Older man with pills, scary side effect, too many prescriptions

Will you ever be able to afford to retire? According to the Pew Research Center, 10,000 baby boomers turned 65 today. Roughly the same number will turn 65 tomorrow and the day after that. In fact, it is estimated that over the next decade 10,000 people will turn 65 every single day. That’s because the baby boomer generation represents a huge bulge in the population—76 million people born between 1946 and 1964. When so many baby boomers retire will the medical profession be ready for them?

When Baby Boomers Retire What Do They Want?

As baby boomers retire most want enough money so they don’t have to worry about the basic necessities of life. Many would like to be able to travel or engage in activities that are fun or gratifying.

They also want to be healthy enough to enjoy their retirement. They don’t want to become sidelined by chronic illnesses or the side effects of medications. And everyone wants to avoid dementia that might put them in a nursing home.

The Least Glamorous Specialty: Geriatrics!

Is medicine ready for the boomer bulge? There are not enough physicians specializing in taking care of older people today. That’s largely because primary care such as geriatrics has not been as valued or rewarded as specialties like cardiology, gastroenterology or dermatology have been.

Over the next dozen years the shortage will become more acute. In 2008 one of the country’s most eminent geriatricians, Dr. John Rowe, testified to the Senate that the U.S. health care system is “woefully unprepared” for the impending demand. He went on to say:

“The U.S. health care system is in denial about the impending demands. Little has been done to prepare the health care workforce for the aging of our nation and the current supply and organization of the health care workforce will simply be inadequate to meet the needs of the older adults of the future. For example,

  • Today there are only a little more than 7,000 certified geriatricians, a 22 percent decrease from the year 2000. Some expect this number will continue to decline.
  • Today, there is only about 1 geriatric psychiatrist for every 11,000 older adults; at current rates of growth, in 2030 there will only be one for every 20,000.
  • Less than one percent of nurses, pharmacists, and physician assistants are specialists in geriatrics; less than 4 percent of social workers specialize in aging.
  • Health care professionals, including doctors, nurses, social workers, and others receive very little training in caring for the common problems of older adults such as confusion, incontinence, and falls.
  • The federal standards for the training of nurse aides and home health aides have not changed since they were mandated over 20 years ago. The state of California, for example, requires more hours than the federal minimum, but has even higher standards for dog groomers, crossing guards, and cosmetologists.
  • Informal caregivers, the family and friends of older adults, are also ill-prepared for their significant roles in the care of older patients.”

What’s the Big Deal?

As people grow older their bodies handle drugs differently. Changes in liver and kidney function make many senior citizens more sensitive to potential side effects. As a result, a medication at a dose that was just right for someone at age 50 may not be safe for the same person at 75.

Prescription Drugs And Dementia:

Moreover, there are some medicines that may contribute to dementia. While this is not much of a concern for a 35-year-old individual with plenty of brain reserve, a 65-year-old with emerging health concerns may not have the same resilience.

One reader told of her family’s experience:

“My elderly mother had started falling so often that my siblings and I were seriously considering nursing home care. My brother gathered all her medications and took them to her doctor.

“A review of the meds showed that mom was on six different blood pressure medications. Every time the doctor changed her medication, the old one was not discontinued. Neither her doctor nor the pharmacist had caught this.

“It has now been over a year since mom’s medications were corrected. She is 92 years old. She has not fallen even once since the adjustment to her meds and is still living at home.”

Older people can easily end up on duplicative medications for a range of problems. Here is another reader’s story:

“My husband was in a beautiful, expensive rehab facility after a stroke. After only five days, he was hallucinating and became fearful and combative. I didn’t recognize this person.

“I requested a psychiatrist consultation. He said, ‘Your husband is on NINE different medications! Three would be more than enough.’

“I took my husband home and got rid of everything but his blood pressure meds. Then he got better. My point is: You, or your loved one, must be diligent at all times, and take charge of your care. Ask questions!”

Watch Out, Do Your Homework, Protect Your Loved Ones!

Anticholinergic drugs interfere with the ability of the brain to process information. Acetylcholine is a crucial neurotransmitter. It is essential for adequate cognitive function. It comes as a great surprise to many health professionals (physicians, nurses and pharmacists) to learn how many different kinds of medicines have anticholinergic activity. We have prepared a comprehensive list of anticholinergic drugs at this link.

Many visitors to this website have reported memory problems or confusion associated with anticholinergic drugs. Here is just one:

Ruth in Elkins, West Virginia had a scary experience:

“I ended up in the hospital ‘off my gourd.’ I didn’t even know what had happened until later in the week. I am on several anticholinergic medications such as Elavil (amitriptyline), gabapentin, Benadryl (diphenhydramine or DPH), Vistaril (hydroxyzine), Phenergan (promethazine), Claritin (loratadine), Zantac (ranitidine) and tizanidine.”

Ruth was indeed taking many medications with anticholinergic activity. Her “body burden” was extreme. Gabapentin does not have anticholinergic action, but it too can affect cognitive function. A geriatrician would have likely discovered that Ruth had too many meds on board that could negatively affect brain function.

We have written a comprehensive review on this entire topic in our book Top Screwups. We have included the Beers list of drugs that are inappropriate for people over 65 years of age. We also have our Top 10 Tips to Surviving Old Age. Here are just a few:

  1. Make sure your doctor likes older people. (This is not a given.)
  2. Minimize the number of drugs you take
  3. Beware bad drugs (check out the Beers list!)
  4. Avoid anticholinergic drugs if possible

Here is a link to Top Screwups. If you are getting close to 65 or have passed that magic number, this book is crucial for your good health. Perhaps you know someone who has already retired. This could protect them from some dangerous drug situations. Share your own story below in the comment section.

