Medication Management in Older Adults: Challenges and Strategies
Pharmacology in the Elderly
Aging alters pharmacokinetics: absorption, distribution, metabolism, and elimination. Overmedication is a risk in the elderly with multiple conditions. Close clinical monitoring and quality of life assessments are crucial.
Medication Administration in the Elderly
Different routes of drug administration require special attention in older adults.
Treatment Failure
Treatment failure occurs when a person’s or caregiver’s actions do not align with the agreed therapeutic plan.
Factors Associated with Medication Issues in the Elderly
- Complexity of treatment or care system
- Lack of economic resources
- Inadequate needs forecasting
- Side effects
- Difficulty understanding
- Sensory decline: memory, hearing, mobility, vision
- Low educational level
- Mistrust in treatment
- Lack of therapeutic relationship
- Isolation and lack of support
- Patient or caregiver non-compliance
- Increased complications and symptoms
- Missed appointments
- Abnormal blood level markers
Patient and Family Involvement
The elderly and their families should:
- Understand the disease process and therapeutic regimen.
- Be aware of necessary lifestyle changes.
Care Plan
To improve care:
- Develop empathy and build trust with the care team.
- Introduce necessary lifestyle changes.
- Periodically evaluate expectations and satisfaction.
- Avoid chronic medication use and reassess the need to continue.
- Prevent medication changes by having the patient read labels aloud.
Adequacy of Explanations
When explaining medication:
- Consider the patient’s intellectual capacity.
- Encourage feedback.
- Adapt language and speech.
- Simplify drug names or use pseudonyms.
- Provide dose-adjusted preparations.
- Ensure the patient understands the information.
- Report on dose, route, timing, and possible changes.
- Respect rest hours.
- Report on drug compatibility.
- Explain alarm signals and when to contact a doctor or nurse.
- Provide written information in large, clear print.
- Provide a copy for a relative or caregiver.
- Report on available resources and support.
Devices to Aid Medication Adherence
Devices can help improve medication adherence by:
- Adjusting vision
- Improving memory
- Improving touch
Changes in the Immune System with Aging
Age-related changes in the immune system include:
- Reduced antibody production
- Decreased lymphocyte response
- Reduced allergen response
Complications of Immune Changes
These changes lead to:
- Reduced resistance to infections
- More severe complications
Infection Presentation in the Elderly
Infections in the elderly often present with:
- Increased difficulty and delay in diagnosis
- Complicating existing pathologies
- Muted or slow-appearing symptoms
- Abnormal or absent fever response
- Variable heart rate response
- Difficulties in physical assessment