Aging Parents–New Year’s Resolution: Medication Must-Do’s

Confusion about medications.
Outdated medicines.
Dependable medication reminders.
An at-the-ready list of prescription and non-prescription drugs
:

Let’s hope our parents don’t have the first two– and do have the last two.

We make New Year’s Resolutions when we’re young. Getting our life in order is a priority for many. I’m guessing if we check with our elders, there aren’t so many resolutions made–and if they’re made they don’t include anything related to their medications. Yet taking medications as directed, when directed, would be a worthy–and possibly life-saving–resolution to help parents age well.

“When Taken As Directed Poses A Problem” was the title of a NY Times Health column several years ago. It highlights  legitimate confusion about taking medications–a head’s up to double-check with our parents that they’re doing it right. (Strategy–ask an objective question: “When you get a prescription that says ‘Take twice a day,’ do you take it every 12 hours or how? Someone asked me that question and I didn’t know how to answer it.”)

What about unused, outdated medications? A recently received email from the  National Association of Boards of Pharmacy Foundation (NABPF), calls attention to its Prescription Drug Safety Program (AWARXE) and the dangers an unmonitored medicine cabinet can pose during the holidays (think unsupervised teens home for vacation). It mentions the prevalence of out-dated, unused  medications that hide in the back of medicine cabinets.

My immediate thought: How many of us have found, in our parents’ collection of medications, some partially-empty, little plastic bottles with outdated dates–and wondered what purpose they serve. Flushing drugs down the toilet, like Mother told me her mother did, is not environmentally acceptable these days. So, along with safety information, the drug disposal site information offered should be helpful..

Thinking about these little plastic bottles, reminds me it’s a bad idea to have two look-alike pill bottles sitting side by side, especially for an older person with compromised vision. Ditto for a younger person in a hurry.

True story: Hay Fever was a big problem for me years ago. Early one spring morning I grabbed a glass of water and swallowed what I thought was my prescription allergy pill–while sneezing and running out the door to go to work–and suddenly realized I’d taken the dog’s heart worm pill. The little yellow bottles were side by side on the upper shelf in the kitchen. I had a meeting first thing and excused myself to call the doctor, who said if I didn’t start baking, not to worry (honest!). That said, it could be dangerous for elders. Prescriptions that come by mail order often come in the same looking, same size bottles with the prescription name in bold, but not very largeIs this OK for an elder with compromised vision?

Is this where dependable medication reminders, like those having plastic containers with days of the week compartments, become a must have? If more than 2 medications are involved it could be helpful, even for parents who have no problems remembering when to take them. When parents are forgetful, there are additional options for the medication reminders. Two good products that can be used as a yardstick are Philips and Guardianmentioned in a 2011 post. There are no doubt updates for those along with new options that make sense to check out.

Lastly, all of us should have an easy-to-get-to list of our parents’ and our medications– probably on our smartphones or in our wallets. Laminating the list makes it last longer. While everyone should have their list with them at all times, it’s especially important when they go for a doctor’s appointment.

In the event we’re confused by our elders’ medications, check out this helpful WebMD pill-identifier website. It displays a color picture of every medication you search, which can be even more helpful if printed out. Since dosage–along with “when,” and “with or without” food–is important, add that information if appropriate. (Some adult children tape the printout on the bottle.)

—-Additional ways we can help parents–and those we care about–age well throughout the New Year.

Aging Parents: Problems Swallowing Pills? Here’s Help.

Milk? Tomato Juice? Pill Cutter?

Prescriptions for pills–more prevalent as people grow old. Yet before we are old, many of us are accustomed to taking non-prescription pills–some large, like Calcium. Perhaps that’s the time we learn whether swallowing pills is easy for us.

I never thought about pills causing anyone difficulty….until Mother, who had osteoporosis, couldn’t swallow Calcium pills. “Purchase a pill cutter” and “take them with a liquid heavier liquid than water, like tomato juice or milk,” was the advice. The heavier liquid solved the problem, although we’d already purchased a pill cutter (which we discontinued using). That was a decade ago. Chewable calcium has now solved that problem for many.

