Over Medication Is a Real Problem

There is a culture of over-medication and unneeded procedural care in senior care.

Having seen first-hand pill bottles galore in the cabinets of many seniors, the question has to be asked: are seniors being over-medicated? Stories abound in community centers, assisted living, nursing homes and in the homes of those seniors still living at home, of seniors taking an excess of 25 pills a day. Geeze, what are all the meds for?

Are all these pills needed? Are they necessary? What is their purpose? Is there duplication? Do the prescribing doctors know what other medications the senior is taking?

There can be an enormous lack of communication between specialists (there could be several) and the senior’s general practitioner. Often, it is the pharmacist who sees that a negative reaction is about to occur! Sometimes the senior is using more than one pharmacy. What then?

Who is staying on top of the med-list? Who is responsible for updating a senior’s information? The general practitioner? The pharmacist or pharmacists? A family member? The caregiver? Who?

There are many seniors that have no idea why they are taking a particular medication; all they know is that it was prescribed to them. Well, honestly, our seniors need to know more.

The real issue is: who knows the WHY in relation to the senior’s care? When a senior receives specific medication, who is it that makes the decision that the meds are a necessity? Are there alternative or more natural means of targeting the senior’s symptom or illness? Who knows this? Who should know this?

Recently, geriatric care managers have surfaced, and the above is why they have become important. They actually review the senior’s med list and they are charged with making sure the meds are not excessive or harmful. Often, a geriatric care manager will find that a senior’s specialist is changing up the meds with instructions for the patient to return for a follow-up in several weeks. What if the senior doesn’t have a geriatric care manager? Will that senior go back? Who is checking on that senior? Did they stop taking their meds? Are they filling in with older meds, meds that should have been discarded? The dissemination of prescription drugs to seniors without a true overseer is a serious problem.

There are many, many doctors, caregivers and family members that are trying to do the right thing by their senior clients, patients and family members. They are true advocates for their clients and loved ones. The fact remains that most seniors have several levels of care and someone needs to be the consistent person responsible for the medicinal needs of that senior.

Questions to ask and get the answers to: why is a certain medication needed, and how does it interact with meds that are already being prescribed? Is the senior being medicated because of behavior (seniors’ individual personalities and traits should not be controlled through medication)? Is the medication that was prescribed working as it was intended?

There is an additional struggle in the healthcare industry as it pertains to the over-use of procedures: repeated labs, MRIs, X-Rays, and so forth. Do 80-90 yr olds need preventive care (scopes, mammography, pelvics)? Are these procedures really going to make their lives better?When is enough enough? Who is minding the store?

The key element in all this is a strong doctor-patient and patient-caregiver relationship. If seniors receive regular visits from family and friends, there is the capacity to nip problems in the bud. Unfortunately, this is not something our healthcare system usually promotes or accommodates.

Sadly, a key issue in the prescribing of too much medication goes back to the profits of the pharmaceutical companies, and given the fact that many seniors are hesitant to question their providers, change must come through “the boomers.” We must ask the hard questions and request the availability of other alternatives to assist in our parents’ and our treatment.

Become an advocate for what is right and just. Do not worry about hurting someone’s feelings or being politically correct. Do not worry about offending the physician by questioning his knowledge. This is someone’s life and rights. We are talking about seniors do not need over-medication and countless invasive procedures.

Check out some practical advice and think about requesting (FREE) Home Instead Senior Care’s Emergency Kit.

This story was first published in the Foxboro and Wrentham PATCH…

What She Has To Offer

I’m in the kitchen starting the coffee when Mom comes in. “What can I do to help?” she asks before she even clears the door.

It is very important to Mom to feel useful. She doesn’t like others doing things for her. I try to make sure there is always a job she is able to do. Sometimes that is difficult, but this morning I am prepared.

“There’s Windex and paper towels on the table there,” I say. “Can you just wipe the table off for me?” She cleaned it last night, but she won’t remember that.

“K.O., I’ll do it!” she says, tearing off several paper towels with alacrity. “Is this the Windex?” She motions toward the blue spray bottle.

I turn from the coffeemaker. “Yep, that’s it.”

