Medication Safety for Seniors – Five Star Senior Living



oh I forgot to take yesterday's I'll just take another one today it's written that hello hello nurse this is my name is press I'm feeling really terrible a really awful I think I took too much medication I took yesterday's pills and today's pills together I feel real woozy and then I speak to the doctor one of our members is on several prescription medications he came down with a cold so I went to the pharmacy and got some over-the-counter cold medication after he took the medication it reacted with his prescribed medication as a result he became extremely ill and was rushed to the emergency room pills we take help us deal with medical conditions they improve our function to help us go about our daily duties but these wonder drugs contain a hidden danger if they're misused or if we develop a negative side effect and we ignore that or we don't tell our doctor right away I think the the bad news is that medication errors right now are resulting in the estimates are approximately 7,000 deaths per year so that's to September 11th per year people dying from medication errors and another million people a year being injured by medication errors the Institute of Medicine was estimating and just from the inpatient hospital side of this the 10% of hospitalizations that are resulting from these errors and the injuries being caused by the ears they estimate that to be somewhere in the neighborhood of three point five to five billion dollars a year I think that people over medicate I think that people as a whole whether they're elderly or young there is a tendency to just go look for something that'll treat any kind of condition that you have with the elderly and I think in our previous discussions we talked a little bit about this that the most widely abused class of drugs and they although they are laxatives so let's look at some of the simple problems that occur number one we're trying to get as a culture to a point where we have no more handwritten prescriptions for years that was a problem and we've done that here we try to do all of our prescriptions electronically so we're in the exam room together we pick the medication we pick what pharmacy we fax a typed out form that goes to the pharmacist and then it also gets entered electronically into your drug profile of current medications that you're taking confusion with the medication for a long time Wisconsin did not allow the name of putting the branded generic name on prescription labels no doctor would say I'm gonna prescribe lasix then they would go to the pharmacy and the insurance would require that the pharmacy fills it with furosemide and somebody would get home and say well the doctor wants you taking lasix well on I of this frost might is that the same thing the hard part for patients and for everybody involved this process is that drugs have two names you have a generic name and you have a brand name so let me just give you take one simple example and look at all the potential error points along the way in a patient who's on just one drug and I'm gonna call this drugs Iook it's a high blood pressure medication and see what can happen as he goes from the office to the hospital back to home you would think it would be very simple he's on diet goes in the hospital they decide to keep him on it and then he goes home on it well first of all Sayaka another name the generic name is bisoprolol hydrochlorothiazide so let's say on a particular weekend this patient says well I see there's a special at pharmacy acts of giving the discount so I go there and they give me the medication and they say do you want the brand name of generics so you say you want the generic so they put the generic name this a purple hydrochlorothiazide the person takes it home but maybe another weekend they go to a different pharmacy and the pharmacist put on it the brand name is Iook and now the patient has both battles at home if the person is is has any kind of cognitive impairment any type of confusion all of a sudden they're going well syak bisoprolol well i guess they're two different things they take one of each and now a medication errors occurred they have overdosed on hypertensive they bottomed out they have a fault they fractured hip they end up in the hospital and that's just what people also get very confused about when they're taking a medication whether or not they are allergic to it or they're having a side effect and what I try to tell people is that every Troy you take is gonna have some kind of effect on your body both good and bad I will see very often people who say they're allergic to codeine which is a very inexpensive a very effective pain reliever and when you ask them how are you allergic to it what happens when you take it they say well it hurts my stomach or it makes me sleepy no codeine irritates the stomach it causes drowsiness those are side effects that's not an allergy a couple that's living independently ninety-one years old and 88 years old okay now they both have a cyber psychotropic meds one of the the 91 year old is taking meds not only for anxiety but for dementia the wife is taking medication for anxiety and so he runs out of his pills on a Saturday night so he says well you have a nerve pill I have a nerve pill I'm gonna take your nerve pill so you know so then they start sharing medications huge thing I have to stress over and over and over is don't take someone else's medications when I see it happen the most is with the elderly with spouses and so that while an antibiotic may work for a certain person the other another person might be allergic to it they may have other medications they're taking that would be complicated with it they may have underlying conditions that would compromise the person if indeed they took it I remember one time I went to visit my mother in Florida and she was telling me she says oh you know she was at the mahjong group with her lady friends and her son is the doctor so she says well you know Ethel was telling me that you know she's got you know palpitations and she takes this pill and it works really good for her so I asked her to give me some of hers well yeah that she was under Jackson for atrial fibrillation and go mom no don't don't do that the elderly especially have multiple medications there's any number of medications that they are taking for different conditions whether it's blood pressure whether it's diabetes with it and sometimes people get confused it's so exactly what medication should be taken