It's a pretty simple formula to follow: As people rise in years, so rises the likelihood that they will be prescribed a pill for what ails them. It's the end results that are so disturbing: Those aged 65 to 69 take an average of 15 prescriptions per year, while those from 80 to 84 take an average of 18, according to the American Association of Consultant Pharmacists. It's a practice that begins early. AARP found that, on average, 45-year-olds take four different prescription drugs -- every day.
It gets worse. The AACP says that this practice -- known as "polypharmacy" -- has a high price tag. The economic impact of medication-related problems is estimated at $177.4 billion per year, rivaling that of Alzheimer's disease, cancer, diabetes and heart disease. Plus adverse effects brought on by the combination of multiple drugs are thought to be responsible for nearly a third of all hospital admissions. Each year 32,000 seniors suffer hip fractures caused by medication-related problems. It's simple: They are overmedicated, feel dizzy when they stand up, and fall. Or worse, get behind the wheel of a car.
Polypharmaceutical practices often are in full evidence once a patient enters a care facility. Some nursing homes unnecessarily dispense powerful antipsychotic drugs to many elderly residents, including residents with dementia, according the Health and Human Services inspector general. A ProPublica investigative report also found that drug companies were promoting off-label use of their medications to doctors and nursing homes.
Luana Hillin, 58 and of Temecula, California, went through this with her husband -- a man 20 years her senior. He was diagnosed with Parkinson's Disease when he was in his 40s. He later developed severe dementia as well. Hillin says she reached the point she could no longer care for him at home and he spent about seven or eight years in hospice before dying of Parkinson's. Yes, hospice.
"When he was in the convalescent home," she said, "they definitely over-medicated him. They wanted him passive. Many of the meds they were giving him -- or I was charged for -- he didn't need." At one point, she said, they gave him medication for diabetes, which he didn't have. "They had him on at least seven different medications in the home, maybe more." The goal in giving these drugs to her husband, she believes, was to keep him "passive." It was an awful, painful experience for the family to go through and watch. And they felt powerless to combat it. He died at age 72 in 2010.
If we're placing blame, our arrows should be aimed squarely at the medical community. The Journal of General Internal Medicine found that U.S. doctors routinely prescribe potentially harmful drugs to older patients even when equally effective, less powerful drugs are available. Truth is, even some of the most commonly prescribed drugs can be problematic for elderly patients because they linger in their systems longer, causing higher rates of complications.
But there's also a message in here for those of us caring for older parents or spouses: Take ownership of the meds your loved one takes and don't be afraid to Google drug interactions. Challenge each new prescription added to the mix and be convinced there isn't a less potent way to go.
Like a lot of things in life, when it comes to Grandma's medications, sometimes less is more.
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