When Norma Bartlett fell for the third time in the same week, this time painfully injuring her wrist and sustaining several deep bruises, her daughter Jennifer Weekly finally insisted her mother see the doctor. After putting Mrs. Bartlett's fractured wrist in a cast and giving her a prescription for pain, her doctor suggested that Mrs. Bartlett see a neurologist to be evaluated for possible Parkinson's disease. The next morning, Mrs. Bartlett fell again. She was admitted to the hospital confused and combative.
While Mrs. Bartlett was in the hospital her attending doctor made several changes to her daily medication regimen. Within a few days her thinking appeared to be more clear, and her balance improved substantially. Before she was even discharged from the hospital her daughter Jennifer made an appointment with a new physician, a geriatric specialist.
After a thorough review the new doctor was of the opinion that Mrs. Bartlett's primary problem was not neurological, but drug related. Sure enough, after three months on only half as many medications as she was taking when she went into the hospital, Norma Bartlett is walking without support and has had no new falls. She still must be vigilant because her blood pressure medication can cause dizziness, but she has learned to cope with that without resorting to another pill.
JAMA, the Journal of the American Medical Association, recently ran an article in which they stated that if drug reactions were classified as a disease, it would be the fifth leading cause of death in the United States. Because of the number of medications they take and the way their bodies process these chemicals, seniors are particularly susceptible to drug-related issues.
Only your elder's physician can tell whether he is suffering from an actual disease or whether symptoms may be caused by medication side effects. Some doctors are better at this than others.
There are several things you can do to prepare yourself before you visit the doctor with your senior to talk about the possibility:
1. Some drugs do not mix well with other drugs. You can check for possible drug interactions at the Physicians Desktop Reference simply by typing in your medication list. Don't have your elder stop taking anything this site flags without talking with the doctor, however. Sometimes there is a good reason for using potentially problematic drug combinations.
If your elder is taking herbs or supplements, you can check for possible interactions with drugs here.
2. Check the Beers Criteria. The Beers List, developed by Dr. Mark Beers, is a list of drugs that often cause problems for older adults. If one of your senior's drugs appear on this list, ask the doctor if there might be a less dangerous alternative. Again, don't stop a medication without consulting with the doctor, as that could be just as risky.
3. Ask your elder's pharmacist for a drug review. Be sure that the pharmacist has a complete list of all the medications and supplements your elder is taking. When prescriptions are filled at several pharmacies no single pharmacist will have a complete profile.
Any time a patient is taking more than four drugs the risk of adding complications goes up exponentially every time a new prescription is added to the mix. The risk is even greater when the patient is over 65. Whenever your elder consults with a new physician be sure that the new doctor has a complete written list of all the medications already prescribed. And be sure to let every doctor know if something has been added to the medication list since your parent last visited. Don't depend on doctors to inform each other. They won't.
Remember our drug take back day on April 28th. The event will provide free, anonymous collection of unwanted or expired drugs between 10 a.m. and 2 p.m. at the following location:
, 3609 Market Place West Suite 201, University Place