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Is your Dad's confusion dementia or too many prescriptions?

by Carol Bradley Bursack, Editor-in-Chief

Many adult children find themselves worried about their parent's failing memory or balance issues only to discover that the parent is taking an armload of drugs prescribed by different doctors. Once all of the drugs are examined by one doctor and many of them eliminated, the parent is often back to a normal pattern of life. Keeping all of the prescriptions at one pharmacy can also help.

As people age, they generally have more health issues than when they were younger. This often means more doctors become involved in their care, which can mean more prescriptions.

Unfortunately, if the elder sees different doctors, especially those at different clinics and hospitals, prescriptions are not always tracked efficiently. This can lead not only to over-prescribing, but interacting drugs and increased side effects, where doctors are unknowingly prescribing one drug to counteract the side effects of another drug. Add to this the fact that the aging body often is generally less tolerant of drugs than the younger body and there is the potential for serious negative results.

More than once I've had someone talk to me about their parent's balance problems or their "foggy brain." The adult children chatting with me about these issues are often the out-of-town siblings of the in-town caregivers. The families are generally close, and there is typically one person who keeps an eye on mom and dad because they live in or near the parents' home town.

The in-town caregivers see their parents regularly, and the changes are often gradual, so they aren't always aware of the more subtle changes in their parents' health.

Elder Care and Prescriptions: A Fresh Set of Eyes

Then the sibling who hasn't been home for a year shows up and is appalled. She notices Dad is hanging onto whatever he can grab when he gets up from a chair and sees that he is uncertain when he walks. He wasn't like that last year. The visiting sibling also notices Mom has gotten forgetful and that everyone around seems to automatically cover for her.

After a chat with the other siblings, the adult children talk with their parents. Together, they look over medical bills and check prescription bottles. They track drug stores and see that the same prescriptions from the old family doctor that Mom and Dad have been seeing for decades are still being filled at the original drug store near home. Then they see that there are some newer prescriptions that are being filled at the hospital pharmacy, from when Dad had heart surgery. They also note a chain drugstore, that now has a convenient location, is filling another prescription Mom got when she had knee surgery and an orthopedic doctor saw her a few times.

Elder Care and Prescriptions: Taking Action

The family gathers up all of the prescriptions, makes an appointment for each parent with a geriatrician, and at the appointments they bring in all the prescriptions. Dad still needs heart medicine, but he has had two kinds, as his original doctor put him on one before surgery and the cardiologist put him on another afterward. They are filled at different drug stores. Dad is reduced to one. Mom's pain medication is really no longer needed, but she's forgotten what it's for and the orthopedist has kept authorizing refills. This is withdrawn.

By the time the geriatrician is finished with the physical exams, he has taken both parents off of several drugs with the idea that they should return in a month and see how they are doing. With careful monitoring both parents end up taking half the medications and enjoying far better health.

Dad's balance could use work and he was given some exercises to do, but taking him off of the double heart medication made a huge difference. Dementia isn't Mom's problem--yet. The memory problems were caused by too many medications interacting with one another.

Elder Care and Prescriptions: A New Technological Era

The bottom line is that medications can increase the quality and quantity of life for many elders. But years of doctoring and patronizing different drug stores have left many elders with expensive and even harmful combinations of medications. All medications should be listed on every medical record and it is by far best to get them all filled at one modern pharmacy where personnel automatically check for duplications and drug interactions.

These adult children need to keep an eye on Mom and Dad. But now they can do it with the help of one doctor who can orchestrate all of the care, even if other specialists are needed. Also, this doctor and others are going to use one pharmacy. The rest of the accounts are closed. Mom and Dad still have some good years left, and now they can enjoy them more.