Medications to avoid with seniors Archives

Deprescribing: How to Be on Less Medication for Healthier Aging

Have you ever wondered whether you — or your older relative — might be taking too many medications?

You’re certainly right to ask yourself this. I consider this for all my own patients, and wish every doctor would.

In part, this is because over the years, I’ve had countless older adults express their worries and frustrations, related to their medications. These include:

The hassle of having so many pills to take
Worries about side-effects
Frustration with medication costs
Wondering whether a given medication is the “right” one for you, or for your condition
The sneaky feeling that some of those medications don’t seem to help much
The hassle of coordinating a long medication list among multiple doctors

Needless to say, all of this is not so good for quality of life while aging.

And unlike some things that people worry about, these concerns are all actually justified, given what geriatricians know about older adults and medications.

So if you’ve ever experienced the above worries — or if you (or your older relative) are taking more than five medications — then I want to make sure you know about a process that can improve or resolve all those problems that older adults have with their medications.

It’s called deprescribing, and it’s really essential to optimizing the health of an older person.

In this article, I’ll cover what every older adult and family caregiver should know about it:

What is deprescribing?
Why is deprescribing especially important for older adults?
How does deprescribing work?
What medications are most important for older adults to consider deprescribing?
How can older adults and family caregivers get doctors to address deprescribing?

This way, you’ll have a better shot at what everyone wants when it comes to medication:

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Preventing Falls: 10 Types of Medications to Review if You’re Concerned About Falling

by Leslie Kernisan, MD MPH

Have you been concerned about falls for yourself, or for an aging parent?

If so, do you know if any of your medications might be increasing your risk for falls?

In its Stay Independent brochure, the Centers for Disease Control (CDC) recommends older adults do the following four things to prevent falls:

Ask your doctor or pharmacist to review your medicines.
Begin an exercise program to improve leg strength and balance.
Get annual eye check-ups and update your glasses.
Make your home safer.

In this article, we’ll focus on medications for three reasons:

Medications are among the most common causes of increased fall risk in older people.
Medications are usually among the easiest risk factors to change, when it comes to falls in older adults.
Medication-based risks are often missed by busy regular doctors. Older adults and family caregivers can make a big difference by being proactive in this area.

I want you to understand just what types of medications you and your doctors should be looking for, when you address medication review as part of fall prevention. This article will also explain exactly what to do, once you’ve identified any medications that are associated with falls.

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How to identify risky medications for older adults

by Leslie Kernisan, MD MPH

Many family caregivers know that medications can cause side-effects in older people, and may worry that perhaps their loved ones are being affected by medications.

It’s a very reasonable concern to have. Studies have shown that older adults, especially those taking multiple prescription medications, often experience potentially serious side-effects from their medications.

But having talked with many family caregivers over the years, I’ve found that even the savvy ones often haven’t heard of the “Beer’s List.”

What is the Beer’s List?

Technically known as the “American Geriatrics Society Updated Beers Criteria: Medications that Older Adults Should Avoid or Use with Caution,” this is a carefully reviewed list of medications that are “potentially inappropriate” for older adults, and includes many of the medications that we geriatricians tend to stop or reduce in our patients. (Seriously, identifying and reducing these medications is a big part of my clinical practice!)

Although mainly meant to be used as a reference by clinicians, the American Geriatrics Society(AGS) also provides the information in an easier-to-read format here.

What to do if you realize that you or a loved one is taking a potentially risky medication? Conveniently, AGS addresses this very issue and provides a handy online guide on “What to Do and What to Ask Your Healthcare Provider if a Medication You Take is Listed in the Beers Criteria for Potentially Inappropriate Medications to Use in Older Adults.”

If you’re a caregiver: Have you ever used the Beer’s list as a resource? Other ideas for how caregivers can be empowered to check on their loved one’s medications?

A blog about geriatrics for caregivers

by Leslie Kernisan, MD MPH

Hello and welcome to this blog about geriatrics for caregivers.

I’m Leslie Kernisan, and I’m a geriatrician with a particular interest in enabling family caregivers to better manage the health needs of their older loved ones.

Through my Bay Area geriatrics consultation practice, I work closely with families and geriatric care managers, to improve the health and wellbeing of older adults.

But, I’d like to be able to help even more older adults get better medical care. (This in large part because I have a wonky health policy and quality improvement background, and I love to think about how we as a society and healthcare system can take better care of our aging population.)

So I’m starting this blog, in order to share tips and advice on better medical care for elders with as many caregivers as care to visit the blog.

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What is the Beer’s List?

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