As we grow older and our bodies become less vibrant, daily routines often involve one or two rounds of pills — prescription drugs, vitamins, supplements. And with that many pills on the menu each day, accidents can happen.
Pills can be forgotten. Dosages misread. Refills neglected.
It is estimated that 40 percent of people 65 and older take at least five prescription drugs and 18 percent take 10 or more. Depending on the study, at least one-fourth of those seniors will experience a bad interaction or reaction to the drugs and end up in a hospital.
"It's definitely a problem," said Dr. Laurence M. Solberg, a professor of geriatric medicine at the University of Florida. "More of an epidemic since the aging of the population of people over 75 in the last 10 years."
The problem, according to Solberg, is that as the body ages, the liver and kidneys naturally process the ingredients of prescription drugs less efficiently. Thus, medications stay in the body longer, creating the potential for unplanned drug interactions.
For caregivers, especially adult children, medication safety is an increasing concern as they worry about their aging parents.
Adult children may find themselves in a role reversal, taking the mature, logical but caring role of adult monitor of their mother or father and their drug management.
The key for caregivers is to be observant, Solberg said. Changes in behavior, sleep patterns or a daily routine, as well as lethargy, dizziness and upset stomach or bowels, can be signs of a drug reaction.
Sometimes, misuse of prescription drugs can be a natural result of aging, according to Heather Hardin, clinical assistant professor at UF's College of Pharmacy. Fading eyesight can make it difficult to read labels. Poor hearing can mean doctor or pharmacist instructions aren't heard clearly.
When adverse reactions happen, the effects can be mild or major. Falls are a major concern, as are allergic reactions that can cause breathing difficulties, said Dr. Carol Fox of the University of South Florida's College of Pharmacy. "Adverse reactions are the fifth-leading cause of death in older adults — at least 7,000 a year."
Fox suggests that caregivers look for obvious signs of trouble: empty pill bottles not refilled, full prescription bottles that stay full, out-of-date prescriptions still being used.
There are a number of resources available to caregivers. They can accompany their parents to doctors' appointments to see and hear about proper prescriptions, and the neighborhood pharmacist can review a parent's list of drugs and supplements.
"The pharmacist is one of the best and most underused resources," Solberg said. Not only can pharmacists review a patient's full regimen of drugs, vitamins and supplements, but they can advise on potential reactions. They can also provide information about devices that might assist in pill management, from pill boxes to electronic gadgets that dispense daily dosages on a timer.
"One of the major issues is over-the-counter drugs," Solberg noted. People see them advertised on TV and think they are okay to take. Perhaps they used a particular drug when they were younger and had no problems, but now the same drug "induces side effects as the person gets older."
In an effort to promote prescription drug awareness, Home Instead Senior Care, which offers in-home elderly care services, has launched "Let's Talk About Rx" at letstalkaboutrx.com.
"What we've learned is that many seniors don't know everything they need to take," said Kristi Campbell, who owns Home Instead Senior Care franchises in Brandon and Tampa. "There are multiple doctors and multiple scripts (prescriptions) that could conflict with each another."
The letstalkaboutrx.com website features a variety of information, including guidance on how adults can talk with their parents in a caring and mature way, even if the traditional parent-child roles are reversed.
When the time does come for an adult child to counsel a parent about proper medications, "check your emotions at the door," Campbell said. "Check your opinions at the door.
"Talk to them the way you wanted them to talk to you when you were a child," she said. "Remember what it felt like when someone was trying to help you and how that conversation went."
Having "the talk" can be a challenge for any adult child, and each situation is different.
"This role reversal is one of the hardest conversations anyone can have," said Colin Castle, director of marketing for Home Instead in Pinellas County. "Take a logical path. A lot of our seniors are willing to admit they have an issue with their medications."
The talk also can be difficult because seniors "are losing some independence," said UF's Hardin. "That's hard for anyone to accept." It's especially true if an adult child takes charge of monitoring a parent's medication plan.
Solberg echoed Hardin's sentiment and suggested that the adult child put the conversation "in terms of empowering the parent and saying, 'Show me all of your medications and I'll help you talk with your doctor.'
"The key is talking to them and getting their permission," he said, "and not just telling them."
Contact Fred W. Wright Jr. at [email protected]