I once heard from someone that he is spending more time swallowing his pills than his food. This is especially if the elderly person is already struggling to finish his full share of food due to possible swallowing impairment or due to the progression of his illness like dementia.
This led me to writing this blog on Polypharmacy. I wonder how it is like to be caregiver who has to look into the many issues of caregiving, not just the physical needs, emotional, spiritual, social needs and also in the area of medications.
I am privileged to be trained as pharmacist and is a board certified geriatric pharmacist (BCGP). Part of my work involves medication review of nursing home residents in Singapore. In my practise, I often see the elderly residents with many medical illnesses and on multiple medications.
This knowledge in medication management is helpful as I manage my mother’s medications.
Let me share with you what does Polypharmacy really mean?
World Health Organisation (WHO) defines: Polypharmacy is a
term most commonly applied to situation where patients took 5 or more medications. In my mother’s instance, it not only includes the medications that are prescribed by her various doctors for her chronic diseases like hypertension, dementia and others. It also includes
the glucosamine supplements that she takes for her osteoarthritis and the vitamin C for her general health. Occasionally she also takes an histamine for her cold.
Indeed, she takes more than 5 medications and one with special instructions like once a week and to be taken on empty stomach. She certainly has Polypharmacy.
With an increased in number of disease and medications my mother and a large number of elderly in Singapore have, it is no doubt medication management and polypharmacy is an issue that caregivers would need to spend time looking into and understanding it so as to ensure correct medication taking.
What is the impact of Polypharmacy ?
Poly pharmacy may
increase pill burden
decrease compliance in medications.
Confused and forgetful patients may result in medications taken at the wrong time or missed doses which results in ineffective treatment.
Non compliance whether intentional or unintentional may increase the risk of emergency visits or admissions to the hospital, thus may reduce the quality of life of the patients and cause distress to the caregivers as they have to response to health crisis.
Patients or caregivers need to work with your local physicians or pharmacists to clarify the use of each medication, to discuss goals of care and express any issue with the complexity of the administration of the medications.
When caregivers purchase Over-the-Counter (OTC) medications like ibuprofen or aspirin which can be used for toothache or fever or pain. It is important to consult the pharmacists at the retail store and inquire if it is safe for the patient. This is important as some over counter medications may interact with the other medications that your loved one is taking and may increase risk of harm.
As a caregiver of 5 years, I still feel that there is so much for a caregiver to learn and I am still learning. It is easy to feel overwhelmed. However, let us take courage, to take baby steps to learn more about our loved one’s illness, the progression and trajectory of the illness. Always have a complete list of our loved one’s medications and show it to our healthcare professionals so that they can advise and detect if there is any drug drug interaction or any medication related issues.
If in doubt, do always consult your doctors and pharmacists.
Please do note that this blog does not replace professional advice but is my personal opinion of how to manage medications.
Let us continue to be thriving caregivers. Press on.
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