Geriatricians are in short supply. These physicians have spent years learning how to care for older patients.
The scarcity of these specialists could not come at a worse time. Aging baby boomers are about to strain the health care system beyond its breaking point.
One of the biggest challenges these doctors face is wading through the huge number of pills their patients are often taking. Senior citizens frequently have numerous medical problems that are treated with multiple medications.
Sometimes these drugs don’t work well together. They may even cause new symptoms.
We often hear scary stories from our readers about situations such as this one: “A few years back, we frequently visited a friend’s mother, who had suffered for years from mild dementia and was in a nursing facility. This woman took many drugs daily for several medical problems, but when she clearly was in her last two or three days of life, our friend requested that all the meds be stopped.
“The dementia then disappeared! What a shame that no one had figured out the source of the dementia many years earlier so that the meds could be adjusted.”
Another reader wrote: “My mother was deteriorating before our eyes, and we were so worried about her. I was not happy with the physician she was seeing and took her to consult my doctor. My physician took her off Detrol and Norvasc immediately, then changed another medication, I think the one for cholesterol, to a natural supplement.
“Her blood pressure stayed in an acceptable range with some moderation in her diet and 1/2 hour of walking each day. Her brain fog (mimicking dementia) lifted almost immediately. Her cholesterol also went to an acceptable level, and all the terrible side effects were gone. She is absolutely fine today. So many medications are dangerous to seniors.”
Too often one medicine leads to another in a cascade that ends in confusion. One woman described her friend, a man who was physically active and had a superb memory. Then he suffered a small heart attack and was put on medications, including the cholesterol-lowering drug simvastatin and blood pressure pills.
He developed pain and weakness that interfered with physical activity. He described it as feeling like a welding torch in his legs. He was given NSAIDs, prednisone and Imuran for the pain, along with allopurinol for gout. No one considered the possibility that the gout could have been drug-induced.
Lack of activity led to weight gain, and he was put on medication to deal with type 2 diabetes. He developed stomach ulcers, quite likely as a result of the NSAIDs and prednisone.
The more medicines he took, the more confused he got. Eventually he was put on an antipsychotic drug called risperidone and died in a nursing home at age 74.
To help readers understand which medications pose special risks for senior citizens, we offer our Guide to Drugs and Older People.

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  1. D.M.,M.D.
    Reply

    I am a physician. We are afraid to stop medications because if something happens, we will be blamed and sued for “causing” Mom’s death, stroke, etc. I love it when my patients stop their medications or refuse to take more because then I am “safe” from our culture of blame and many of my geriatric patients are on far too many medications and are better off without them. It takes enormous moral courage to do the right thing in our current litigious environment.

  2. J.S.
    Reply

    I am 74 years old. My doctor prescribed drugs for high blood pressure, cholesterol, thyroid, and a few others others. After a time, I began to break out in a rash. She changed the prescription, and again I broke out. Finally I eliminated each one by one, and each time the rash subsided. Again it arose, and I worked to find the right combination. The bottom line is that now I am totally drug –free because I break out with anything, and rash-free as well.
    The doctor says it is not due to liver or kidney problems, and is confused by the problem. However, I must say, after a year drug-free, I feel better than I have in several years – even with the drugs, and have more energy.

  3. J. M. W.
    Reply

    Seeking an out-of-the-box answer to this question: If I was to discontinue paying into my ever -increasingly expensive long term care program, (CALPERS), to what other use could I put that premium amount into that would 1. keep me healthy without the use of drugs? 2. keep me in touch with a gerontological program with group physicians who’d be familiar with my own particular condition, (if there is such a program), and with whom I could consult with by phone or internet as needed?
    Older people cannot stay healthy with the stress of higher and higher LTC premiums and not enough other money to pay their bills, much less eat. I think this is a tragic dilemma for many of us and there has to be a better answer than what we’re being told now. Thank you for advocating for us on your radio program which takes on many important issues that need attention and answers. Janet

  4. Pat
    Reply

    How does a Patient know, even a well informed one, when a med that a Doctor prescribes is really necessary? I have tried some supplements & herbs and a few home remedies and most of them don’t work for me. I have a heart condition, and I know many people with heart conditions who use Coq10 with very good results.
    I cannot afford it because I get a very small Social Security check. I also cannot afford any of your books. There are many alternatives to drugs out there, but they are out of reach for many of us seniors. What can we do?
    PEOPLE’S PHARMACY RESPONSE: AN OPEN DIALOG WITH YOUR DOCTOR IS THE BEST PLACE TO START. EXPLAIN YOUR FINANCIAL CONSTRAINTS AND EMPHASIZE THAT YOU WANT ONLY MEDICATIONS THAT ARE TRULY ESSENTIAL. YOUR DOCTOR SHOULD BE ABLE TO EXPLAIN TO YOU WHICH ARE ESSENTIAL AND WHICH WOULD SIMPLY BE HELPFUL.

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