Medication Safety And The Elderly

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Too Much of A Good Thing: When Unmonitored Medications Can Be Dangerous for the Elderly

Growing older naturally comes with more aches and pains for most people. Being afraid of getting sick is a valid fear. For many elderly people, the worry that something might be wrong can be overwhelming. 

Sometimes this they might be trying to treat something that already exists with different types of remedies. But they could also be trying to prevent common issues "just in case". When its a "minor" issue they might think they can treat it themselves easier or "cheaper" . Or they may feel that is "so small" its not worth bothering their doctor. (Especially if they have a many medical conditions already being treated.) 

In these cases, seniors may turn to OTC medications, ointments and supplements. And while these things are safe enough if used correctly, what happens when they are being abused? Or when a certain medicine is not supposed to mix with a prescription medication they are already taking?

It can make your loved one sick. Or in some cases, it can even put them in danger. 

Taking too much medication, not enough, or the wrong kinds can have serious health implications. This is something my parents and myself witnessed first hand, and it was it a genuine struggle to correct it. 

Locking Down the Meds

My grandmother is not the elderly lady who refuses to take her medication. She loves to take pills. She also likes ointments, salves, OTC meds, tinctures, tonics and home remedies. When she moved in with my parents, she brought a whole home pharmacy with her.

She always felt awful.  We discussed it with her doctor, who, after an evaluation suggested that the medicine be removed from her room and safely locked away and supervised from there on out. 

When we started this process, we discovered outdated medications, prescriptions that belonged to other people (outdated, and mixed up in generic bottles) and all manner of ghastly and dangerous things. 

Although her dementia is in the early stage (meaning she still understands that some things go on the skin, and other things are to be swallowed) she was definitely showing a lack of understanding about the basic function of medications. We discovered that over the course of a day she was:

• Double or triple dosing on her prescription medications

• Taking numerous  laxatives per day

• Following the laxatives with anti-diarrheal medication

• Taking 5-10 acid reducers

• Applying  different lotions, alcohol, Listerine, Aspercreme, Vick's, Germ-x, triple-antibiotic ointment, heat rub, Witch hazel, peroxide, and vinegar. 

• Taking up to 7 aspirin a day

• Taking 4-7 Excedrin per day

• Taking several different vitamins supplements including multi-vitamins, creating double or triple doses of some elements.

• Taking herbal supplements incorrectly

Needless to say, this meant she was poisoning herself on a daily basis. She was exhausted, weak, and could barely eat without suffering indigestion.

Weaning her from the excess medications was very stressful for everyone. Physically, she had only a positive reaction.  Her health improved by leaps and bounds almost immediately. Emotionally, though...she was a wreck. She cried, she screamed, she threatened. 

For the first few weeks she was terrified that she was dying without these extra meds. (Please note that all of this was done under a doctors supervision, with all the meds documented. Her prescriptions were also put in a safe place and were given as prescribed on the clock.) She would ask for her pulse to be checked, she would list numerous things she could "feel" wrong with herself. 

Alarmed by this, we spoke to her doctor. He assured us that none of the OTC meds she had were addictive, however the mental dependency on the idea of taking them. And some had created a dependency, (laxatives) that required more care.  He emphasized the importance of keeping the medicines monitored. 

During this time she was both very afraid that she was going to have health problems from not treating things in advance (such as with the laxatives), and at the same time resentful that she had to lose the independence to handle her medicines herself. (This is understandable, and is also an issue with seniors who refuse to take their medications.) 

Along with the guidance of the doctors, we eased her through this time, understanding that the dementia was making it difficult or impossible for her to understand the self harm she was causing. 

Medication Safety Tips: 

1.  Watch Carefully :  See what is being taken, how often, and why. Familiarize yourself with the prescriptions, including the dosages and any warnings. 

2. Make a Cheat Sheet:  Write down current medications and anything that is OTC that is being frequently used. Also when and how meds should be taken (in the morning? With a meal?) so its easier to follow the plan at a glance than having to look at the bottles every time. 

3. Ask the Doctor: If you are worried they might be taking too many OTC medications, or taking them incorrectly, tell their doctor and ask for their advice. If they developed a dependency, they may have to be weaned off gently over time. 

4. Invest in a Locking Cabinet: If it gets to the point where you absolutely have to monitor and hand out medications yourself, then its probably safest to lock the medications up. Sometimes you may only need a pill box with the daily cubes. It can be enough to keep your loved one safe. However you may still  have to lock more risky OTC items away. (like laxatives, cold medicines, Benadryl, etc.)

5. Be Patient: and keep reassuring your loved one you aren't punishing them, and you aren't trying to harm them. They may not understand, or they may choose not to believe you. Its okay to discuss reactions and behaviors with the health care team. They will help guide you as you help your loved one. 

6. Everyone's Medications: If it reaches a point where your loved one is overmedicating themselves and need supervision, then all the meds in your house will have to be kept secure, especially if your loved one has dementia.

Be Responsible With Medication

The elderly often have difficulty with their medication. They may not be able to read the labels, they may not understand how they are supposed to take certain pills. They sometimes don't understand the danger of OTC medications, especially in combinations. 

Whereas the majority of caregivers have issues with their loved ones refusing pills or simply forgetting to take them; it is still important to monitor ALL medications in the house. It can certainly go the other way. 

Luckily, we were able to stop the abuse before it did irreversible damage. There were some  side-effects though. The use of so many topical creams had led to some skin infections, some that caused scarring. Digestive issues were the longest to heal, and her liver health had to be monitored.

It has taken a full year to reverse the damage to her digestive system. But she is finally able to eat without having major gastro-intestinal upset. Thus, she is better able to absorb her vitamin supplements.

 After her body had time to heal, her doctor said that she could have certain things to use daily, such as Vicks and lotion. Thus, she still feels as though she is "doctoring" herself, but these items are harmless in small quantities, since they aren't being mixed with so many other chemicals. 

Talk you your care provider about any medication issues your loved one may have. Never assume they are treating themselves responsibly, especially of they are suffering from dementia or Alzheimer's.