Often when we encounter an older adult who appears confused or withdrawn we automatically assume that they are exhibiting signs of dementia. However, this is not always the case. Polypharmacy is a word used to describe a situation where a senior is taking four or more prescriptions at any one time. Many seniors with multiple health conditions are in fact taking many more than four prescribed medications. Matters can be further complicated if a senior is seeing multiple physicians all prescribing medications for various ailments. If there is no communication between these health professionals the results can be fatal. Dangerous drug interactions can cause a host of health complications and even death. Communication and organization are key in preventing a potentially dangerous combination of drugs or hazardous dosages of potent medications. Be sure that all of your doctors are aware of exactly what medications you are taking and in what dosages. It’s also important to take great care to take only what medications have been recommended for you and in the manner prescribed. Below are some important issues in determining your risk for overmedication and what you should be doing to minimize and potential problems.
You should ask your physician or a clinical pharmacist to perform a comprehensive medication review if:
• You take five or more medications or 12 or more drug doses each day.
• More than one physician regularly prescribes your medications, or more than one pharmacy provides them.
• You take several medications and have had falls, insomnia, incontinence, or changes in mental status; generalized symptoms such as dizziness, fatigue, swelling, or muscle or joint pain; or gastrointestinal problems.
• You start a new medication and a side effect occurs.
To make the most of a review:
• Take notes, ask questions, and (if you’re accompanying an older relative) be an advocate if needed.
• Bring a list of medications, along with their strength and dosage. Include OTC drugs, vitamins, and supplements.
• Explain that you would like to consider reducing or simplifying your or your parent’s medications. List your specific concerns — potential side effects and interactions, or the impact of drugs on quality of life. The physician should respect your concerns and goals; if not, get another opinion.
• Ask whether any of the medications are ineffective, unnecessary, or potentially dangerous.
• Inquire about changes in exercise, diet, sleep, or stress management that might enable you to reduce medication.
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