Medication mistakes cause at least one death every day in this country and injure roughly 1.3 million every year, according to the U.S. Food and Drug Administration. People aged 65 and older are especially vulnerable to medical errors, for reasons that are described below.
Caregivers can play a vital role in keeping seniors healthy by familiarizing themselves with the most common medication errors — and taking the following steps to preventing them.
Ignoring Dosing Requirements
Overdoses are a leading cause of medication fatalities. And although prescription drugs are the most common offenders, it's also possible to overdose on over-the-counter medications. Seniors, in particular, are at risk of overdosing due to declines in memory.
Many prescription medications also require that patients take medication with a certain amount of liquid, with or without food, or after taking an antacid. The medication may not work or may harm the patient if the instructions aren't followed. Read all medication labels completely, and follow all directions carefully.
Stick with a schedule. When seniors take many medications, it's easy to lose track, a common cause of overdoses. Encourage your aging loved one to take his or her medications at the same time every day—for example, with breakfast or at bedtime. Keep track on a calendar to avoid accidentally doubling up or skipping doses.
Simple pill organizers are an effective way to ensure that seniors are taking their medication in the proper doses. Today's sophisticated "smart" pill organizers use technology to help people to remember to take their medications at the right time while also preventing them from taking the wrong amount.
Caregivers should familiarize themselves with dosing requirements for all prescribed medications. Watch for signs and symptoms of overuse, such as prematurely running out of medication, mood swings, and over-sedation. If you do notice changes in thinking, feeling, or appearance, check in with your aging loved one's doctor.
Polypharmacy and Drug Interactions
One of the challenges in caring for seniors is managing the dosage and side effects of multiple medications (polypharmacy), often prescribed by different specialists. While each prescription may be safe on its own, when several are combined they can lead to drug interactions and can be difficult to keep track of and understand. And if a physician lacks complete information about what a patient is taking, he or she may unknowingly add a potentially dangerous medication to the list.
Caregivers can help avoid this problem by maintaining a comprehensive list of all medications and sharing it with a "gatekeeper" healthcare professional whenever a new medication is prescribed. Keep this list in a handy place and make sure all caregivers also have access so it's readily available in the event of an emergency. This personal medication record template from the AARP offers a useful start.
Bring the medication list to all appointments so doctors have access to the "big picture." It's also worth asking your doctor about potential ways to minimize the medication list. The more pills a person has to take in a day, the greater the likelihood of nonadherence, such as missing or doubling a dose.
Pharmacists can also play a vital role in catching potential drug interaction issues. Fill all prescriptions at one pharmacy. This can help pharmacists keep watch for any potentially dangerous drug combinations. Understanding the purpose of each new medication can also alert caregivers to the possibility that multiple medications have been prescribed to treat the same condition.
The following video answers many of the questions surrounding polypharmacy and how best to manage multiple medications:
Not only may drugs interact with one another, but combining certain foods with certain drugs can also lead to life-threatening outcomes. Some foods may render certain drugs ineffective. Others may alter the way a drug metabolizes in the body.
Again, read medication labels completely, and pay close attention to potential food and drug interactions. If there are questions, consulting with your doctor and/or with a pharmacist can help prevent avoidable errors.
Mixing Up Medications
In addition to taking too many medications and/or medications that shouldn't be taken together, many seniors are also taking the wrong medications entirely. This can be caused by similarities in names (Celebrex versus Celexa, for example) or by pills that resemble each other.
Sorting medication in advance can help head off confusion. While filling and organizing pillboxes takes discipline, experts agree that this is a particularly effective method for simplifying the multiple medication process. Some seniors will need assistance with this task. Store all medications separately to reduce the risk of mix-ups.
Be aware of common mix-ups and check for them three times—at retrieval, when preparing medications for administration, and just prior to administration—to help minimize mistakes and maximize safety. Incorporating medications into seniors' routines—such as just before bedtime or after brushing teeth in the morning—increases the likelihood that seniors will take the right medications at the right times.
How a medication is taken can be just as important as taking it. Unfortunately, seniors sometimes get the administration wrong, such as swallowing a pill meant to be absorbed under the tongue or injecting a liquid intended for use as a nasal spray. The administration of medications by a different route than prescribed can lead to problems, including death.
Reading labels and following instructions is key, as is asking questions if you're uncertain. If a senior is having difficulty taking a particular medication properly—for example, if he or she struggles with swallowing pills—check in with your doctor or pharmacist about whether another administration route may be available.
How To Spot Problems
Unfortunately, some seniors may be embarrassed or ashamed to reveal their medication management challenges. Keep watch for signs that your loved one may be struggling, such as expired medications, pill bottles that appear to be unused, or signs that refills are delayed or missed completely.
As with most caregiving issues, open lines of communication are essential. Let your aging loved one know that medication management is a common problem and that you are there to help ease the process.
Caregivers can play an important role in preventing medication mistakes. From understanding common medication terms to following best practices for medication administration, they can help safeguard the health and wellness of seniors through sound medication management.
If you're looking for a comprehensive resource for family caregivers, check out our online Family Caregiver Guide.