all enjoy respite from the hectic days ahead and find some time to care for yourself.
Best to you,
Carolyn and Mikol
AgingParents.com
Attorney for a person accused of elder abuse
“That was a very creative solution you suggested. You got right to the problem she had and helped us figure out something that would work. She’s relieved.”