Less Is More

By Melissa Hutsell

The elderly population is reaching an all-time high as the baby boomer generation fades into the golden years. With aging comes several questions concerning the best means of care including medication, frequency and dosage. When it comes to this particular topic, according to Dr. Schnoze Del Pozo, Geriatric Specialist with UC Davis and Doctor’s Hospital in Manteca, less is more.

There are lists of medication to avoid giving the elderly populations, says Dr. Del Pozo, “Rather than adding more medications when an elder experiences side effects from the first medication, it is better to remove the first medication or do behavioral changes to avoid further side effects.”

“Benadryl can cause delirium, urine retention, and increase falls. Narcotics increase urine retention, constipation, and falls.  Many studies have also shown that target goals for blood pressure, diabetes, and low thyroid are different in the elderly given adverse effects if tight control is sought. For example, if the physician is targeting a goal blood pressure of 120/80 in a 90 year old, this can actually cause decreased perfusion to the brain leading to confusion, fatigue, and syncope (passing out).”

As with all health concerns, it’s important to look toward alternate solutions rather than medication such as antipsychotics or sedatives. According to both Dr. Del Pozo and the American Geriatrics Society, “antipsychotic medicines are often prescribed, but they provide limited benefit and can cause serious harm, including stroke and premature death. Use of these drugs should be limited to cases where non-pharmacologic measures have failed and patients pose an imminent threat to themselves or others. Identifying and addressing causes of behavior change can make drug treatment unnecessary.” In addition to those listed, there are several medications typically prescribed to the elderly that should only be used as a last case scenario. Research shows that medication including antimicrobials or benzodiazepines is known to increase the chance of falling, accidents, incontinence and infection in elderly patients.

It is very important to keep track of what medications the elder is on, when medications were added, and if incontinence started after a new medicine was added,” for example, Dr. Pozo adds, “Because elderly patients are so susceptible to side effects of medications, it is important to first find ways to intervene without adding more pills. Keep a diary of what medication changes have occurred or what makes incontinence worse.” Dr. Del Pozo recommends having the patient’s doctor go over your list of medications carefully and try to remove any that cause incontinence. In addition, attempt lifestyle changes like decreasing fluids (especially caffeine and alcohol) after 4 p.m., the use of diuretics (like Lasix) in morning, and lastly – surgery, if necessary.

It’s no secret that medication has side effects, some so severe that it can become life threatening or produce additional symptoms or disorders. For the aging population, it’s important to pay attention to medication and their side effects simply because it can do more harm than good.

 

For More Information:

 

The American Geriatrics Society

AmericanGeriatrics.org

 

Doctors Hospital of Manteca

1205 E. North St., Manteca

(209) 823-3111

DoctorsManteca.com

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