Henry’s kitchen table is littered with drug paraphernalia. There are syringes, bottles, vials, nebulizers and a pill cutter. Henry is not a drug abuser…rather he is a senior citizen with a pill problem.

Despite appearances, Henry is entirely respectable. Like many older people, Henry is on so many different prescribed drugs it is almost impossible to keep everything straight.

He takes insulin and metformin for diabetes; digoxin, furosemide, warfarin and potassium for his heart; albuterol, prednisone, salmeterol and a triamcinolone inhaler for a breathing problem; omeprazole for heartburn; Mobic and amitriptyline for arthritis, back pain and fibromyalgia.

In addition to these 13 different prescription medicines Henry uses over-the-counter ibuprofen for inflammation, omeprazole for stomach pain caused by the ibuprofen and milk of magnesia for constipation brought on by the amitriptyline.

Henry complains that he is a walking drugstore. It’s hardly any wonder that Henry has a hard time dragging himself through the day. Some of these medications are inappropriate for older people, and Henry is in his 70s.

Part of the problem is that Henry has a lot of health problems. But his physicians have not coordinated his prescriptions and he has far too many. Side effects and drug interactions have turned Henry into a ticking time bomb.

Data show that more than one in six Medicare patients receives at least one inappropriate medication. Hundreds of thousands of older people are hospitalized every year because of adverse drug reactions.

Dizziness or unsteadiness caused by medicine is responsible for 32,000 hip fractures from falls. It is estimated that as many as 16,000 automobile accidents among elderly drivers may be due to drug-related impairment of vision, judgment or coordination.

Often, the most serious complications are indirect and hard to document. If Henry develops a bleeding ulcer because of the prednisone, Mobic and ibuprofen, will anyone recognize it as a drug-induced problem? Should Henry become a bit confused or have memory problems, will his doctors attribute it to the anticholinergic effects of amitriptyline and cimetidine or the vitamin B12 depleting activity of omeprazole and metformin?

As America ages, medical schools are not keeping up with geriatric pharmacology. Senior citizens are far more vulnerable to side effects from certain drugs, but most medical students are not taught about this problem. The average internist may not realize how many medications are inappropriate for people over 60.

What is the solution?

Older people and their families will need to watch out for themselves. Grown children must know more about their parents’ medications. It is no longer enough to ask mom and dad how they are doing and assume they can report accurately on their health situation. If dad falls and breaks a hip on the way to the bathroom at 3:30 in the morning, the whole family will be affected in a disastrous way.

People should NEVER be left in a hospital by themselves. Here’s just one example.┬áJ.D. posted this comment to our website:

“Based on my own recent experience being hospitalized, I feel sorry for any elderly person who does not have a family member to come and assist and advocate for them. The nurses come in to your room and feel they complete their duties by simply filling your stomach with the medication prescribed. They don’t seem to pay full attention to possible drug interactions nor do they realize the ill effects of taking too many pills on an empty stomach.

“Despite my requests to take my medications with a meal, I was instead given my meds several hours later, and in the end I wound up with three gastric ulcers.”

That is why we wrote a chapter titled “The Screwing of Senior Citizens.” In it you will learn about the Beers List of drugs older people should generally avoid. Your doctor may not know about Beers, but we provide you a detailed of drugs that can be disastrous if you are over 60.

Worried about your memory? Perhaps your medicine is contributing to the problem. Most physicians would flunk a test about which drugs have anticholinergic activity that can impact cognition. The list includes cimetidine, desipramine, digoxin, diphenhydramine, fesoterodine, hydroxyzine, meclizine, oxybutynin and tolterodine, to name just a few. You will also discover more details about our 10 Tips to Surviving Old Age in the book, Top Screwups Doctors Make and How to Avoid Them.

  1. See a doctor who likes older people.
  2. Find a good geriatrician.
  3. Ask about special dosing requirements
  4. Beware bad drugs.
  5. Avoid anticholinergic drugs if possible.
  6. Minimimize the number of drugs you take.
  7. Seek nondrug treatment when practical.
  8. Be assertive.
  9. Have an advocate.
  10. Stay active.

Following these tips could save your life or the life of a loved one!

Henry could be anyone over 60. He needs an experienced geriatrician to review all his medications. That person should spot dangerous interactions, such as that between prednisone, Mobic and ibuprofen.

