Managing Medication Safely at Home

You may have seen recent coverage of the new White House Prescription Drug Abuse Prevention Plan, which is designed to address the growing problem of drug abusers who use prescription drugs non-medically. The program seeks to protect Americans through provider education and stricter controls.


People of every age are at risk of harm from incorrect use of prescription drugs. And geriatricians agree that overdependence on certain medications can be a significant problem for older adults. But many pain specialists also express concern that people living with chronic pain—especially seniors—are already having trouble accessing legitimate medications they need.


A recent issue of the Gerontological Society of America’s What’s Hot newsletter examined in depth the role of pain management in reducing disability in older adults. The writers confirmed that "effective pain management is crucial to the well-being of seniors today," and list medications as one of the key modes of treatment. 


“Under-treatment of chronic pain in older adults is common, contributing to unnecessary suffering,” said study advisor Deborah Dillon McDonald, RN, Ph.D.
This is only the latest "medication paradox" we’ve seen in the news. Medications can prolong and improve our lives. But they can also increase fall risk, cause depression and confusion, even result in a fatal overdose. Every week, it seems, we read about the latest exciting new drug on the market—or that a drug has been abandoned as ineffective or with unacceptable side effects. Since seniors on average take more medications, it is no surprise that they also express the most concern about medication safety.
Geriatricians suggest that older adults take three medication safety steps:

1. Talk to their healthcare provider about the prescription and over-the-counter medications they take;
2. Take medications correctly—the correct dose, at the correct time interval; and,
3. Be alert for side effects, especially when starting a new medication.

But taking medications correctly can be a challenge, especially when a senior takes multiple medications, each with its own schedule and dosage. Visual impairment and memory loss add to the challenge. Families may live at a distance, or may not be available to provide the level of supervision their loved one needs. 


In-home care may be the solution to promote both safety and independence. If a senior’s health needs are complex, skilled nursing care can be provided in the home. But in many cases, in-home companion care, which can be provided at a far lower cost, is the perfect choice. A trained in-home caregiver can support effective medication management in four important ways:


Help senior clients get prescriptions filled. Many seniors fail to fill or renew prescriptions because they can’t get to the pharmacy. Neglecting to take their prescribed medications can have serious consequences. For example, the Gerontological Society of America reports that seniors who do not take their medications are at a 50% greater risk of experiencing a fall. In-home caregivers can provide transportation to the pharmacy, or pick up prescriptions for clients. 


Remind senior clients to take medications on time, and in the correct way. In-home caregivers can provide medication reminders, and can also help the senior client use prescription memory aids, such as pill organizers, medication checklists, specially packaged doses, or medication calendars. For clients who take pain medications, the caregiver can note whether pain is adequately managed, and be alert that the client might be taking more than the recommended dosage.


Report negative drug reactions.  As we grow older, our bodies process substances less efficiently, and drug side effects become more of a concern. According to the Commission for Certification in Geriatric Pharmacy, a startling 17% of hospitalizations of older patients are due to adverse reactions to medications. And sometimes the patient is the last to notice the problem! Trained in-home caregivers can be alert for signs of confusion, weakness, depression, or agitation or dizziness.


Encourage senior clients to be physically active and engaged. You might not think of this as part of a safe medication strategy—but studies show that increasing activity can decrease the need for some medications, such as pain medications, antidepressants and even blood pressure medicine. (Note: never reduce or discontinue a medication without consulting your healthcare provider.)


As our senior population grows, it is no coincidence that the field of geriatric pharmacy is also growing. Managing medications helps seniors stay healthy and safe. And when seniors live at home, extra help from a professional caregiver provides peace of mind for senior clients and family alike.


Learn More
The National Council on Patient Information and Education sponsors the Medication Use Safety Training (MUST) for Seniors program, with information for seniors and family caregivers.


The Commission for Certification in Geriatric Pharmacy offers more information about "The Silent Epidemic" of medication problems.


The U.S. Food and Drug Administration offers the factsheet As You Age: You and Your Medicines.