medication Archives - Better Health While Aging

One of the greatest challenges, when it comes to Alzheimer’s disease and other dementias, is coping with sundowning and with difficult behaviors.

These are symptoms beyond the chronic memory/thinking problems that are the hallmark of dementia. They include problems like:

Delusions, false accusations, paranoid behaviors, or irrational beliefs
Agitation (getting “amped up” or “revved up”) and/or aggressive behavior
Restless pacing or wandering
Disinhibited behaviors, which means saying or doing socially inappropriate things
Sleep disturbances

These are technically called “neuropsychiatric” symptoms, but regular people might refer to them as “acting crazy” symptoms. Or even “crazy-making” symptoms, as they do tend to drive family caregivers a bit nuts.

And when these behaviors happen in the late afternoon or early evening, it’s usually called “sundowning“. (In most cases, sundowning is triggered by fatigue; anticholinergic medications may cause sundowning symptoms as well.)

Because these behaviors are difficult and stressful for caregivers — and often for the person with dementia — people often ask if any medications can help.

The short answer is “Maybe.”

[Read more…]

Today we’re covering a touchstone resource for geriatricians: the “Beers List” of medications that older adults should avoid or use with caution.

(Technically, it’s called “The AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults.” I personally think of it as the list of “risky medications” for older adults.)

If you want to know which medications older adults, in particular, should be careful with, this is the list!

Now, I have good news and bad news about the Beers criteria.

The good news is that they were just updated and revised, so the Beers Criteria published in January 2019 is about as up-to-date as you can get for this type of guideline document. (Yay!)

The bad news is that this year, the American Geriatrics Society (AGS), which has historically made the list freely available to the public on HealthinAging.org, has not released the updated information for free on its page about the Beers Criteria. (Bummer!)

Instead, they’ve posted a notice that “To access the complete AGS Beers Criteria^® and its related resources, please visit GeriatricsCareOnline.org.” From there, the article is available for purchase.

(My suggestion for those who really want the list: consider getting the handy 2019 AGS Beers Criteria® Pocketcard, which is $9.99. Or, ask your health provider to print it for you.)

[Update Dec 2020: I have found a PDF copy of the 2019 Beer’s criteria posted here.]

I think it’s really too bad that it’s become harder for regular people to access this wonderful resource, but oh well.

Whether or not you obtain access to the full 2019 Beers Criteria, I still think it’s important for older adults and families to at least be aware that this resource exists, and to understand how it can help make the medical care of older adults safer.

You absolutely should know that experts in geriatrics and in medication safety go through a very careful process of reviewing the research on medications, and of updating this list of medications that older adults should avoid or use with caution.

So in this article, here’s what I’ll be sharing with you:

[Read more…]

5 Types of Medication Used to Treat Sundowning & Difficult Dementia Behaviors

Medications Older Adults Should Avoid or Use with Caution:
The American Geriatrics Society Beers Criteria (2019 Update)

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