From the
Toronoto Star:
They are the drugged-out generation, and they're not who you think they are.
They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.
The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve percent are on 10 or more meds, sometimes up to 20 or more drugs; 23 percent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many
drugs.
Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects. Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication.
Dr. Mark Nowacynski, an exceedingly rare family doctor who does home visits on a full-time basis, shakes his head. "So many old people are prescribed so many drugs, they don't know what they're for and they often don't take them properly," he says.
One of the reasons overmedication is such a serious issue, apart from the biological aspects, is that seniors become vulnerable to serious falls when they're excessively drugged, and serious falls can lead to a downward spiral of hospitalization, extreme fear of going out, isolation and death. As well, many seniors have trouble sleeping; instead of being encouraged to tire themselves out with exercise and activities, they may become habituated to sleeping pills that leave them groggy during the day.
Another problem, says Dr. Paula Rochon, a Baycrest geriatrician, is that doses for older people should often be much lower than for younger people. She notes that Valium is long acting and very sedating and shouldn't be prescribed at all to seniors.
Not only does overmedication cost the health-care system millions of dollars annually in unnecessary, expensive prescriptions but also the entire system slows down – and wait times for other patients lengthen – as emergency departments and hospitals struggle to diagnose drug-related problems.
Doctors and nurses trained in the ailments of old age and alert to the problem of overmedication can resolve many of these issues quite quickly, but most doctors haven't had any significant geriatric training. Stories are legion about elders blocking emergency rooms and being admitted to hospital, with doctors thinking the old people are having heart attacks and ordering expensive tests when the problem is simply overmedication.
The Ontario government has responded to the issue with the MedsCheck program (MedsCheck.ca), in which pharmacists are paid to assess seniors' medications and detect problems. People who have an OHIP card and are taking three or more prescription drugs for a chronic condition are eligible. On presenting their card, they receive a one-on-one, private consultation for up to 30 minutes with a pharmacist, who will make sure they are taking their drugs properly and educate them about possible adverse drug reactions.