Q. My father takes many pills, too many in my opinion. He seems to take them at his convenience. Sometimes he complies; other times he ignores. Can you write about this kind of dilemma? Many thank. S.L.
The issue you describe is a common one. Up to half of older adults do not take their medications as directed, taking less than prescribed or stopping after six months. The more we understand the conditions and reasons, the better we can help individuals comply with their medication plan designed for their health and wellness.
Adults age 65 and older tend to take more medicines than any other age group because they often have several diseases or other health problems at the same time. Almost 80 percent take at least two prescription drugs and over one-third regularly take at least five. And others report over half of older adults are taking four or more medications. When over-the-counter and dietary supplements are included, these rates are even higher. Many of the conditions are chronic such as arthritis, asthma, coronary heart disease, depression, diabetes, and hypertension.
Medication schedules can be complex. And the more complex, the greater the risks of mistakes. Confusion can occur when medications need to be taken at different times during the day, with or without food combined with other types of schedules.
Your concern that your father is taking too many medications often is referred to as polypharmacy, taking multiple drugs for multiple conditions. Inappropriate polypharmacy is the use of excessive or unnecessary medications that increase the risk of adverse drug effects, including falls and cognitive impairment, harmful drug interactions and more. This is a growing concern according to the National Institute on Aging.
Here are some reasons for the lack of medication compliance, suggested by the Chen Senior Medical Center.
Unaffordable. This is considered one of the biggest barriers. Some older adults live only on Social Security and have multiple chronic conditions that are costly. As a result, they may ration their medications to last longer or even prioritize paying their rent rather than purchasing their medications.
Memory issues. This is another barrier. That may be due to cognitive impairment or just forgetting. Remembering what to take when and how frequently can be a challenge.
No symptoms. Here’s the irony. The medication may remove the symptoms. Consequently, the patient feels better and stops the medication. They only feel better because the medication worked. Also, some conditions do not present symptoms such as high blood pressure, cholesterol and diabetes, that is until the condition gets worse.
Mistrust. During the COVID-19 pandemic, there was distrust of the vaccine and pharmaceutical companies. That distrust has lingered today, reports the Chen Senior Medical Center.
Fear. Patients may fear side effects or fear they may become addicted to certain medications. They also may be afraid to take the prescribed drug because friends report experiencing bad side effects for the same drug or it was ineffective.
So, what can be done to help individuals take the right medication in the right way?
Health providers can better inform patients on the benefits and risks of medication adherence.
To minimize cost, individuals can ask their doctor or pharmacist if there is a lower-cost version of the medication.
Individuals can use medication reminders. These include smartphone apps including the Apple Watch, pill containers with digital times and prepackaged daily pill packs offered by some pharmacy services and other memory aids.
Healthline describes and recommends medication reminders that vary in function and price.
Here are three examples. For more complete description and the pros and cons, go to www.healthline.com/health/best-medication-reminders#our-picks.
The TabTime Timer sets the timer with up to eight independent alarms for daily reminders about specific medications.
The e-pill TimeCap & Bottle is a pill bottle that has a timer built into the bottle cap. The cap is portable to other pill bottles.
Hero is a pill dispenser with medication reminders. It connects to Wi-Fi, signals when it’s time to take your meds and dispenses preset doses. There is a monthly fee.
Thank you, S.L., for your important questions. Hope this information will be helpful to your dad in managing his medications so he can enjoy as much good health as possible. Stay well and spread the gift of kindness.
Helen Dennis is a nationally recognized leader on issues of aging and the new retirement with academic, corporate and nonprofit experience. Contact Helen with your questions and comments at Helendenn@gmail.com. Visit Helen at HelenMdennis.com and follow her on facebook.com/SuccessfulAgingCommunity