With careful supervision, it might be possible for Henry to simplify his drug regimen and reduce his risk of serious side effects. We hope our chapter can help you or someone you love. You will find it in our book, Top Screwups Doctors Make and How to Avoid Them. Here is a link for more details.

Share your own story below in the comment section.

 

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  1. Jand
    Reply

    I recently tried to quit taking Omeprazole cold turkey with bad results. Diarrhea and severe back pains. Researching I found it could also be the cause of my hair loss. I would appreciated information concerning the best way to eliminate Omeprazole from my life.
    Thank you.

  2. Cindy M. B.
    Reply

    After reading about Henry’s medications I almost had to go throw up. ANY ONE of those has side effects, and all of them put together is just unthinkable! WHAT IS THE ANSWER?? Yes, Henry has a host of medical problems. BUT WHY? Well, I don’t know about Henry, but I DO know that most folks are just not that careful about their personal habits and nutrition until they’ve got to Henry’s state of affairs and are facing multiple problems, multiple meds/side effects, multiple treatment conundrums.
    Every day I see people gorging themselves on the most unhealthy, fattening, totally non-nutritious foods! And smoking, drinking, sitting around not getting exercise, etc. etc. I see people lined up to get “elephant’s ears” or “curly fries” at fairs and festivals… why not just put a bullet in your brain and skip the middleman! When are people gonna learn that they HAVE TO TAKE GOOD CARE OF THEMSELVES while there’s still time — or else face situations like Henry’s in later life! Sure, there’s such a thing as just plain bad luck. But most of these things can easily be averted if one is vigilant and motivated early on.
    I’ll be 66 this month. I used to be an IV drug abuser (speed). I smoked cigs and drank too much most all my life. I spent every summer MAHOGANY from uber-tanning. But about 15 years ago I smartened up and became VERY VERY CAREFUL about what I put in my mouth and how I live. I ditched the cigs, took the alcohol way down, and mj in moderation is my only recreational drug.
    I’ve studied every health/nutrition topic and really educated myself. NOW, I look 20 years younger than my age, am very active in extreme sports, and take not one Rx med. My multiple sports injuries heal lightning-fast and I rarely see a doctor or even catch a cold. Thank God I smartened up! People tease me and call me a “health nut.” But I’ll be the last one laughing, of that I’m sure.

  3. CLK
    Reply

    You might want to request your doctor run a pharmacogenomics test — it is a DNA test that tells how your body metabolizes medications/drugs so that Rx can be individualized. Seniors are able to have much better success with getting a correct Rx and those with mental health issues can be Rx a medication that will match what they need.

  4. br
    Reply

    Be aware that a number of meds that are normally prescribed together are being combined into one pill. If you are sensitive to one of these meds you are wasting your money as these are more expensive than individually.

  5. PJ
    Reply

    Our seniors have a very sad existence and very bad medical treatment. There is a tv commercial for a pharmacy technician school that runs on tv here that lures students by promising that elderly people need more and more medication to live a satisfactory life. As a child/caregiver for my parents, I have found it exceedingly difficult to locate a doctor who cares about patients–regardless of the patient’s age.
    Good geriatricians are rare and if you find one, they may not be accepting new patients or may not take your insurance. We have many geriatric clinics in my own town that only accept, in addition to Medicare, a very short list of secondary private insurances that cover the non Medicare costs.
    Also, I have no medical background and have not been able to determine if my parents have even been given the correct diagnosis before being provided with drugs. My mother, who was not on any medication, was hospitalized three years ago with hallucinations. As far as I know, she was dehydrated and had a bad UTI. Though she improved in a few days, she was put on Aricept and I was told to find a nursing home for her–permanently–though her memory problems were not major impairments. Namenda was added to the Aricept and she has been in mental decline ever since she was put on them–my opinion.
    Now her doctor has recommended an increased dosage of the same drugs despite the fact that her memory is worse than ever and she has lost 30 pounds during three years without trying. “Is this a natural progression of dementia or the side effect of drugs,” I asked? The doctor said he didn’t think it was a drug side effect (but these drugs are known to cause weight loss), but he didn’t know what the cause of the weight loss was. He referred her to other doctors for a series of tests that my mother was not comfortable with. She is 86 years old and refused to see more doctors.
    I feel like I need a medical degree myself and do not know what doctors or information to trust. I have yet to get a straight answer about whether a person should be on or off these “memory” drugs. I am afraid to stop them. I am afraid to continue or increase them too.
    People’s Pharmacy response: In older people, a UTI can indeed cause confusion and hallucinations. That might not be a good reason for the Alzheimer’s disease drugs.