But before she can start, Mom sits abruptly in the large kitchen armchair, wincing. “Oooh,” she murmurs, rubbing her legs, the paper towels still in one hand.

Mom does not show pain often, so I’m alarmed. “What?”

“Well, it’s just …” She pulls both soft cotton pant legs up to her thighs. Her lower legs are puffy above her tight ankle socks and around her knees.

For the full article

Thanks to the NY Post Blog for this article!

Several Bills Currently In Congress

There are several bills currently in Congress that will impact Medicare and senior service providers:

The first is a reintro­duced initiative to forgive student loans for those medical professionals who agree to service seniors in underserved ar­eas.

The second is a bill which would modify the new rule requiring a face to face doctor visit for ordering Medicare home health nursing services, by expanding the rule to allow nurse practitioners to order the visits as well.

Third, patients, families, and facilities are negatively impacted by the arcane rule requiring a three day stay in the hospital in order for Medicare to pay for the skilled nursing facility charges. There is a bill before Congress that would change this requirement to include “observation” time.

Thanks to Robin Smith Consulting for these valuable updates

Caring For Loved Ones With Alzheimer’s

http://www.thetakeaway.org/2011/jun/21/caring-loved-ones-alzheimers/.

Never an easy task, the above link offers support and help from Julie Noonan-Lawson. Julie talks openly about her families struggles and how they have handled the illness in her family.  The interview was conducted by Sean Corcoran, the lead reporter for WCAI radio on Cape Cod.

Plan For The Worse…Live For The Best

Here is what I know – At 59 I’m healthier than either of my parents were at age 59. I have never smoked. I’m fairly active and exercise some but not overly. I eat fairly well, but not always. I drink socially but not in excess. So what are my odds of remaining healthy and being able to care for myself? Better, I’m sure than my parents but the fact remains that the odds of something happening to me beyond my control still exists. Any number of accidents could befall me. What then?

We Boomers don’t like to think or talk much about aging. For us, and many in our generation, the idea of needing long term care is down the road a ways.

We avoid discussing these issues for several reasons; most notably as discussed above is that of denial. Secondly, I think that we have come to expect that the government will take care of us through Social Security, Medicaid and Medicare. Unfortunately, we ignore the fact that these programs are not fail safe measures of obtaining care especially if we want to remain in our homes. Yes, it is likely some form of government benefits will be there but statistics and finances will make it more difficult for us to receive these benefits.

Read More Here

What Is Home Health Care?

Simply stated it is the physical and mental supportive system and care services provided to those persons wishing to remain in their homes or assisted living apartments by a caregiver, caregiving agency, and/or assisted living environment when they can no longer perform (without help) the day-to-day activities of everyday living.

Today, many persons are opting for home care, and or home care assistance in assisted living environments as outpatient care has become the ‘norm’ for hospitals and insurance companies. Home care is appealing to many of us as we most often feel that our home is an extension of ourselves.  Receiving ‘in-home-health-care’ can be a great benefit to those recovering from surgery or other medical procedures that can limit their ability to easily take care of themselves, or maybe they just require a little extra help managing things as they grow older or maybe they are learning to live with a medical condition or disability. Whatever the scenario, I urge you to review and consider the questions below as this ‘issue’ nears closer to you and yours.

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Answering The Call

Family caregivers understand the apprehension that often comes with worrying about their senior parents…the anticipation of a midnight phone call can be nerve-racking for anyone. According to the American Society of Consultant Pharmacists (ASCP) even though seniors represent just over 13 percent of the population, they consume 40 percent of prescription drugs and 35 percent of all over-the-counter drugs…

Most often family caregivers don’t know what their loved ones’ are taking and to add to the confusion, they are in the dark about their parents and financial and legal information. Home Instead Senior Care® surveyed future family caregivers…those individuals who plan on caring for their parents when the need arises to determine their level of knowledge and awareness when it comes to important information about their parents…What we found was that:

While survey participants overall feel informed about their parents’ health situation, there were ‘knowledge gaps’

A significant number of survey participants predict that they will begin caring for their parents within the next three years; nearly one in 10 says he or she could be called into action literally any minute.

