'Families on the Brink:' Elders Confused By Too Many Medications
Intervention can keep elders safe.
Feb. 1, 2011— -- 91-year-old Maynard Merel takes ten different types of pills every day. Ask him to tell you what each pill does for him, and the chances are he'll tell you he has no idea.
Although he suffers from high cholesterol, high blood pressure, an underactive thyroid, and chronic asthma, he can't remember which pill combats which ailment, or the proper dosage he needs.
During a doctor's visit, his geriatrician reminded him that he only needed to take one thyroid pill a day. Maynard Merel was taking ten.
"We have to straighten out all of these – too many medications," said Merel's geriatrician, Dr. Barbara Paris, director of geriatrics at Maimonides Medical Center.
Francis Merel, Maynard's wife, agreed.
"I think he is a mess," said Francis. "He's been taking too much of the drug. He is just lethargic."
Merel is one of many seniors at risk of dying from polypharmacy, the term for when a patient takes too many potentially unnecessary medications.
"There are a lot of patients who see multiple specialists, and nobody is coordinating their care," said Paris. "And they get into dangerous situations where the right hand doesn't know what the left is doing."
Nearly one-third of Americans ages 57 to 85 take at least five prescription drugs -- people with chronic illnesses may take more than 20. Sixty-eight percent of Americans are also taking over-the-counter medicines or supplements, according to a 2008 article published in the Journal of the American Medical Association. These combinations may lead to dangerous and often unmonitored interactions.
"There are over 100K deaths per year related to polypharmacy and medication misuse and adverse reactions, which brings it to one of the leading causes of death in this country," said Paris.
Seniors can experience polypharmacy not only when they are prescribed numerous medications, but also when they start taking the medications of other family members as well.
While Paris put Merel on a new plan, which reduced three of his medications, she discovered he was taking his wife's prescription anti-depressant medication.
"One night he said 'I don't want dinner, I'm going to lie down,' and it just seemed to me to be a kind of depression," said Francis Merel. "He isn't as hotsy totsy as he used to be. ... It's not his style."
Maynard Merel needed help to manage his care. But, like many seniors, Maynard said he felt that asking for help would compromise his sense of independence. And many times, adult children find it hard to determine whether they should step in, in the belief that changes in their parent's behavior are just the natural signs of aging.
Family members can watch for signs of polypharmacy at home, according to ABC's chief health and medical editor, Dr. Richard Besser. These signs can include weight loss, depression, or lack of interest in normal activities.
Also, there are forms an elderly patient can fill out, which will allow family members to discuss the care of their loved ones with the doctor.
"You may find that your parent's doctor won't talk to you because you are not approved due to privacy laws," said Besser.
Filling out HIPPA (Health Insurance Portability and Accountability Act) release forms beforehand can assure you'll be included in conversations about your loved one's care, Besser said.