How To Handle Multiple Medication Safety & Your Elder

Medications-pills capsules and bottlesFor many older persons, multiple medication use is the norm.

What is Polypharmacy?

Polypharmacy is the use of multiple medications at one time, and is a very common problem associated with medication use among older adults and those with disabilities.

More Medication=More Problems

Research has even shown that the more medications a person takes, the greater the risk of experiencing a medication-related problem. This is not a new theme gentle readers.

To best manage chronic diseases often requires the use of multiple medications. Diseases like Heart Failure, Parkinson’s, High Blood Pressure, Diabetes, Arthritis, Pulmonary (lung), and Dementia can require more than one medication for the best results. Both the older adult and caregiver must consider the appropriateness, effectiveness, and safety of all prescription and over-the-counter medications.

Questions to ask physicians/nurses/physician assistants/ and pharmacists:

1. Is this medication most appropriate for the condition considering other diseases present?

2. Is it absolutely needed?

3. Can it be started at the lowest dose?

4. What are interactions with other drugs or over-the-counter supplements?

5. Considering the other diseases present, can this drug be taken properly?

6. What is the best way for all treating health care providers communicate about this medication list?

Avoid Medication Problems

An important part of care giving and senior advocacy is asking the right questions. Become more active in the life of your Elder to help avoid medication related problems. More importantly, your knowledge can contribute to their wellness and safety during this vulnerable time in a senior’s life.

Heart Health & Aging


gored-400x0American Heart Disease Month means more than a quick blood pressure check, skipping bacon, and wearing red. Although I really like the wearing red part!


There is a ton of research that suggests you take steps to reduce cardiac risk factors during middle age, then you can stave off  heart disease for 14 years! Considering the risk of developing any type of cardiovascular disease in one’s lifetime is 60% for men and 55% for women, preventative effort is needed and beneficial. Cardiovascular disease includes heart disease and stroke, which can both result in death. Often at a very early age. Researcher J.T Wilkins, MD reports this and more in a wedMD article this month.

Despite high-tech innovations, medications & procedures, strict exercise and diet regimens that have been found to ‘fix’ symptoms of heart disease, we still see that moderation of diet and paying attention to a healthy life style pays off to prevent use of these modern ‘therapies and treatments’. Seems easy right? When you take your health into our own hands, you can influence that which we can control. Fact is, there is no changing your family history if one parent died of heart disease or stroke but you can mitigate the outcomes if you know and change your lifestyle accordingly.

Steps You Can Take Now

ABC-HeartPreventionWe CAN control our stress levels, the foods we consume and the approach we take to working exercise into our daily lives. Here are some activities you can do today:

  • Deep breathing is a natural way to reduce stress: take five slow, deep breathes- hard to feel anxious while focusing something completely natural, right?
  • Look into yoga- there is something for everyone.
  • Healthy food just tastes good- no denying fresh fruit trumps the canned, syrup-laden kind. America is in the midst of a healthy food movement- try it, you’ll like it.
  • Lots of attention to using a pedometer to track your steps lately too: a small investment to dial-in to your activity level and really understand the benefit, a simple bit of extra walking can add to your overall wellness. Before you know it, you will be parking farther away and taking the steps.

Give yourself some grace and understand making life changes like even the simple ones I have mentioned may be a challenge, especially at first. Also, know the rewards are worth having and lead to increased health you may never have known, which is a gift to you and your family.

We are living longer as a society because we are learning the steps we need to take to ensure a healthy life. By committing to living better now, you will continue to live well as you age.

Creating a Bucket List with Your Elder

What is a bucket list?

the-bucket-listIt is a list of things to do before you die and comes from the term “kicked the bucket”.

There is a great movie from 2007 called The Bucket List with Jack Nicholson and Morgan Freeman. It is a story about corporate billionaire Edward Cole and a working class mechanic, Carter Chambers that have nothing in common except for their terminal illnesses. While sharing a hospital room together, they decide to leave it and do all the things they have ever wanted to do before they die according to their bucket list. In the process, both of them heal each other, become unlikely friends, and ultimately find joy in life.

Aging used to mean that the quality of life went down. It used to mean “Old Folks Homes” and institutions. It doesn’t have to mean that anymore. There are so many options for seniors. Just because they are aging doesn’t mean they still don’t want to do things. Keep them active.

5 Questions to Ask Your Senior:

1. What do you miss doing that you used to do when you were young?

2. What did you always want to do but never had the time or money to do?

3. If you could do anything, what would you want to do?

4. Where would you want to travel to if you could go anywhere?

5. What talent do you wish you had learned as a kid?

By listening to your loved one, you can help them create a bucket list of items to do. Start planning for a trip, hire a piano teacher or enroll them into drama classes. Here is a great website where you can log your items. It is never too late to do the things they want to do. You just might need to be a bit creative to make them happen.

Five Elder Abuse Signs

Elder-AbuseHard to imagine and way under-reported

Nurses, physical therapists, counselors etc, who provide care in the community are on the front lines identifying potential elder mistreatment. Abuse and neglect of the elderly is a serious and prevalent problem that was estimated to affect more than a million individuals. And that number may be conservative.


Terry Fulmer, PhD,  Advanced Practice RN, reported in her article in The Hartford Institute for Geriatric Nursing, only one in ten cases of elder abuse are actually reported and there is even serious under-reporting by clinical professionals.  Ms.Fulmer attributes this professional under-reporting to, most likely, lack of appropriate screening instruments. Elder mistreatment is defined by abuse (physical, verbal and even sexual), mistreatment, neglect, exploitation, and abandonment.

We use a screening tool called the Elder Assessment Instrument (EAI) which has been present in literature since the 1980’s. This tool or some variation of it, may be used in all clinical settings by people who treat the elderly population. The tool takes about 15 minutes to use and includes assessment of five indicators.

These indicators include:

  • A general assessment
  • Possible abuse
  • Possible neglect
  • Possible exploitation
  • Abandonment

What to look for:

General assessment includes appearance of clothing/hygiene/ skin/nutrition and any additional findings of care and environment.

Abuse and neglect indicators include injuries, bruising, various stages of fractures, sexual abuse, and clinical signs like bed sores, depression, diarrhea, poor hygiene, and failure to respond to warning of obvious disease and repetitive hospital admissions due to probable failure of health monitoring.

Exploitation indicators include misuse of money and finances with reports of demands for goods in exchange for services and inability to account for money and/or property.

Abandonment may include withdrawn care without alternative arrangements, or evidence a senior citizen has been left alone in an unsafe environment without adequate support.

Each of these indicators also may be reported by the elder in question as well. Although there is not a formal scoring system in this tool, clinicians AND care-givers can be more aware of the signs of elder mistreatment by using the tool as a starting point and guide.

As we provide care to our ever-increasing elderly population, responsibility lies not only with clinicians but well-meaning family and friends. If there is ANY question an Elder is being mistreated, a social service referral should be generated.

How to report or inquire about elder abuse:

The National Center on Elder Abuse (NCEA) serves as a resource center dedicated to the prevention of elder mistreatment. It was first established by the U.S. Administration on Aging (AoA) in 1988 as a national elder abuse resource center. I have included the link above so you may review this site for more details and contact information for reporting potential elder abuse and local support in your geography.

All of us have the responsibility to participate in the full circle of properly caring for our wise, valued, and vulnerable seniors.