Elderly Medication Management: Ensure Safety and Independence

The ability of an individual to properly manage his or her prescriptions and other supplements will in a large part direct the course of how independent an aging person can be. Proper elderly medication management is crucial for maintaining safety and independence while preventing medication errors that could lead to adverse outcomes or nursing home placement.

Non-adherence to complex medication regimens is a major cause of nursing home placement of frail older adults.

In the United States, an estimated 3 million older adults are admitted to nursing homes due to drug-related problems at an estimated annual cost of more than $14 billion. Older adults are the largest users of prescription medication, yet with advancing age, they are more vulnerable to adverse reactions to the medications they are taking. Approximately 30 percent of hospital admissions of older adults are drug-related, with more than 11 percent attributed to medication non-adherence and 10-17 percent related to adverse drug reactions (ADRs).

Older adults discharged from the hospital on more than five drugs are more likely to visit the emergency department (ED) and be re-hospitalized during the first six months after discharge. Nursing interventions that assist older adults in managing their medications can help prevent unnecessary, costly nursing home admissions, hospitalizations, and ED visits, as well as improve their quality of life.

While anyone can assist in setting up and arranging a senior’s medication lineup, a licensed nurse in an assisted living or memory care community is the only legally permitted individual to actually administer, or hand over the medication to a patient who is not capable of self-administration, as determined by a physician.

Fortunately, many newer drugs are more targeted with lower side-effect profiles than their original ‘parent’ agents (antidepressants & anti-anxiety agents for example). Anyone, however, could have an atypical or idiosyncratic response to a single drug or in combination. A diligent physician and pharmacist will regularly inquire as to how the meds are managed and by whom.

TIPS:

We advise patients and their caregivers with complex regimens to:

• stick to one pharmacy for all their prescriptions
• keep doctors informed of delayed or premature refills, duplicate therapy, and related concerns
• have separate pill organizers for different times of day
• store medications according to directions
• don’t miss a dose unless discussed with a doctor

When a senior can participate and engage in their drug therapy, the direct impact on their sense of autonomy, recovery, and overall well-being is tremendous, reducing the risk of medication errors.