  6. tutorjb1JB
    Reply

    I’m 61 and have been taking increasingly strong phenodiazepam drugs for 40 years to deal with disabling pain resulting from being a passenger in a bad auto accident, I live in a small N.C. town, where no Dr. will treat me because none will accept responsibility for prescribing the Meds I need. In a way that turned out well.
    I asked the last Doc in town to refer me to a neurologist and she referred me (after asking why I wanted to see a neurologist – I almost shouted BECAUSE I HAVE A BRAIN INJURY, FOOL! at her, but held back) to a wonderful neurologist with an even MORE WONDERFUL nurse-practitioner in a somewhat larger town nearby. They’ve helped me reduce the Klonopin I take, but added 3 other brain meds.
    After a short trial, I declined 2 of them because their side effects outweighed their intended effects and was granted a larger dose of the 3rd (that was helping without noticeable side effects), I’m alone so have to watch out for myself, I’ve found that learning the generic names of drugs helps me do that, since I often read articles and listen to NPR shows such as “The Peoples’ Pharmacy” where the generic, class (as anticholinergic) and chemical names of drugs are used and I listen and read as much as I can.
    I prize my computer more than a TV (which I’ve neither owned nor watched in over 6 years) as I can research drugs and much more online. TVs tend to stay on all day and cable costs a fortune, whereas I only boot with something specific in mind, and shut down immediately after learning it and some ISPs cost a fraction of the cheapest TV signal. I’ve been a videot long enough.
    There’s a lot left to read online.
    JB

  7. Donnie
    Reply

    I’m interested in seeing comments from other people on this subject.

  8. Donnie
    Reply

    I’ve known many older people who were taking a lot of drugs, and were seriously harmed by them. Some died from the medication they were taking, per their doctors orders. Seniors are cash cows for drug companies, doctors and hospitals. So many are prescribed expensive, but dangerous drugs that cause more harm, then good. Older people need someone to advocate for them, because the medical establishment cares more about profits, then patients.

  9. bb
    Reply

    My husband took all of the above. He believed his doctors over me until I printed your thoughts about statins. His doctor wasn’t happy when he quit but he was happier and more alert. I have mentioned before that after he died, he was 80 but active up to his death, I checked the side effects of all his drugs on the internet. All of them had similar side effects. Imagine how 10 times the similar effects made him feel. I agree, doctors should check these these things out when they prescribe a new drug.

  10. JM
    Reply

    My husband, a stroke survivor, recently changed from his long-used pharmacy to another closer and more convenient. His prescriptions and dosages remained the same. Within a short period, he began experiencing dizziness/vertigo, nausea, and vomiting. The result was a three day hospitalization and every cardiac and neurological tests available being done, all revealing no abnormality. Returning home, experiencing the same symptoms, it dawned on me to ask the new pharmacist about possible causes.
    It was then revealed that the new pharmacy purchases medications from different companies for each of my husband’s prescriptions. Bingo! Back to the old companies and no more problems after six weeks of misery and thousands of dollars in medical costs. I’m hoping this will be helpful to other readers.

  11. crandreww
    Reply

    This is so sad, what we allow our senior citizens to endure. Guinea pigs…and for the sake of the almighty dollar. When doctors and other prescribers are educated by someone other than the one who stands to make a $$ from the product they are pushing, and when nurses are educated as to the REAL risks and benefits profiles of drugs is when patients are given proper care. And so many of our older population are taught not to question the doctor. Well, I am here to tell you, you have every right to question your doctor/nurse/whoever you want to…it is your body, your life..and the ONLY ONE who has your best interest at heart is YOU!

  12. ruth
    Reply

    good advice. my husband was given avelox after finishing up 3 week course of other antibiotics to clear up mrsa. after 2 days he began having stroke like symptoms with loss of mobility, general disorientation and not able to communicate properly (couldn’t find correct words to make himself understood). after 2 days in the hospital and taking avelox, the symptoms cleared up. he is now doing much better and has no more stroke like symptoms.

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