when plus they will then go and buy over-the-counter medications and acids or laxatives other medications for cough or calls that they take on top of everything else so just the sheer number of medications that some of the elderly are taking great confusion so they ration their pills by taking a lower dose they go from one pharmacy to another pharmacy to another pharmacy looking for bargains they send it off to the Canadian pharmacies to get something inexpensive they try to get by maybe by taking an over counter thing that they see an ad for that is described as something that's good for your diabetes are good for your cholesterol or good for your you know for arthritic pain or good for migraine headaches and so they start getting these concoctions of things going that no one knows they're taking the pills that our doctors prescribed for us are specifically designed to care for and to relieve a variety of ailments and medical conditions and we all develop those as we get older but it's up to us to make sure and to pay attention to how we use what's in these containers when the doctor does give you a prescription you want to know why you're gonna be taking this what if why am i taking this what can I expect to have happen and you should be asking the doctor at the same time exactly how do I take it do I take it once a day do I take it in the morning when do I take this how do I take us how long do I take this and you should be asking the doctor what are the side effects with that so you know what they are when they occur and then the last question that you want to ask the doctor is there a generic for this drug and whenever possible you want to use a generic drug because yes they are in my opinion equally effective to the brand name product and substantially less expensive with it once you've gone to the doctor and got in the prescription you're going to ask the same questions of the pharmacist if every single patient had in their wallet that simple list what the names of my medications are and why I'm taking it the the the prevention of ears would be enormous so we haven't evolved to the same place as Coles target and the banking industry in medicine we're all these different computer vendors and computerized medical record systems have a common repository where they can at least put critical information that can be shared across the different platforms and if they go to a doctor they ask an electronic record system like I can they can just say can you print me a list we have a thing called the patient friendly medication list I can just hit a button I can print them what I think there are they can then take that home or their daughter can take it home for an elderly parent and compare it to their meds at home and say oh yeah well this this is what they're taking I have a hearing loss so sometimes I don't catch everything exactly the same well the elderly as a whole have usually diminished hearing so sometimes they will not hear something correctly so they have a family member along or a friend along somebody who can listen and taking that information would be very valuable when you can have a family member come along who you can give that list to and they and also they can also help tell you about other medications that the patient may be taking that are over-the-counter you should also tell the pharmacist and the doctor for that matter any over-the-counter meds that you are taking are you taking antacids if you're taking antacids you certainly don't want to take it when you're taking the medication for thyroid because it will inactivate it especially for elderly patients kidney function is critical in dosing of many medications people can have mild kidney impairment and that will affect the dosage of what they take if they're unwell for a urinary tract infection if the dosage may have to be cut in half or 25% of what the normal dosages because they have a mildly impaired kidney found like fine wine drug did not improve with time that they actually diminish in potency over a period of time however from a practical standpoint it is not a good idea to keep medications after a year's time and that yes you should get rid of them so having a pillbox where once a week you lay out your pills morning pills afternoon pills and you have this dispenser once a week they just lay out the pills and there's nice little devices for doing that many people keep their medications in the in the bathroom which is tends to when you take showers it gets steamed up against moist and therefore medications deteriorate more so the bathroom is the worst place to keep your medications you don't want to keep them somewhere that is sunny and bright so you want to keep in a cool and dry place and not have them in the bathroom elderly people will have little you know kids over grandchildren you got to make sure especially if you transform to those pill boxes now many of those are a lot easier to open those weekly or monthly pill dispenser things that you keep those out-of-reach the patient needs to ask questions the patient needs to understand how they are going to take this why they are taking this what can they expect to have happen from this and then they need to follow through on that there's been studies done on a whole that have indicated that most people don't really do that and that on a whole roughly 44 cents out of every dollar spent on prescriptions is wasted because people don't take it correctly they don't get it fill they don't follow through on these things and yet if you ask questions if you make sure that you understand what you need to do here and if you follow through with taking the medication then the odds are that not only you're gonna get your money's worth out of the prescription your health will be maintained and isn't that what we're doing this off for in the first place we need to listen to our doctors the pharmacist when they're prescribing our medications when they're telling us how and when to take them write down the instructions don't have them write them down don't be glad to do that for you we also need to tell all our doctors and many of us see more than one doctor we need to tell all our doctors all the different medications that were on and this is really important only take the medication that is specifically prescribed for you don't offer your medication to somebody else and don't take medication that somebody offers you and that is going to help you to more fully enjoy your golden years

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