Q&A #105

By Carol Abaya, M.A.

Question:† My mother is taking three different medicines every day and often forgets to take them or takes them twice.† I canít keep calling her from work to remind her.† What can I do?

Answer:† Mistaking prescription medicine and/or adverse drug reaction are on top of the list of why older people end up in hospital emergency rooms.

Recent studies also indicate that adverse drug reaction is one of the leading causes of death of those over 65.

So making sure medicine is taken properly is very important.

You should first talk with your motherís doctor and establish on-going communications with him.† Ask what each medicine is for and why your mother needs it.† Often a person is given medicine for a particular illness and just keeps taking it even though he may no longer need it.† Often an older person does not tell the doctor† about all of the other medicine he is taking.† Make sure all are really necessary at this time.

To help your mother take the pills properly, there are various pill containers that are available.† Some can be used for daily doses.† Others can be set up ahead of time for several days or a week at a time.

If memory lapses are minor, such a simple plastic pill holder can be used, with the day of the week and the time the pill needs to be taken clearly marked on the appropriate compartment.† Then if the pill is no longer in the compartment, your mother knows she has taken it.

If mental confusion is more severe, there are containers with time release mechanisms.† This way, the person cannot take too much.

If you do not live nearby, it is important you identify and arrange for someone reliable to set up these containers on a regular basis.† Also make sure your mother does not have access to the drug store pill bottles.

Besides asking the doctor whether all pills are necessary, ask him if any foods will interfere with the effectiveness of the drug.† For example, if a person is taking blood-thinning medicine, he should not eat broccoli or spinach, which help thicken the blood.

Question:† My father has had high blood pressure for years and has now developed heart problems.† However, he loves Chinese food.† The doctor says he shouldnít eat Chinese food at all:† but he refuses to listen.† How can we get him to watch what he eats?

Answer:† Many older people (my mother was one of them)† refuse to accept their illness.† They become stubborn and turn a deaf ear to something they may not like to hear.†

Sit down with him and talk with him in simple terminology and explain why salt is so bad for him.† Explain that if his body has too much salt that water can accumulate in his lungs.† He will have trouble breathing and can experience severe pain across his chest and upper arm areas.† He can develop congestive heart failure, which if not watched carefully can lead to death.

Remember that beside Chinese food, all kinds of cold cuts, frozen foods and salads on buffets in restaurants are all loaded with salt.† All can contribute to water accumulating in the lungs.† A minimum amount of salt should be in the diet of someone with high blood pressure and heart disease.† Guideline of 1,500 mg or less a day is advisable.† More than 250 grams in any one food or service should be used as a maximum guideline.

If your father insists on eating Chinese food and has a favorite restaurant, talk to the owner.† Arrange for your fatherís food to be made without any salt or MSG.

Also go through your fatherís pantry, freezer and refrigerator and point out all the foods with high salt content.

Question:† I am 73 (male), go to the chiropractor once a month, and take a number of vitamins and herbal supplements.† Although I take a prescription medicine for high blood pressure, my pressure continues to be high.† What should I do?

Answer:† I am not a doctor, but that is where you need to start - with a geriatric primary care physician who is also knowledgeable about alternative medicine.† If your current doctor dismisses your questions and concerns about vitamins and herbs, seek another doctor.† Comfortable communication and trust is critical in patient-doctor relationships.

More people, like yourself, are using alternative medicine to keep themselves healthy.† Latest studies show more visits to alternative practitioners than regular medical doctors.† However, at least 40% donít discuss everything with their regular doctor.† This can be dangerous.

While the chiropractor visit is very helpful in keeping up body functioning and is not dangerous to oneís health, certain vitamins and herbs can be counterproductive.† This is even more true if you take prescription medicines.† One or more of the vitamins or herbs may be preventing the blood pressure medicine from working effectively.

For example, taking coumadin or aspirin together with ginkgo, feverfein, or bromelain to reduce blood clotting after a stroke, for example, can be dangerous.

Combining antidepressants and St. Johnís Wort can also be dangerous.† And combining certain herbal laxatives with other medications, if for high blood pressure, can deplete the body of important minerals and has resulted in death.

Best advice is to talk to your doctor and the† person recommending vitamins and herbs, research interactions and identify potential problems.

Question:† Iím 84 (male) and in good health, but worry about memory loss.† Iíve read about various herbs to help.† Whatís your opinion?

Answer:† If you donít have any chronic illness that interferes with blood circulation, memory generally stays intact.† At the same time, a certain amount of forgetfulness is common among any age group.† Is there anyone who has not left something cooking, walked away and forgot about it?†

A sound diet, moderate exercise, and some basic vitamins (like C, E, B-complex, zinc) can be helpful.† If youíre not on any prescription medicines, some herbs can be helpful.† But in many cases, like ginkos, positive results have yet to be scientifically verified.

Both my parents went to a chiropractor regularly and took some basic vitamins.† My father did two to three miles a day on a stationary bike, until he was 92, and my mother did water exercises until she was 90.

Even more important is eating nutritious meals regularly.† Food fuels the brain.† And donít diet.

Question:† I was shocked to see all the medicines in my parentsí medicine chest.† They (both in their 80ís) live 500 miles away, and we donít visit that often.† When I asked why they were taking them, their answer was very vague.† My mother has had high blood pressure for years, and my father has had several mini-strokes.† But the number of pills seems too large.† Should I call their doctor?

Answer:† Yes, you should call their doctors and develop an on-going dialogue.† Before you call, make a list of the prescriptions you found.† It may well be that they are taking too many different medicines, and are taking them incorrectly.

Ask the following questions:

  1. What illness is each pill for?
  2. What is it supposed to do?
  3. How should it be taken?
  4. How long have they been taking it?
  5. Should they continue taking it and why?
  6. What other medicines (both prescription and over-the-counter) and foods should be avoided?
  7. What are the side effects?† (Look especially at balance and mental confusion elements).
  8. What are the interactions between the various medicines?

Too often people just continue taking medicine even though they may not really need it.† The problem is complicated if the person goes to several different doctors, who may - or may not - confer with each other.

It is important that medicine be taken properly to be effective.† Missed dosages of certain heart medicine can result, e.g., in cardiac arrest.† Certain common foods render certain medicine ineffective.

Question:† My mother, 76, takes various medicine at different times during the day.† She does a lot of volunteer work, and is gone from the house for long periods of time.† So she takes with her the dayís supply, putting them all in one container.† Should she be mixing all these pills together?

Answer:† Probably not!† Many pills have negative interaction, thereby affecting their effectiveness.† Certain pills are also impacted by the kind of container or body heat.† (Many men will carry a small pill container in their pocket, and the pills may be affected by body heat).

Talk to the pharmacist to determine the best way for your mother to carry her pills.

Question:† I recently had a stroke, but have returned to work.† I get so involved with work, I often forget to take my pills.† How can I make sure I take them on time?

Answer:† There are all kinds of compartmentalized containers that can help.† Some even beep when itís time for a dose.† The National Council on Patient Information and Education in Washington, D.C. has a catalog.† Their telephone number is† 202-347-6711.

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