One in three people vomit, gag, or choke when swallowing pills, according to the Harvard Health blog’s post/article about swallowing pills (see sidebar for recent article or click link). Pharmaceutical companies, aware of the problem, have manufactured pills in many easier-to-swallow forms than those chalky white aspirins of decades past. Yet this hasn’t solved the problem for many.

While the article offers two “tricks” (which seem a bit odd to me) and the warning “Don’t try these alone,” plus other suggestions, there is professional explanation–with diagram– of how swallowing works and can be evaluated (some people suffer from dysphagia). The Comments section (at the very bottom following the post) offers additional simple “tricks,” and one reader who said the “tricks” worked.

It’s human nature to avoid doing something that’s difficult or unpleasant, we know this. We also know it’s easy for older people to forget to take their medications. Can avoidance subconsciously enter into forgetfulness? In any case, avoiding an important medication because taking it is difficult or unpleasant, can only encourage the problems the medication is prescribed to prevent.

Remembering and suggesting the swallowing tips is another way we can be helpful–as we try to help parents age well.

Check out “Newsworthy” (right sidebar). Links to timely information and research from top universities and respected professionals, plus practical stuff–to help parents age well.

Making it Better for Parents in Assisted Living

 Is “assisted living” a euphemism for warehousing aging parents in an attractive place where we think they’ll be well taken care of? The PBS documentary “Life and Death in Assisted Living” is, I certainly hope, not the norm. What is the norm (and not the fault or responsibility of the assisted living facility’s administrators) may be the inattentiveness on the part of adult children once their parents are in assisted living.

Is it purposeful? Do children’s caring instincts become numb when many daily-living responsibilities are handed over to others (the facility in this instance)? On my yearly summer trips west, I have the advantage of seeing people (young and old) whom I haven’t seen in a year. My mind’s eye and my mental makeup record people as they were a year ago. Then there’s the present. In some instances it was heartening; at other times, downright depressing. Assisted living accounted for the latter.

As young parents, it’s easier to get on with our lives when our children are put in daycare with a responsible person, and then preschool etc. etc. But of course at the end of the day children come home and demand a certain amount of interaction and normalcy prevails. Is it a stretch to say that an unknown number of adult children get on with their lives when their still mentally capable parents are in assisted living? And they forget the importance of daily normalcy–whether in assisted living or not.

No doubt every family has members who are tone deaf to this. Hopefully every family also has others who find it easy to contribute normalcy or could contribute but only know how to pay a visit.

Diane Ackerman , poet, essayist wrote “I don’t want to be a passenger in my own life.”

Unless parents are resourceful and take advantage of the many activities that fill a page on the weekly assisted living calendar, they can easily become a passenger in their own life. That becomes depressing.

Trying to get along within the confines of their assisted living space, with but a fragment of their old furniture and their old life, can be depressing.  And anti-depressants (which I’m guessing many take), don’t change the institutional setting, different routine, lack of interactions with family and long-time friends–the lack of normal  (as they knew it) life.

5  Family Must do’s When Elders are in Assisted Living

1. Friends or family interaction (in person) on a daily basis can alleviate some of the isolated, lonely feeling. and bring moments of normalcy. Assign people to visit each day; possibly offer suggestions to those who may lack the creativity to go it alone.  Those suggestions could include:
Talking Points: Years ago a good friend of my husband’s always brought a list of “talking points” when they’d meet. It sparks conversations and is a reminder of what’s important to share.

2. Visiting and acting like a visitor may not provide real interaction.
–What about bringing a deck of card, a game (Scrabble?), or a crossword puzzle to work together to stimulate the mind and add some normal fun? Leave the cards, games, puzzles there for the next visit.