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  1. Dee
    FL
    Reply

    We have been conditioned by the medical, pharmaceutical, insurance, & government that in order to stay healthy we must take bp meds, statins, etc. I’ve come to the conclusion that it is all just big business – get your money – who cares about the individual. I would much rather be treated holistically/naturally first before drugs are given. Here in Florida medicare patients are cash cows to the medical & pharmaceutical profession. And with the buying up of medical practices & consolidating into big groups, doctors do not take the time to know their patients. I’m 65, & if I’m 10 points over the standard 120/80 bp in the dr’s office (after fighting traffic, dealing with a long wait, etc.), they’re ready to throw me on drugs – even if I tell them one’s bp fluctuates due to outside conditions! I am very disheartened with how the medical profession is evolving; no wonder we have very little to no trust. And the insurance companies & government are no help.

    Medical colleges need to change their ways of teaching. Nutrition should be first & foremost – knowledge in different ways of eating. Even my dr poo-pooed the low carb eat (good) fat program as he was not aware of it. He never even heard of the gin-soaked raisins! I question everything today, something the drs do not like.

    There needs to be a change as it is only going to get worse before it’ll get better. Meantime, us “baby-boomers” are going to suffer the effects of over-mediation & inferior care.

  2. mary
    USA
    Reply

    Took my 90 yr old mother to ER, Er doctor came out yelling who had her take the flu shot? My brother said he did, the doctor said: Don’t you know that the flu shot is Geriatric Genocide?”
    Well mom ended up with congestive heart failure from the flu shot. We ended up taking her to the Er 3 more times.

  3. Terri
    Ga
    Reply

    I am 66 and have nerve damage from neck surgery and a botched Epidural. Developed Fibromyalgia in the midst of all this. My life is a prison of pain and insomnia. Pain meds just aggravate Fibromyalgia and cause awful side effects. I want to play with my grand children, get out, be active, stay connected yet pain and fatigue keep me inside. Depression dogs my heels. Yet my state will not get its act together about Medical Cannabis. It appears I will die while waiting……

  4. J. David Auner
    Springfield, MO
    Reply

    Lisinopril and other ACE inhibitors are among the most anticholinergic drugs – a problem for most elderly folks. Doctors in primary care and geriatrics seem to have holes in this part of their knowledge base.

  5. Jan
    Reply

    I am an RN with certification in gerontological nursing. I was working in an urgent care clinic on a Saturday when a woman brought her mother (who was in her eighties) in for evaluation because in the previous 24 hours, she began to experience dizziness, and needed physical support to keep from falling. On review of her medications, I found that her physician had ordered Librium for treatment of “nervousness”. This medication is on the Beers list of those that should be avoided in the elderly. The daughter said that was the only new medication, and the dizziness started after she took her first dose. I shared that with the urgent care physician, and he discounted the medication as a cause for her change in condition, telling me “It can’t be Librium–the dose is too low.” He told the patient and daughter to continue the medication. Alarmed by the doctor’s instructions, I took a substantial professional risk by telling the daughter to not give her mother any more of the medication for the weekend, and until she spoke with the prescribing physician to ensure he knew about her condition and the timing of the onset. I feared the patient could have suffered injury due to the effects of medication.

  6. Jane
    Colorado
    Reply

    I find myself wondering why people are so willing to do ” whatever the doctor says,” no questions asked. It seems many are almost eager to do anything EXCEPT excercise, eat better, and take advantage of great information from sources like this website.

    It seems it was here that I read the conservative estimate that health care is # 3 cause of death in the US. A number of sources place it at # 1. Perhaps we’d all do better if we didn’t cooperate with the medical machine’s ever-growing lust for an ever-bigger slice of the economic pie.

  7. Marsha
    PA
    Reply

    According to AARP the new tax bill cuts $25 Billion from Medicare in 2018 and possibly more in the future. AARP explains that this is a measure triggered by the “pay-as-you-go” law. That means there will be fewer doctors who will take Medicare patients because they will not get paid.

  8. Tom M
    Reply

    The common theme seems to be as many prescriptions as possible. Keep the patient on drugs, and keep the insurance overpaying for them. It is going to be a disaster if you get caught on the Big Pharama merry-go-round. Best to get as healthy as you can before retiring, but from what I see, many boomers are not in great shape before retirement. I don’t expect the government to get a handle on this ever because they are more concerned with staying in power than helping the country.

  9. Steve
    Maryland
    Reply

    Too few trained in geriatric care is only one hurdle to ensuring that our aging population is healthy and productive. The other is the geriatric patient. For too many years too many have blindly gone along with whatever the doctor tells them to do. Take this medication for this, and then take this one to help offset the side effects of the other, and so on. Now enter a family member or third party who is concerned about potential over-medication and they soon find any effort to help as fruitless. I mean who are we? We don’t have a medical degree so why should we have any sway.

    I speak from experience. I recently turned 65, and all I take is 5mg of lisinopri. For the past 15 years doctors have been trying to get me to take statin drugs. I have rigidly refused. Alternatively, I have followed the Linus Pauling protocol and added Euromega3, and a few other things. I play baseball in the summer and fall, just started a third career in construction, own a tech company and physically do just about anything I wish. Many people who see me are quite surprised that I am 65.

    On the other hand, my peers and those much older than I have little interest in the medical choices I have made, and yet many are moving to homes all on one level. Look and act much older than mid to late 60’s and still go along with what a doctor tells them without question. Add to that attitude never-ending drug commercials, and there can be no wonder as to why people are over-medicated.

    In this era we have easy access to information. Too many just don’t want to spend the time to care for the gift they’ve been given of one life! This attitude I believe will contribute to even more people being over-medicated.

    • Victoria
      GA
      Reply

      Amen!

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