Older adults often face multiple health issues that require various medications, increasing their risk of drug interactions, overdoses, and serious adverse effects.
 
Safe Medication Practices
As people age, their bodily functions, including mobility, eyesight, and memory, naturally decline. Therefore, it is important for a family member or caregiver to supervise medication use to ensure that older adults take their medications correctly. The most important step is to carefully read the medication label to confirm that it is the right medication for the right person, for the right condition, at the right dosage, by the right route, and at the right time.
 

Medications that need to be taken before meals should be taken at least 30 minutes prior to eating, while those that should be taken after meals can be taken immediately after eating or within 15 minutes. There is no significant difference between the two.
 

If medication is forgotten, it is advisable to consult a doctor or pharmacist for guidance on the next steps. Some medications can be taken as soon as remembered, while others should be skipped until the next scheduled dose.

 

In addition to having a caregiver supervise medication intake, other tools can help prevent missed dose and ensure correct adherence, such as:

• Medication boxes with days of the week clearly labeled. Older adults with complex medication regimens may use boxes divided by specific mealtimes.
• An alarm on a watch or mobile phone to remind the patient when to take medications.
• Various free smartphone applications that can alert patients when it’s time to take their medications.

It is not recommended to prepare a large quantity of medication in advance. If possible, keep the medication in its original packaging and remove it only when it is time to take it, as some medications must be kept away from light or moisture to remain effective.

 

Increasing the medication dosage on one's own can lead to serious side effects, while decreasing the dosage may reduce the effectiveness of the treatment. For example, blood pressure medication helps maintain control as long as it is taken regularly. If the medication is stopped, blood pressure may rise to dangerous levels. It is important to avoid adjusting the medication dosage without consulting a doctor.

 

The liver and kidneys play a vital role in removing chemicals from the body. In older adults, these functions naturally decline compared to younger individuals. As a result, the same dosage of medication in both age groups may cause older adults to retain more of the medication. This issue can be exacerbated if the medication itself has a negative effect on the liver and kidneys, leading to further deterioration of these organs. Regular monitoring and dosage adjustments by a doctor are essential.

 

Due to the deterioration of bodily functions in older adults, the risks associated with medication use are higher. For example, older adults may experience dizziness or fainting when changing positions or standing up, due to inadequate blood supply to the brain. If they are taking medication to further lower blood pressure, they may be even more prone to fainting, falling, or having accidents.

For those experiencing knee or joint pain who require nonsteroidal anti-inflammatory drugs (NSAIDs), which can irritate the digestive system, decreased pain perception may cause them to ignore symptoms until they become more serious. Caregivers and patients should regularly monitor symptoms. If dark urine or bloody stools occur, this may indicate bleeding in the digestive tract and requires immediate medical attention.
 

Medications that require especially close supervision in older adults include sedatives, antidepressants, antihistamines, and pain medications. These can cause side effects such as dizziness, drowsiness, and confusion, which increase the risk of falls. Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs) can elevate the risk of hypertension and kidney failure, so they should be avoided or used for very short periods, and closely monitored in patients with a history of high blood pressure, heart disease, or kidney disease. Older adults should only take medications prescribed by their doctor and avoid purchasing medications without a prescription.
 

In older adults, certain groups of medications, when taken together, may exacerbate each other's side effects. For example, pain medications that cause drowsiness, when taken with sedatives, can lead to dangerous oversedation or confusion. Some medications, when used in combination, can also decrease the effectiveness of others. For instance, certain antibiotics, when taken with milk, calcium, or antacids, may not be properly absorbed. These medications should be taken at least two hours apart. When hospitalized, older patients should bring a list of all their current medications so that the doctor and/or pharmacist can adjust the medications or their timing to avoid contraindications.
 

Carefully consider all vitamins, herbs, and supplements to ensure they are appropriate for the patient's health condition. Some herbs or supplements should be avoided in patients with kidney disease, as they can cause electrolyte imbalances or negatively affect kidney function. Research is essential to confirm their safety and effectiveness. Always consult a pharmacist or doctor before starting any herbs or supplements to avoid potential complications from interactions with medications being taken.

• Always maintain an updated list of all medications, including those prescribed by specialists and hospitals, over-the-counter medications purchased, and any supplements or herbal remedies. Bring this list to all doctor appointments, ensuring that all physicians prescribing medications are aware of the other medications being taken.
• Familiarize yourself with the names and purposes of each medication. Regularly ask the doctor if they are still necessary and if the dosage is correct. Request the discontinuation of any unnecessary medications.
• When prescribed a new medication, ask about possible side effects and interactions with current medications.

• U.S. Food & Drug Administration. 5 medication safety tips for older adults. Available from: https://www.fda.gov/consumers/consumer-updates/5-medication-safety-tips-older-adults [Accessed 5 November 2024].
• National Institute on Aging. Taking medicines safely as you age. Available from: https://www.nia.nih.gov/health/medicines-and-medication-management/taking-medicines-safely-you-age [Accessed 5 November 2024].
• Yodpetch S, et al. School for the Elderly: How to Become a Healthy Elderly Person. Bangkok: Mada Publishing; 2017.