3. Taking assisted-living residents out of the facility as often as possible each week so they are still in touch with “normal.”  Suggestions: A meal; sitting somewhere and people watching; watching a movie in a movie theater; visiting a friend; attending a grandchild’s sporting event or play or concert; or walking through a garden center or a park; or going shopping with those who have decent mobility

4.  Sometime family visitors busy themselves taking care of things (making the bed, straightening up) instead of interacting with person they’ve come to visit. It may not be appreciated. Taking dirty laundry home (if you are good at at laundry) is appreciated, but busying yourself while coming to visit?—no. If you’re compulsive about doing something work-related, asking when/if convenient is respectful.

5. Understand medications and their side-effects. Nix the antidepressants if they’re not absolutely necessary. (Isn’t it legitimate to be depressed when surrounded by elder, needy people day in, day out in assisted living?) Understanding the degree of depression is key. Knowing an anti-despressent’s side-effects is just plain smart. Talk with the doctor if in doubt about the necessity of an anti-depressent (if your parent is taking one) and about side effects of all current medications.

When living at home jeopardizes life and limb and honest, competent home care givers aren’t possible, assisted living is the fallback. But–also–check out the aging in place information below.

Related:
Technololgy to help parents remain in their homes

PBS News Hour Video August 8, 2013–There’s No Place Like Home: Seniors Hold on to Urban Independence Into Old Age

More about Beacon Hill

Note: “Of Current Interest”(right sidebar). Links to timely information and research from top universities about cancer, dementia, Parkinson’s, plus some fun stuff–to help parents age well.

 

Aging Parents and Medications: Missed? Mixed Up?

Pills

This past week geriatrician, Mark S. Lachs, MD, author of Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Health Care as You or a Loved One Gets Olderwas one of two presenters at a symposium I attended: “Helping or Harming? Navigating the Supplement and Medication Maze.” Its Sponsor: NY-Presbyterian/Weill Cornell Medical Center’s Women’s Health Center.

I’ve written previously about medications: “Medications: Taking Them or Perhaps Skipping Them” and “One Size Doesn’t Fit All.” Dr. Lachs’s presentation illuminated, with research and professional expertise, this important aspect of helping parents age well.

He spoke about “the collision of drugs with an aging body that creates issues;” and told us that as many as 25% of medicare hospital admissions may be due in some way to an adverse drug event. I think most of us were astonished at this statistic, but when you think twice about it, it’s understandable.

The 2002 statistics from the Alliance for Aging–that dealing with 3 medical conditions is average for a 75-year-old (see “Medications” post)–seem basically unchanged in 2011. By age 75 people are dealing with 2-3 medical conditions that require prescribed medications, according to Dr. Lachs. Check out your friends. I’m guessing many women, at least, have one condition–bone density–if not more. Add to this the vitamin supplements we take and it adds up to a lot of pills. And a lot of pills can lead to confusion (even danger sometimes) for aging/older/elderly parents and possibly for us.

While younger people may be more adept at multi-tasking while eating breakfast, for example, and remembering that they’ve taken all pills–including vitamins–older people may be distracted and forget whether or not they’ve taken one of their pills; then either skip–or take an extra. Not good!

Some people dump all pills in a ziplock bag to take on vacation, also not so good as it necessitates remembering which pill is which and making certain to take the right pill at the right time. Scarier is the fact that elderly people, in their own homes, can become confused and forget if the big pink pill is for hives and the small pink pill is for heart or vice versa (my example). This helpful website displays a color picture of every medication you search, which can then be printed out. Since dosage–along with “when,” and “with or without” food–is important, add that information if appropriate.

Dump the picture(s) in your ziplock bag. Dr. Lachs recommends attaching the pill’s picture to each container of older/elderly parents’ pills, making them easily identifiable… helping to prevent confusion.

The value of geriatricians to the aging population is beyond measure as we try to help aging parents. And Dr. Lachs goes beyond even beyond this. He is a highly regarded professional with an impressive list of accomplishments, and a gift for providing important, practical information in an interesting, understandable, way we can all relate to–in his book and in his presentation.

