As you get older it's likely that the number of medicines you take will increase. In this guide, we provide examples of 10 common medication-related problems you may encounter as you get older and tips to help you overcome them.
Why do older adults need extra care with medicines?
Older adults tend to have more chronic conditions such as diabetes, high blood pressure, arthritis and cancer and often take more prescription medicines, over-the-counter (OTC) medicines and herbal supplements. 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 to manage your health, there can be side effects or risks with taking them. This is particularly so in older adults because of age-related changes to your body.
- Your kidneys and liver, which help your body breakdown the medicines, may not work as well.
- Weight loss, decreased body fluid and increased fatty tissue can change the way medicines are distributed in your body. This may cause medicines to stay in your body longer.
- Impaired vision, hearing or memory can make taking medicines more difficult.
- Being more frail increases the risk of falls; this may be worsened by some medicines that cause drowsiness and affect your balance.
- 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 we provide examples of ten common medication-related problems and tips to help you overcome them:
1. How to take your medicines or use medical devices
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 instructions about how to use inhalers, testing kits or meters. Even if you have been using a device for years, it's still good to have reminders!
2. Keeping track of medicines
If you're having trouble keeping track of your medicines, talk to your doctor, nurse or pharmacist about having an up-to-date list of your medicines. This medication list (also called 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 also includes any over-the-counter (OTC medicines) you may buy, vitamins and herbal or dietary supplements you are taking.
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 discharged from hospital or seen a new doctor.
3. Can't read the medicine labels
It’s important that you can read the labels on your medicines so you know about it, how to take and store it and the expiry date. Let your pharmacist know if you cannot read the labels as they may be able to make labels with larger print, or write the medicine details on another sheet. You could also use a magnifying glass.
4. Remembering to take your medicines
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 pillbox or ask your pharmacist about compliance packaging. This means repacking your medicines into blister packs or sachets, to help you remember to take them. Read more about tips for remembering to take your medicine.
5. Difficulty swallowing your medicines
Weak oesophagus muscles and some health conditions can make it hard to swallow tablets or capsules. If this happens, ask your doctor, nurse or pharmacist if other forms of the medicine are available such 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 dispersed in water, before taking them. Only some tablets and capsules can be taken this way.
6. Side effects of medicines
All medicines, including OTC medicines, herbal remedies, vitamins and supplements, can have unwanted effects. The chance of getting side effects varies from person to person. Some side effects are more common than others and older adults may be more at risk of some of them.
If you notice a new problem that starts within hours or days of taking a new medicine, it could be that the medicine is the cause. There are also medicines that have delayed side effects, which may arise after taking the medicine for some time. If you think that your medicine is causing a side effect, talk to your doctor, nurse or pharmacist.
Read more about side effects of medicines.
7. Worried about falls
Older adults have a greater risk of falls and they are more harmful as you age, causing broken bones, severe bleeding and other serious injuries. Some medicines can increase your risk of falls. These include medicines that affect your balance, blood pressure or vision, or medicines that cause drowsiness, dizziness or confusion.
The risk of falls caused by medicines increases:
- as you take more medicines (taking 4 or more medicines)
- when you stop or start a medicine or have changes in the dose
- if you drink alcohol with some medicines
- if you also take some OTC medicines including cold and flu medicines.
If you are worried about your risk of falls, do not stop taking your medicine suddenly. Rather, discuss this with your doctor or pharmacist. Sometimes are more suitable alternative can be found. Some medicines need to be stopped gradually, as sudden withdrawal can make the effects worse.
When starting a new medicine, take care and get up slowly when 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.
8. Feel like you're taking too many medicines
Some medical conditions need treatment with more than one medicine. However, sometimes medicines may no longer be needed. It’s a good idea to have all of your medicines checked once a year by your pharmacist or doctor. If you are unsure if all the medicines you are taking are necessary, talk to your doctor.
Read more about polypharmacy, a term used to describe taking a large number of medicines (usually more than five). Also see 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. What to do with unwanted medicines
Having expired medicines at home 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. Managing your medicines when travelling
It’s easy when travelling to forget about your medicines – things like storage, knowing what to do if you run out or miss a dose, so it’s important to plan ahead. 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 (FDA), USA
Medicine safety Ministry of Health, 2015 New Zealand
Problems swallowing pills NHS Choices, 2017 UK
Know what to ask ACC, New Zealand
Preparing to leave hospital Health and Safety Commission, New Zealand
- Helping medicine capsules go down Medsafe Publications, May 2003, New Zealand
- Older people taking lots of medicines (polypharmacy in older people) The Atlas of Healthcare Variation, New Zealand
- Medicines: balancing intended benefits and increased falls risk Health and Safety Commission, New Zealand