Many elderly patients fail to keep up with their medications

April 22, 2004|HERB BROCK

When they took their wedding vows many years ago, Richard and Lorene Cooper of the Hustonville area promised among other things to be there for each other "in sicknesss and in health." When they got married, they probably weren't thinking too much about that part of their vows. Now in their mid-70's, the couple are preoccupied with it.

Between the two, the Coopers take 21 medications every day in an effort to stave off sickness and stay healthy. Despite what may appear to be an awesome daily drug regimen, the couple appear to handling it well with Lorene Cooper serving as manager of both her and her husband's medications.

"I have a pill box and every Saturday I fill it up for the week ahead with his and my medications divided up by dosages and day and time we're supposed to take them," she said. Mrs. Cooper takes eight different drugs and other medications a day while her husband takes 13.


But she doesn't stop with just filling up the couple's pill box. She also makes daily reminders.

"I try to use persuasion with Richard to make sure he doesn't forget. He has so many pills to take," she said.

Richard Cooper calls his wife's reminders something more than "persuasion."

"She fusses at me," he said with a chuckle.

The Coopers are a model couple - and all too rare

To John Brislin, a pharmacist who is president of OptiMed, a Lexington-based consulting service for elderly people and facilities that take care of them, the Coopers are a model couple - and all too rare.

According to Brislin, the Coopers are doing what a lot of seniors either are not or cannot do. All too many elderly people aren't taking their medications when they should or are taking higher-than-prescribed doses of some while taking too few doses of others or skipping them altogether, he said.

Brislin would like to see more seniors follow the Coopers' example as conscientious managers of their medications, and that's why he is going to senior citizens centers and nursing facilities with advice on medications management.

At nursing homes and for private individuals, he will do complete reviews of all medications for each patient, and he charges a fee for the service. At non-profit facilities, such as seniors centers, he is offering his service free to clients.

The latest central Kentucky seniors center to offer Brislin's program is the one in Boyle County, and Brislin was there Wednesday morning, at the invitation of center executive director Jackie Sims, to put on the first stage. He was accompanied by Jamie Hobbs, a fourth-year pharmacy student at the University of Kentcuky.

In an interview before his session with some 40 clients, Brislin said the goal of his company, whether it's for a fee or free of charge to seniors center clients, is to "make sure as many seniors can remain as independent and can live safely as long as possible, and one of the biggest things that can be done to keep seniors out of nursing homes is proper management of medications.

"While most nursing homes do an excellent job in administering the medications of their patients, there are many, many seniors who are struggling to remain independent, but a lot of them have problems related to their taking so many medications, both prescription and over-the-counter drugs," he said.

"Staying in a nursing home costs a person on average $50,000 to $60,000 a year. A senior can avoid that expense if he or she is in relatively good health for their age and if they make sure they take their prescribed medications when they should and keep in close contact with their doctors and pharmacists," he said.

Hospitalization, nursing home admission are possible consequences

Brislin and Hobbs gave the clients at the Boyle center a number of examples of how poor management of their medications can cause serious, sometimes life-threatening health problems that often lead to hospitalization and nursing home admission.

"There is one recent case where a man was renewing his prescriptions a little early, and he would keep the old bottles with a pill or two in them and then put the new bottles in his medicine cabinet with the old ones," said Brislin. "I checked his medicine cabinet and found a bottle that had expired 10 years earlier."

Hobbs cited a case where a man was taking a certain variety of Tylenol that left him dehydrated and caused dizzy spells. He eventually fell and broke a hip, and that landed him in a hospital and then in a nursing home.

"One of the biggest problems seniors have with medications is buying over-the-counter medications without telling their doctors or pharmacists and finding out the effect the over-the-counter meds will have on them, especially when they are put in their bodies with the prescribed meds," he said. "Dehydrations and toxicity and many other adverse effects can occur."

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