Less than one-half of future caregivers say that they are knowledgeable about their parents’ medical histories in case of an emergency.

Even though a majority of future caregivers say their parents are healthier than other people their age, nearly two-thirds of the parents have two or more medical or health conditions, and nearly one-half takes at least three medications.

Nearly one-half of the parents exhibit three or more “risk factors” that could lead to medication-related problems.

Future caregivers have varying degrees of knowledge about their parents’ advisors and service providers; they are most likely to know their parents’ banker, primary care physician and health insurance provider.

Knowledge of important documents runs hot and cold, with nearly one-third of future caregivers reporting that they don’t know where their parents keep their will and testament or don’t know if they have one.

A significant number of future caregivers say they have not tried to ask their parents for information related to their parents’ health histories or their parents’ plans for the future.

As a result of this study, the Home Instead Senior Care network worked with the American Society of Consultant Pharmacists (ASCP) to provide additional information about the relevant topic of medication management. Also, the Home Instead Senior Care network and Humana Points of Caregiving® worked together to develop the Caring for Your Seniors: Senior Emergency Kit; an information management tool and website to help family caregivers track medications and other important financial information regarding a senior loved one’s health. This toolkit includes checklists and worksheets for medications, conditions, allergies, doctors, health advisors and a place to store other vital records.

Home Instead Senior Care Is On Cable!

Finally, we are ON AIR! Just wanted to let our BLOG, TWITTER and FACEBOOK friends and readers know that the Home Instead Senior Care cable show is on! Hope you enjoy watching and hearing from those business’ and people who offer additional support and help to the growing population of seniors. It is my hope that the cable show will offer insight into better managing our families as we all enter into the ‘golden years.’ Here’s the cable station internet, AACS link where you may view the shows that have previously aired. Each week additional shows will be added. Lots more to come…guests are already booked through August. Any ideas for what you may want to know more about, your comments and/or input is always appreciated!

Caregiver Strategies!

Below are some strategies that may help family caregivers turn resistance into assistance! And always feel free to call on us as well for support and resources.

1. Understand where the resistance is coming from. Ask your parent why he or she is resisting. “Mom, I notice that every time I bring up the idea of someone coming in to help, you resist it. Why is that?” Oftentimes older adults don’t realize they are being resistant.

2. Explain your goals. Remind your loved one that you both want the same thing. Explain that a little extra help can keep her at home longer and will help put your mind at ease as well. Have a candid conversation with him about the impact this care is having on your life. Oftentimes seniors don’t understand the time commitment of a caregiver.

3. Bring in outside help. If a relationship with a parent is deteriorating, ask a professional, such as a geriatric care manager, for an assessment. A third-party professional can provide valuable input. If you are having problems getting through to your older adult, consider asking another family member or close friend to intervene. If you’re not making headway, perhaps there’s someone better to talk with your parents.

4. Research your options to find the best resources for your loved one. If you decide outside help is needed, reassure your parents and tell them you have researched caregivers and you are confident you have found the best one you can find to come into the home to help.

5. Respect your parent’s decisions. Sometimes you won’t agree with your parent’s decisions and that’s O.K. As long as your loved one is of sound mind, he or she should have the final say.

Elder Mediation: Helping Adult Familes Resolve Conflict

The disputes may start quietly, but they can and do brew into hot and heated arguments and believe it or not they have split families apart.

Take for example:

Mom left a pot boiling on the stove again…you are fearful she’ll burn the house down.

Dad is getting forgetful and isn’t paying his monthly bills. You, and your siblings live far away and through neighbors find out that the heat and electricity were turned off.

Dad’s got more scrapes and scratches on his car than the grandkids do on their knees…you want him to STOP driving.

As adult children you are concerned and decide amongst yourselves to take-over…One of you wants to get Dad declared mentally incompetent, so the family can take control of his finances. One of you threatens to take Dad’s car keys. He threatens to write you out of his will. Another one of your siblings wants the house to be sold and Mom to enter assisted living.

Dad is now very angry…Mom thinks you’re over-reacting. Both parents are mortified…Dad because his kids are looking into how much money he has and how his finances are organized and Mom because she feels as though the children are trying to control her life.

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