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5 Medication Safety Principles for Older Adults

Have you found yourself eyeing an older person’s medication list, wondering if you should worry?

It’s smart to be concerned, especially if your older relative takes five or more medications. Medications can provide many benefits, but they also can easily cause problems.

The CDC estimates that every year 177,000 older adults visit the emergency room due to medication-related problems. But even medications that don’t prompt ER visits may be causing more harm than good, and researchers have documented that “inappropriate prescribing” is common among seniors.

For all these reasons, a big part of what we do as geriatricians is to regularly review an older person’s medications, for safety and appropriateness.

Now, to properly review medications, you do need to work with clinically trained professionals such as doctors, pharmacists, and nurses.

But I am a big believer in the idea that well-informed patients and families are key to getting the healthcare work done better.

So I’ve written a two-part article for A Place for Mom, about how you can help an older person get the most out of his or her medication review. Here’s part one:

“How to Think Like a Geriatrician About Medications for Older Adults“

In this article, I share five medication safety truths that I always keep in mind, and that you should too! They are: [Read more…]

How You Can Help Someone Stop Ativan

by Leslie Kernisan, MD MPH

Have you heard of Ativan (generic name lorazepam), and of the risks of benzodiazepines drugs in older adults? Is an older person you care for taking prescription medication for sleep, anxiety, or “nerves”?

Would you like an easy, practical tool to help someone stop a drug whose risks often outweigh the benefits?

If so, I have good news: a wonderful new patient education tool has been created by a well-respected expert in geriatrics, Dr. Cara Tannenbaum. Best of all, her recently published study proved that this tool works.

As in, 62% older adults who received this tool — a brochure with a quiz followed by key information — discussed stopping the medication with a doctor or pharmacist, and 27% were successful in discontinuing their benzodiazepine. The brochure includes a handy illustrated guide on slowly and safely weaning a person off these habit-forming drugs.

This is big news because although experts widely agree that long-term benzodiazepine use should be avoided in older adults, getting doctors and patients to work together to stop has been tough. It is, after all, generally easier to start a tranquilizer than to stop it!

But through a patient education brochure, Dr. Tannenbaum’s team was able to make this tricky process much more doable for older adults, their families, and their doctors.

The must-read information brochure on Ativan and older adults

If your older relative is taking Ativan (generic name lorazepam), I highly recommend you read Dr. Tannenbaum’s brochure. It provides really good information about these drugs, and includes practical tips on how to address sleep and anxiety issues without using drugs. [Read more…]

How to find geriatric care — or a medication review — near you

by Leslie Kernisan, MD MPH 21 Comments

A caregiver brought up a common question during a recent Q&A call:

“How can I find a geriatrician to review medications, and help care for my mother with dementia?”

Although my recent posts have been about preventing falls, I’ve often emphasized the importance of spotting and reducing risky medications. That’s because medications are one of the easier risk factors to modify, when it comes to preventing falls.

Understandably, this caregiver — who lives far from her parents — wants to find someone to help her mother directly.

Now, medication review is usually included in geriatric primary care care. Geriatric care, after all, means healthcare modified to be a better fit with what happens as people get older. And being careful with medications is pretty integral to this approach.

But, although geriatric primary care is certainly worth looking for, it can be hard to find. (Read on for suggestions below.)

So it’s good to have a plan B, which can be getting a medication review — and fall risk assessment — outside of geriatric primary care. This can also be a good option if your parents are reluctant to change primary care doctors.

In this post, I’ll describe 3 places to look for geriatric primary care, and then 3 options for medication review. [Read more…]

Blood pressure medications linked to serious falls: What you can do

by Leslie Kernisan, MD MPH 39 Comments

Have you had any concerns about an older person falling, or being at risk for a broken hip?

A new clinical research study relevant to millions of older adults was just featured in the news.

The study, completed by a team of geriatrics researchers at Yale, found that in older adults aged 70 or older, taking blood pressure medication was linked to a higher risk of serious falls. (Serious falls as in, falls that caused an ER visit for a fracture, a dislocated joint, or a brain bleed. Serious stuff indeed!)

So, if the person you care for has a diagnosis of hypertension, and if you’ve had any concerns regarding falls or near-falls, these study results should be of interest to you.

In this post, I’ll review the key results of this study. Then I’ll tell you what I think are the most important practical take-aways for family caregivers.

This post will also include some practical tips to help you minimize the risk of your loved one experiencing a serious fall. [Read more…]

More Tips to Avoid Medication Mishaps in Aging Adults

by Leslie Kernisan, MD MPH 2 Comments

Many thanks to those family caregivers who joined me on the Q & A call about medications earlier this week!

In this post, I’ll provide a little more information related to some of the questions that came up on the call.

How to check for risky interactions between different drugs

One caller asked me if I knew of any ways she might be able to check an older person’s medication list for problematic interactions. (I myself use an interaction-checker embedded in UpToDate, but this is a subscription service that costs money and is designed for healthcare professionals.)

After the call, I looked online to see what is available to the general public. Naturally, I turned to Google, searched “drug interaction checker,” and found that several interaction-checkers are available for free.

Having briefly tried the top three search results, here is my current top choice: [Read more…]

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The must-read information brochure on Ativan and older adults

How to check for risky interactions between different drugs

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