As you get older your body may not react to medicines in the same way as a younger person's does. Here are tips to help you with 10 common medicine-related problems that can happen as you get older.
Why do older adults need to take extra care with medicines?
Older adults tend to have more health conditions, such as diabetes, high blood pressure, arthritis and cancer. This means you often take more prescription medicines, over-the-counter (OTC) medicines and herbal supplements as you get older.
Most New Zealanders over the age of 70 years are prescribed 4 or more medicines, and a small number take as many as 20 different medicines.
Although medicines help you manage your health, there can be side effects and risks with taking them. This is especially so in older adults because of age-related changes to your body.
- Your kidneys and liver, which help your body break down the medicines, may not work as well.
- Weight loss, less body fluid and more fatty tissue can cause medicines to stay in your body longer.
- Poor eyesight, hearing or memory can make taking medicines more difficult.
- Being frail increases the risk of falls. Medicines that cause drowsiness and affect your balance could make this worse.
- Weakened muscles around your oesophagus (food pipe) can make swallowing difficult.
Also, you may be seeing more than one doctor and are likely to have more medicines. If you are using many medicines, these may interact with each other, increasing the chances of unwanted side effects.
Here are tips to overcome 10 common medicine-related problems.
1. Know how to take your medicines
If you are unsure, ask your pharmacist to explain how to take your medicines so that you get the right dose of the right medicine at the right time.
Your pharmacist can give you written information and show you how to use inhalers, testing kits or meters. Even if you have been using these for years, it's still good to have reminders!
2. Keep track of your medicines
If you're having trouble keeping track of your medicines, talk to your doctor, nurse or pharmacist and ask them for an up-to-date list of your medicines. Your medicine list (also called a yellow card) includes the name of the medicine, your dose, the time to take it, any special instructions and what it is used for.
This list should also include any OTC medicines and any vitamins and herbal or dietary supplements you are taking. Remember to ask your pharmacist if they are safe to take with your other medicines.
Having this list helps you to give this information correctly and quickly at a time when you might need it the most, such as in an emergency.
Remember to ask your healthcare provider to update this list when you have a new medicine added, a medicine stopped or a change in dose. This can happen if you have had side effects, been unwell or in hospital or seen a new doctor.
3. Make sure you can read the labels
It’s important that you can read the labels on your medicine so you know what it is, how to take and store it and the expiry date. Let your pharmacist know if you can't read the labels. They may be able to make labels with larger print or write extra information on another sheet. You could also use a magnifying glass.
4. Use reminders
Taking your medicines as prescribed will help you get the best results. To help you remember, you can mark the calendar, use a wall chart, set an alarm, use a reminder app on your phone, use a pillbox or ask your pharmacist about re-packing your medicines into blister packs or sachets.
Read more tips for remembering to take your medicine.
5. Get help if you have problems swallowing your medicines
Some people find it hard to swallow tablets or capsules as they get older. If this happens, ask your doctor, nurse or pharmacist if your medicines are available as a liquid, dispersible tablet (dissolves in water), patch or suppository.
Ask your pharmacist if your tablets can be crushed, or your capsules opened and mixed in water before taking them. Only some tablets and capsules can be taken this way.
Read more about difficulty swallowing your medicines.
6. Look out for side effects of medicines
All medicines, including OTC medicines, herbal remedies, vitamins and supplements, can have side effects. The chance of getting side effects varies. Some side effects are more common than others and older adults may be more at risk of experiencing them.
If you notice a new problem that starts after taking a new medicine, it could be that the medicine is the cause. Talk to your doctor, nurse or pharmacist if this happens.
Read more about side effects of medicines.
7. Take care to avoid falls
Older adults have a greater risk of falls, and falls are more harmful as you age, causing broken bones, bleeding and other serious injuries. Some medicines can increase your risk of falls. These include medicines that affect your balance, blood pressure or eyesight, or medicines that can make you dizzy, drowsy or confused.
The risk of falls caused by medicines increases:
- as you take more medicines
- when you stop or start a medicine or change the dose
- if you drink alcohol
- if you also take some OTC medicines, including cold and flu medicines.
If you are worried about your risk of falls, don't stop taking your medicine suddenly. Instead talk to your doctor or pharmacist – another medicine might be better for you.
If you need to stop taking a medicine, your doctor or pharmacist will give you advice because some medicines need to be stopped slowly to make sure they don’t make the problem worse.
When starting a new medicine that can make you dizzy, get up slowly from lying down or sitting. If you feel dizzy, stay sitting or lying down until you feel better. Tell your doctor about this.
If the medicine makes you feel drowsy or sleepy, ask your pharmacist if taking it at night may be helpful. If you do feel dizzy or drowsy, do not drive until you feel well enough to do so. Read more about medicines and falls risk and preventing falls.
8. Get a medicine check every year
Sometimes medicines may no longer be needed, or doses may need to be changed as you get older. It’s a good idea to have all your medicines checked once a year by your pharmacist or doctor. If you're not sure whether all your medicines are needed, talk to your doctor.
Read more about polypharmacy, a term used to describe taking a large number of medicines. See the following Choosing Wisely NZ for advice on how to manage issues with your medicines:
- Medicines – making decisions for older people
- Medicines – review
- Medicines – stopping a medicine
- Medicines – when can medicine problems occur
9. Clear out unwanted medicines
Having old medicines at home that you no longer need increases your chances of accidentally taking them, so it’s important to clear them out. Take them to your local pharmacy for safe disposal. Don't get rid of them in rubbish bags, bins or down the toilet. This can cause problems with the environment.
Read more about how to dispose of unwanted medicines safely.
10. Manage your medicines when travelling
It’s easy when travelling to forget about taking your medicines, so you need to plan ahead. Make sure you take enough with you and think about how you will store them safely. If you're travelling overseas, many countries have different regulations about medicines.
Read more about how to manage your medicines while you travel.
Medicines and you – a guide for older adults Food and Drug Administration, US
Medicine safety Ministry of Health, NZ
Problems swallowing pills NHS, UK
Know what to ask ACC, NZ
Preparing to leave hospital Health and Safety Commission, NZ
- Helping medicine capsules go down Medsafe, NZ, 2003
- Older people taking lots of medicines (polypharmacy in older people) The Atlas of Healthcare Variation, NZ
- Medicines – balancing intended benefits and increased falls risk Health and Safety Commission, NZ, 2020
Additional resources for healthcare professionals
Stopping medicines in older people: the flip side of the prescribing equation BPAC, NZ, 2020
Successful care transitions for older people: a systematic review and meta-analysis of the effects of interventions that support medication continuity Oxford Academic, 2020
Prevention is better than cure: five tips for keeping older people healthy and out of hospital during winter BPAC, NZ, 2015
Managing medicines in older people BPAC, NZ, 2012
A practical guide to stopping medicines in older people BPAC, NZ, 2010
Falls in older people: causes and prevention BPAC, NZ, 2010
Older people taking lots of medicines (polypharmacy in older people) The Atlas of Healthcare Variation, NZ
Medicines: balancing intended benefits and increased falls risk Health and Safety Commission, NZ