As you age, you may develop conditions or diseases that require you to take medication. For some people, the number of medications and their specific instructions can become increasingly complex.
Additionally, aging can affect memory and cognition. As a result of these factors and many others, many older adults do not take their medications as instructed.
However, there are a number of ways to work out possible solutions to this problem. These include finding out what usually leads to medication problems for older adults and learning which problems apply to a person specifically. They can also include learning more about how medications tend to affect older adults compared with those who are younger.
Knowing more of this information can make it easier for you to manage your medication as you age.
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What Causes Medication Problems?
According to Jennifer Pruskowski, PharmD, a palliative care clinical pharmacist at UPMC, more than half of the population (including aging adults) do not take their medications as prescribed.
Reasons for this include:
- Concerns about affordability
- Misunderstanding the instructions
- Weakened cognition
Dr. Pruskowski interacts with many aging patients and has found that one of the primary reasons for not taking medication as prescribed is the hassle of doing so. “As we age, the number of medications that we take increases, and these medications tend to inhibit the normal flow and structure of our day,” she says.
Another concern is affordability, resulting in patients determining their own dosing to make prescriptions last or simply not filling them at all. According to a 2022 study by Kaiser Family Foundation, 80% of adults in the U.S. say the cost of medications is unreasonable. It also showed that people who have the most trouble affording them are often those who take the highest number of medications.
If affordability is a concern, Dr. Pruskowski recommends speaking with your pharmacist or doctor. Pharmacies can often access databases and search for ways to reduce your medication costs.
Another significant reason is a fear of negative side effects. Many aging patients have not discussed potential side effects with their doctors, and those who experience side effects often decide not to take their medication again. About 20% of U.S. adults who participated in a 2020 Health Psychology Research study said that they have a fear of medication.
“When a medication doesn’t make you feel good, and it costs money,” Dr. Pruskowski explains, “and you have trouble remembering when and how you have to take all of these different drugs throughout the day, the whole scenario can inhibit or decrease your quality of life.”
How Medication Affects Older Adults
As we age, we are more likely to develop chronic health conditions. However, our bodies also start to process medication differently, making drugs more likely to interact in a negative way.
If a patient has too many prescription medications, they may stop taking them altogether. But if a patient doesn’t take a prescription medication for treating a chronic illness correctly, their overall health is at greater risk.
“Sometimes an interaction can be mistaken for a medical problem, resulting in additional medications being prescribed,” says Dr. Pruskowski. This is the “prescribing cascade” phenomenon.
Consuming alcohol around the time you are taking medication can also cause negative interactions, especially for prescription medications. These negative interactions, at their mildest, can cause drowsiness.
At their most severe, they can result in heart disease, stroke, cancer, and death. For these reasons, it is always important to check the label for alcohol or other warnings.
There are also risks associated with expired drugs. According to the U.S. Food and Drug Administration, medication that has expired may have changed in terms of its chemical makeup.
It may also have lost some of its effectiveness. This can lead the person who is taking it to have a limited understanding of how the medication is affecting their health. For example, if someone is taking expired medication to fight an infection, the infection may simply continue to get worse.
Perhaps most importantly, expired medication can take on bacterial growth. This can end up leading to illness that is more serious than the condition the medication is fighting. It can also make you develop a resistance to the drug itself.
If you’re concerned about accidentally taking expired drugs or about the person you’re caring for taking them, you can dispose of drugs safely in a couple of ways:
- Participate in a “drug take-back day” at your local pharmacy or police station. (In 2010, the U.S. Department of Justice created an annual National Prescription Drug Take Back Day. Many states have also since established official drug take-back days to encourage their residents to get rid of expired drugs.
- Crush the drugs and mix them with a substance like used cat litter or coffee grounds before throwing them away. This can prevent any risk that children or pets will ingest discarded medications.
Medication Management Tips for Elderly People
So, what are some helpful medication management tips? If you are aging (or if you are caring for somebody who is), ask and answer the following questions:
- What medications am I taking? Why do I need them?
- What is the prescribed dose of each medication?
- What time should I take each medication (and how often) each day?
- Should I take any of these medications with food? On an empty stomach? Do fiber supplements or laxatives affect the timing?
- Can I drink grapefruit juice with this medicine or eat grapefruit?
- Can I drink alcohol while I’m on these medications? How long should I wait after taking them before drinking?
“It’s really important for everyone to know how to take their medications as prescribed, what the medications are for, and what some of the potential side effects are so that they can report these to their providers,” Dr. Pruskowski says.
A pillbox marked with the days of the week is one tool that can make managing multiple medications easier. For tech-savvy seniors, a medication app could be the perfect solution.
To learn more about medication management for seniors and for more medication management tips, please visit the UPMC Aging Institute.
Editor's Note: This article was originally published on , and was last reviewed on .
About UPMC Senior Services
UPMC Senior Services provides resources for older adults, their loved ones, and caregivers at every stage of the aging process. We connect them with educational programs and learning opportunities to help support them, using our services to help seniors live longer and healthier lives. We partner with other organizations to determine the biggest challenges facing seniors and work to overcome them. We also work to inform in-home caregivers, hospital clinicians, and staff about the biggest challenges seniors face, striving to improve care. To learn more about our mission, visit our website.