medications Archives - Better Health While Aging

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: [Read more…]

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

by Leslie Kernisan, MD MPH 18 Comments

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:

Begin an exercise program to improve leg strength and balance.
Ask your doctor or pharmacist to review your medicines.
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. [Read more…]

How to Choose the Safest Over-the-Counter Painkiller for Older Adults

by Leslie Kernisan, MD MPH 86 Comments

Q: My 88-year old mother often complains of various aches and pains. What is the safest over-the-counter painkiller for her to take? Aren’t some of them bad for your liver and kidneys?

A: Frequent aches and pains are a common problem for older adults.

If your mother has been complaining, you’ll want to make sure she gets a careful evaluation from her doctor. After all, frequent pain can be the sign of an important underlying health problem that needs attention. You’re also more likely to help your mom reduce her pains if you can help her doctors identify the underlying causes of her pain.

That said, it’s a good idea to ask what over-the-counter analgesics are safest for older people.

That’s because improper use of OTC painkillers is actually a major cause of harm to older adults.

So let me tell you what OTC painkiller geriatricians usually consider the safest, and which very common group of painkillers you should look out for.

What’s the safest OTC painkiller for an older parent?

[Read more…]

4 Medications to Treat Alzheimer’s & Other Dementias:
How They Work & FAQs

by Leslie Kernisan, MD MPH 30 Comments

If someone in your family has been diagnosed with Alzheimer’s or another dementia, chances are that they’ve been prescribed one of the “dementia medications.”

But were they told what to expect, and how to judge if the medication is worth continuing?

I’ve noticed that patients and families often aren’t told much about how well these medications generally work, and or how to determine if it’s likely to help in your situation.

So in this post, I’ll explain how these medications work. I’ll also address some of the frequently asked questions that I hear from seniors and families.

If someone in your family is taking one of these medications or considering them, this will help you better understand the medication and what questions you might want to ask the doctors. This is especially important if finances or medication costs are a concern.

Note: This article is about those drugs that have been studied and approved to treat the cognitive decline related to dementia. This is not the same as treating behavioral symptoms (technically called “neuropsychiatric” symptoms) related to dementia, such as paranoia, agitation, hallucinations, aggression, sleep disturbances, wandering, and so forth. There are no drugs FDA-approved to treat the behavioral problems of dementia. I will address the off-label use of psychiatric medication for this purpose in a future article.

4 Medications FDA-Approved to Treat Dementia

FDA-approved medications to treat Alzheimer’s and related dementias basically fall into two categories: [Read more…]

7 Commonly Neglected Problems to Address for Healthier Aging:
The Healthy Aging Checklist Part 3

by Leslie Kernisan, MD MPH 9 Comments

This is the third in a series of posts covering the Healthy Aging Checklist.

Again, the Healthy Aging Checklist summarizes the six fundamental activities I recommend when asked what to do to maintain the best possible health while aging. They are:

Promote brain health and emotional well-being.
Promote physical health.
Check for and address common senior health problems (such as falls, memory concerns, depression, incontinence, pain, isolation, polypharmacy).
Learn to optimize the management of any chronic conditions.
Get recommended preventive health services for older adults.
Address medical, legal, and financial advance care planning.

In this post, I’ll cover the third item: addressing commonly neglected senior health problems that routinely sabotage healthy aging.

These issues are sometimes referred to as geriatric syndromes. They affect health and quality of life, and although they happen more in people who are older or frailer, they affect countless people in their 60s and 70s as well.

Virtually all of these issues affect a senior’s ability to socialize, be physically active, and take good care of himself or herself. So addressing these is key to enabling healthier aging.

Unfortunately, these issues routinely fall through the cracks of usual medical care. People often suffer from these problems for years without anyone taking effective action.

This may be because many people — doctors, seniors themselves, or family members — assume nothing can be done about these, and that they are just “part of getting old.”

Don’t believe that. We have studied these problems in geriatrics and most of the time, correctly evaluating and then managing these problems helps older adults and their families feel better, live better, and sometimes even live longer.

Remember, healthy aging is not just about preventing problems. It’s also about spotting them and addressing them before they get worse, or drag down the rest of your health and independence.

So for healthier aging, be proactive in checking for these oft-neglected problems.

And then remember: sub-optimal treatment of these problems is all too common. So you’ll need to be proactive about getting them correctly managed — which might mean either seeing a geriatrician (nice if you can find one) or making sure your usual doctor is thinking like one.

Here’s what to look for, and how to learn more:

7 Common Problems to Check for and Address for Healthier Aging

[Read more…]

What’s the safest OTC painkiller for an older parent?

4 Medications FDA-Approved to Treat Dementia

7 Common Problems to Check for and Address for Healthier Aging

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