What is “Polypharmacy”?

Written by: Jessica Moreau RN

Polypharmacy, defined as the simultaneous use of medications to treat the same ailment, is plaguing our older adult population. It is estimated that 30-40% of seniors take 5 or more medications. When it comes to complex illnesses, such as cancer, heart disease and hypertension, it is common that multiple medications are used to manage symptoms.

A contributing factor to polypharmacy is that patients are often seeing multiple physicans, such as visiting their primary physician, specialists and occasionally a physician in urgent care or the emergency department.

One of the main risks of polypharmacy is drug to drug interactions. If an adverse effect occurs, it can be very difficult to figure out which of the many drugs is the cause, and the correct treatment for the adverse effect. Harmful effects of taking multiple medicines can include:

Falls and fractures (due to dizziness/grogginess)
Memory problems
Hospitalization
Higher risk of death

Multiple medications increase the risks of inappropriate medication use, non-adherence, and adverse effects. Another unwanted effect could be that physicians may hesitate to prescribe a new essential medication to a patient already on five or more. Thus, ironically, polypharmacy can lead to under-treatment. Regular medication reviews should happen to ensure that a patient is only taking what is needed. Here are some helpful questions to ask a doctor or pharmacist:

Do I still need to take all of my medicines?
Are all my medicines still helping me to stay well?
Could any of my medicines be causing ________?
Could any of my medicines be affecting the others?
Is there anything I can stop taking safely?

Deprescribing is what occurs when a medical professional reviews the medication list of a patient and begins discontinuing medications. It involves patients, their family and/or caregiver, doctors and pharmacists who together:

Review all medicines a person is taking and why
Identify how likely each medicine will cause problems
Identify if each medicine is still right for the person or could be stopped
If medicines can be stopped, prioritize which should be stopped first
Agree on a management plan
Stop medicines carefully, one by one
Meet frequently to see if the plan works or the patient is experiencing problems.

Polypharmacy puts seniors living alone at risk for various problems, but knowing your medications and consulting with your health care team is paramount to keeping yourself or your loved ones safe.

About the author:
Jessica is a Registered Nurse and Intake Specialist at Freiheit Care Inc. She has been with Freiheit Care Inc since its inception. She has experience in community nursing and palliative care. Jess sees customers for initial intake assessments.

Aging in Place – “what” and “why”

Written by: Jessica Moreau RN

Aging in Place is a term used to describe when an older adult continues to live in their own home while they age for as long as it as safe to do so. Modifications may be needed in the home to promote safety, such as grab bars in the shower or a chair lift if going up and down stairs is becoming difficult. Older adults may decide to use community resources, such as home care, to assist them with daily tasks. By supporting your loved one in their choice to age in place, you are also supporting their right to autonomy and promoting their independence.

While there are several benefits to retirement home living, the benefits to aging in place are often greater – for the right population. Not every older adult is suited to continue to live in their home, and that is dependent on their condition, their physical limitations, their cognition, their mobility and their comfort level with remaining at home. The decision between aging in place and moving to a retirement home is a personal decision to be made with the advice of their physician by individual and their family.

There are 4 major benefits to aging in place:

1. Decrease loneliness

When your loved one is able to remain in their home, they are remaining in a community they have spent part of their life in. They have created social connections, perhaps engaged in community activities or gone social events. They do not have to go through the process of meeting new people, becoming acquainted and establishing new connections. This can be especially difficult on people who move into retirement communities with a high population of people with advanced stages of disease, such as dementia, as they can typically be less social and less engaged in social interaction.

2. Familiar environment

Change isn’t easy, and it can be even less so as we age. As we get older and our memory lessens, or for those with the beginnings of dementia, it can be difficult to adapt to a new environment and can be overwhelming. When aging in place is an option, the individual remains in an environment they are comfortable with. Some adaptations may be made depending on the condition, however the familiarity of the environment eases some of the anxiety that change can bring.

3. Maintain independence

Studies have shown that maintaining independence has a positive effect on one's quality of life. By aging in place, the individual has the option of receiving the care they need, where they need it, when they need it. Community resources such as personal support care, nursing care and companionship services provide the support one needs while promoting independence at every turn.

4. Routine

Everyone has a routine in some capacity. Wake up, wash up, breakfast, read the paper, walk the dog, feed the cat… In a retirement home, your day isn’t your own. You’re told when to eat, you’re told when activities are. Your entire routine changes. If you have been doing things a specific way for a long time, this may come as a shock to you. Pair this up with an unfamiliar environment, new people and a loss of independence and you may feel overwhelmed.

So, while aging in place offers the independence, familiarity and quality of life that your loved one craves, it also offers them ability to remain active in their community, and combats loneliness and social isolation. Aging in place is definitely something to consider, and if you call us, we’d be happy to discuss it with you.