Capable Adult Children: Stressed…………….. Decisions: Hastily Made……………………. Independent Aging Parent: Unnecessarily Damaged

This is true. It must be told–shared with me by a BFF of many decades. It involves someone she deeply cared about, whose smart, busy, caring children unwittingly compromised their dad’s quality of life. The result: a disaster for him; utter dismay for them.

I wrote about it when I first began blogging. It had no tags. Didn’t realize only a few read it, until today-when someone did read it and, out of curiosity I checked its stats. Because of its relevance to the impact our busy lives can have on independent, aging parents, I’m republishing it, editing it a bit, and changed its title from “A Sad Story,” which it clearly is. I think it offers lessons for us all.

Rodney, divorced, and in his early 80’s, was living happily by himself in a condo in a very nice California suburb. He was a retired professional with many friends and former colleagues who valued his wisdom and kind ways.

But he was increasingly seeming “spacey,”– “dementia-like” to those who knew him well. He appeared unsteady on his feet at times. Close friends noticed this and may have attributed it to his age. Reasons for no one questioning this physical and mental change could be many.

One day Rodney took a bad fall in his apartment. A neighbor heard his call for help; phoned 911. The local hospital supposedly did a full evaluation to determine the cause of his fall, and his daughter was told he needed assisted living. She quickly and efficiently made arrangements, but it was soon evident that Rodney needed more help than assisted living provided so a private aide was hired to be with him. More falls, more trips in and out of the hospital. No one understood the cause, only the effect as Rodney became more and more frustrated and, at times, unruly.

Assisted living lacked approprite staff to care for him–even with his aide. Thus his daughter located a group home with adequate staff to watch him and prevent more falls. The superviser of the home, a thorough person, had a hunch… that medication could be causing Rodney’s problems. Indeed Rodney (who could legally write prescriptions), was using a commonly prescribed sleep aid. Rodney had no primary care doctor (unrelated specialists treated him). Evidently prior to the “hunch” no one knew Rodney was taking this medication, which could produce the side effects Rodney was experiencing.

The good news: the group home’s supervisor changed Rodney’s medication. He became himself again and much steadier on his feet. The bad news: he had nothing in common with this group home’s residents. Disliked being there.

But during these many months his efficient daughter had sold his condo because, she was advised, he could no longer live alone and because funds would be needed for his group home care. Rodney has no condo to return to.

Initially his daughter was glad to see him cared for, didn’t wanted another upheaval, and looked forward to peace of mind. But with new medication, Rodney was adamant: he had no reason to stay in the group home.

A bad start, lack of information, incomplete knowledge, inaccurate assumptions, and a busy, caring daughter’s well-meaning quick fixes. What do we learn?

1.  When making important decisions, think: is it better/easier for my parents or for me?
2.  A current list of parents’ medications may help avoid problems.
3.  Experienced geriatric social workers would most likely have reduced the busy daughter’s stress and helped with well-thought-out changes and a better outcome. Social workers are an excellent resource.
* * * * *
PS.  Rodney did move from the group home to assisted living, since many months had passed leading to other problems. He died shortly thereafter.

Aging Parents: Taking Medications–or Perhaps Skipping Them?

How difficult is it to remember to take medications? Do the number of medications and a good memory determine that? Or is there more to consider? (Of course, read on.)

For young adults it’s easy.  Most have few prescription medications and probably some vitamins–no doubt often gulped down at the same time each day. But what about older people and aging parents?

People over 55, on average, take  6-8 medications daily, according to a July 5, 2011 NY Times article.  I wonder if that number includes vitamins.

Dealing with 3 medical conditions is average for a 75-year-old, according to the Alliance for Aging Research presented in a Tufts University Health & Nutrition Letter article (August 2002). This necessitates about 5 prescription drugs simultaneously, although the article says the number could go as high as 15.

There are of course organizers–from the inexpensive plastic pill-organizing boxes to the more expensive technological products like Philips and Guardian that remind people to take their medications.

