Q: My father takes many pills, too many in my opinion. He seems to take them at his convenience. Sometimes he complies; other times he ignores. Can you write about this kind of dilemma? Many thanks.
— S.L.
A: The issue you describe is a common one. Up to half of older adults do not take their medications as directed, taking less than prescribed or stopping after six months.
The more we understand the conditions and reasons, the better we can help people comply with medication plans designed for their health and wellness.
Adults 65 or older tend to take more medicines than any other age group because they often have several diseases or other health problems.
Almost 80% take at least two prescription drugs, and over one-third regularly take at least five. And others report over half of older adults are taking four or more medications. When over-the-counter and dietary supplements are included, these rates are even higher.
Many of the conditions are chronic, such as arthritis, asthma, coronary heart disease, depression, diabetes and hypertension.
Medication schedules can be complex. And the more complex, the greater the risks of mistakes.
Confusion can occur when medications need to be taken at different times during the day, with or without food, and combined with other types of schedules.
Your concern that your father is taking too many medications often is referred to as polypharmacy, taking multiple drugs for multiple conditions.
Inappropriate polypharmacy is the use of excessive or unnecessary medications that increase the risk of adverse drug effects, including falls and cognitive impairment, harmful drug interactions and more. This is a growing concern, according to the National Institute on Aging.
Here are some reasons for the lack of medication compliance, suggested by the Chen Senior Medical Center.
Expense: This is considered one of the biggest barriers. Some older adults live only on Social Security and have multiple chronic conditions that are costly. As a result, they may ration their medications to last longer or even prioritize paying their rent rather than purchasing their medications.
Memory issues: These may be due to cognitive impairment or just forgetting. Remembering what to take when and how frequently can be a challenge.
No symptoms: Here’s the irony — the medication may remove the symptoms. Consequently, the patient feels better and stops the medication. They only feel better because the medication worked. Also, some conditions do not present symptoms, such as high blood pressure and cholesterol, and diabetes — that is, until the condition gets worse.
Mistrust: During the COVID-19 pandemic, there was suspicion of the vaccine and pharmaceutical companies. That distrust has lingered, reports the Chen center.
Fear: Patients may be afraid of side effects or think they may become addicted to certain medications. They also may be afraid to take the drug because friends tell about its bad side effects or ineffectiveness.
So, what can be done to help people take the right medication in the right way?
Health providers can better inform patients on the benefits and risks of medication adherence.
To minimize cost, people can ask their doctor or pharmacist if there is a lower-cost version of the medication.
People can use medication reminders. These include smartphone apps, including the Apple Watch; pill containers with digital times; daily pill packs offered by some pharmacy services; and other memory aids.
Healthline describes and recommends medication reminders that vary in function and price.
Here are three examples. For more info, go to healthline.com and search “medication reminders.”
The TabTime Timer has up to eight independent alarms for daily reminders about specific medications.
The TimeCap & Bottle is a pill bottle with a timer built into the cap. The cap is portable to other pill bottles.
Hero is a pill dispenser with medication reminders. It connects to Wi-Fi, signals when it’s time to take your meds and dispenses preset doses. There is a monthly fee.
Thank you, S.L., for your important questions. Hope this information will help your dad manage his medications so he can enjoy as much good health as possible. Stay well and spread the gift of kindness.
Helen Dennis is a nationally recognized leader on issues of aging and retirement, with academic, corporate and nonprofit experience. Contact Helen at Helendenn@gmail.com. Visit Helen at HelenMdennis.com and follow her at facebook.com/ SuccessfulAgingCommunity.