Understanding Medication Management in Geriatric Care

Medication management is crucial for older adults because they often have multiple chronic conditions that require treatment with various drugs.

Ageing can also affect how the body processes medicines, making older adults more vulnerable to medication-related problems, like adverse drug reactions, drug interactions, and side effects.

Poor medication management can lead to negative health outcomes, hospitalisation, and even death.

Understanding age-related changes in the elderly

As people age, they undergo several physiological changes that can affect how the body processes medications. These age-related changes influence how medications are absorbed into the bloodstream, metabolised in the liver, and eliminated from the body.

Some of these changes include a decrease in liver and kidney function, changes in body composition, a decrease in stomach acid production, and a decrease in blood flow to organs.

Common Medication-Related Problems that Older Adults Experience

Older adults are more vulnerable to medication-related problems because of the changes in their bodies & minds and the fact that they often take multiple medications. Adverse drug reactions, drug interactions, and medication errors are more common in older adults. Impaired cognitive function and difficulty understanding complex or too frequent medication regimes can lead to medication errors among older adults.

Other medication-related problems are overdosage, under-dosage, lack of monitoring, lack of adherence, and poor communication with healthcare providers.

Importance of Reviewing Medication for Older Adults

Medication review and management are integral to geriatric care because older people are more susceptible to medication-related side effects and medication errors. Medical review is essentially a structured evaluation of an individual's medications to optimise their use and improve health outcomes.

It helps check for drug interactions, monitor any side effects that may occur and reduce the number of medications used. Medication review and management should be conducted regularly, especially when there are changes in a person's health status or medication regimen. This process can help improve medication safety, reduce healthcare costs, and improve the quality of life for older adults.

Tips for Managing Medications in Geriatric Care

• Managing medications can be overwhelming, especially for older adults taking multiple medications. Here are some things to keep in mind!
• Organise medications in a weekly pillbox or a daily medication dispenser to make it easy to take the prescribed medicine.
• Use a magnifying glass to read medication labels and instructions to ensure the right medication is taken at the right time.
• Make a list of all medications, including the name of the medication, its dosage, frequency, and the reason for taking it. Bring this list to all doctor appointments.
• Communicate with your healthcare provider, including doctors, pharmacists, and nurses, about medication concerns or questions. It is important to know what side effects to expect and what to do if there are any concerns or problems.
• Always ask about the side effects or drug interactions of your medications. If it is difficult to remember, keep a list of the same handy.
• Never change the dosage or stop medication without consulting a healthcare provider.
• Always take the medication with water or as instructed.
• Avoid taking medication with grapefruit juice, alcohol, or other substances that can interact with medication.

Important of Adhering to Medication Prescriptions

Medication adherence means taking medications as prescribed by healthcare providers. Poor medication adherence is a major public health concern. Infact, medication non-adherence can occur in about 50% of older adults, which can increase the risk for morbidity and healthcare costs.

Besides forgetting or getting confused about the medications they need to take; older adults have a tendency to stop taking medications on their own if their symptoms have resolved.

Here are some tips to improve medication adherence in older adults:

• Set reminders, such as phone or calendar alerts, to help remember when to take medications.
• Ask family members or caregivers for help to ensure you are taking medications as prescribed.
• Use medication reminder apps to help keep track of medications and dosages.
• Take medications at the same time each day to establish a routine.
• Speak with your healthcare provider about any difficulties you are facing while taking medications, like high cost or side effects. There may be alternatives available that are easier to take or less expensive.

Challenges Older Adults face with Multiple Long-term medications for Chronic Conditions

Geriatric care often involves managing chronic conditions that require long-term medication use, such as chronic pain, dementia, and depression. Older adults with multiple chronic conditions often take several medications, increasing the risk of medication-related problems. These conditions can present unique challenges for medication management in older adults, including:

• Chronic pain medications: Older adults may be more sensitive to the effects of pain medications and may require lower doses to avoid side effects such as confusion, constipation, and falls.
• Dementia medications: Medications used to treat dementia can have complex dosing regimens and may require careful monitoring for side effects.
• Depression medications: Medications used to treat depression can have a wide range of side effects and may interact with other medications, which can make management challenging.

Communicating with healthcare providers about any medication-related concerns, such as side effects or interactions, is essential. Here are some tips for effective communication:

• Prepare a list of questions or concerns before appointments and bring a list of all medications being taken, including over-the-counter medications, vitamins, and supplements.
• Use clear, concise language when discussing medication-related concerns.
• Ask for clarification if there is confusion about medication instructions or dosages.
• Discuss any concerns about medication costs, as less expensive alternatives, may be available.
• Ask about potential side effects and what to do if they occur.
• Speak up if there are concerns about medication interactions with other medications or health conditions.

Conclusion

Older adults are more vulnerable to medication-related problems, like adverse drug reactions, interactions, and medication errors. Though managing medications is essential to geriatric care, it is often challenging for older adults with multiple chronic conditions. Effective review and management can help reduce the number of medicines being taken, adjust dosages as needed, and ensure that medications are being taken as prescribed by the individual's healthcare provider.

Older adults must also ensure regular communication with healthcare providers to address any medication-related concerns they may have. It is essential to follow medication instructions carefully and avoid medication errors.