But this may be only part of the issue.  The July 5, 2011 NY Times article, “When ‘Take as Directed’ Poses a Challenge” addresses  another important aspect. It never occurred to me that “take every 12 hours” and “take twice a day” could cause confusion or be burdensome.  In our efforts to help parents, who take medications, age well, this article is more than worthwhile….and if you wonder if aging parents may be skipping medications, it’s a must-read.

A Father’s Day Round-Up of Gifts for Aging Dads-updated 2012, 2013

Father's Day Cake made by Esperanza

Father’s Day Cake made by Esperanza

NOTE: 2015 ROUND-UP OF GIFTS FOR FATHERS AND GRANDFATHERS–PARTS 1 AND 2– IS THE MOST UP-TO-DATE GIFT LIST. READ NO FURTHER, JUST CLICK THIS LINK 

The cake should look familiar–from my last year’s Father’s Day post. Today I’m rounding up gift ideas from my past posts and adding some. Indeed I’m also adding some hidden agenda items that enhance aging parents’ quality of life, designated **. (You’ve probably thought about them but never had the courage to act.)  Since Father’s Day is Sunday, here’s the list–by categories–that should help us last-minute shoppers.

Accessories/Clothing:

  • Cane (measured correctly) or walking stick
  • Hat (to shade a bald/potentially balding head)
  • Sport shirt. (Dad liked long sleeve ones to protect his arms from skin cancer–a definite concern as he aged.)
  • Sleeveless cardigan (not over the head) sweater vest. Easier to get off and on if buttons aren’t a problem. Older people run cold. Dad wore it at home. It also looked good under a jacket when he went out. (This style is hard to find…know someone who knits?)
  • An easy-to-use umbrella–opens/closes with the push of a button. Note: there has been a lot of rain this spring. (Totes makes one.)

Computers–especially designed for seniors: Check the 6 options in my May post https://helpparentsagewell.com/2011/05/28/computers-especially-for-seniors/  .

  • A-Plus Senior Computer
  • Big Screen Live
  • Eldy
  • GO computer
  • WOW computer
  • Pzee computer

  For the even less-technology-talented, check out 

Entertainment:

  • Magazine Subscription
  • Netflix
  • Subscription to newspaper–hometown, financial
  • Tickets to sporting events etc.–accompany Dad or for Dad and a friend.
  • A short outing with Dad (fishing trip, golf game, movie, zoo, his old neighborhood if it’s near–you might learn additional family history).
Health:
  • Membership to the YMCA
  • Membership to a gym
  • Membership to Silver Sneakers
  • A good blood pressure gauge may be a gift that helps parents age well, possibly recommended by doctor.
  • A great pair of shoes for walking
  • **This medication reminder was featured in a respected hospital’s magazine, sent to seniors in surrounding communities.  http://www.guardianmedicalmonitoring.com/medication-management.asp.  Good idea for forgetful fathers (and mothers)?

Hearing:  Hearing loss in older people is a problem for them and us.

I pay little attention to company’s emails sent to my blog’s gmail, but because of the Times article–this interested me.  Click the amplified phones picture for Clarity’s offerings. A few phones (may or may not meet your Dad’s needs) are on sale for Father’s Day.
 
Googling “telephones for hearing loss” provides additional phone options.

Pampering
  • Starbucks VIA ready brew individual instant coffee packets–regular or decaf in 3 or 12 packs for coffee lovers. Microwave in mug. Pricey. Dad probably wouldn’t buy it for himself.
  • A massage or a professional shave
Vision: We know aging produces vision changes in many.
  • Large print books (for dads who still like the feel of a book)
  • The Kindle or other electronic book, where the font can be enlarged–a Godsend I hear
  • The mini-maglite, small flashlights that give great light in dark places.
  • Pocket magnifying-glass takes up little space, is light weight, not pricey ($9.95 at Barnes & Noble), remains lit without having to keep a finger on any button, great for reading (menus/bills) in dark restaurant.

You can laugh with Dad if your “hidden agenda” gift is discovered. But he will know your heart’s in the right place.

……..additional ideas in next post.