Learn how to protect seniors from the hazards of opioid use.

Opioid addiction is a significant problem in America today, and it affects some of the country’s most vulnerable population – seniors. Opioids, while powerful pain relivers, pose some unique risks to older adults. The home care team at Nightingale Homecare shares the information you need to know to protect seniors from the dangerous complications of opioid addiction.

With the majority of older adults taking not just one, but multiple prescriptions, and with many seniors struggling with chronic pain from a variety of issues of aging, prescription of opioids is common. Unfortunately, with those prescriptions come some serious complications. In fact, opioid issues in seniors accounted for 17% of Arizona’s hospital admissions in 2015, according to the Arizona Department of Vital Statistics.

While use of opioids is dangerous for people of any age, there are particular risks associated with opioid use in older adults. As reported by the Wall Street Journal, older adults are “especially vulnerable to falls, fractures, and respiratory arrest when using prescription narcotics – and often they are taking other medications that magnify the risks.”

To help protect seniors from opioid complications, there are a number of initiatives underway in Arizona through the Area Agency on Aging:

• RxMatters: Created with the Arizona Criminal Justice Commission and Prevention Works AZ, this educational presentation helps seniors and their caregivers understand important facts related to opioid use, storage, and disposal.
• Awareness Campaign: The Area Agency on Aging put together a campaign to address the issue of proper medication use, targeted to thousands of residences state-wide.
• Substance Abuse Efforts: A collaborate effort between several Area Agencies on Aging and Region One, thanks to a grant from the Substance Abuse and Mental Health Services Administration, AHCCCS, and the Governor’s Office of Youth, Faith and Family, is addressing opioid addiction issues in a variety of counties throughout Arizona.

While these efforts are helpful on a broad scale, what can each of us do individually to help the seniors in our lives reduce the risk for opioid addiction? The top tactic our caregivers recommend is being an active participant in your senior loved one’s health care:

• Keep a list of all medications being taken, both prescription and over-the-counter.
• Ensure that medications are taken exactly as prescribed.
• Go with the senior to doctor appointments. Talk with the doctor about any potential side effects from medications being prescribed, and if opioids are being considered, ask for the lowest possible dose for the shortest possible duration. Also inquire about any non-opioid options that may be considered as an alternative.
• Make sure the senior doesn’t drink any alcohol while taking opioids.

It can be challenging for family members to manage all of a senior loved one’s health care needs, particularly when it comes to medication management. The home care professionals at Nightingale Homecare are always on hand to partner with families to ensure that all care needs are fully met at all times. With a full range of in-home care services varying from companionship and medication reminders to highly skilled nursing care, we’re able to protect seniors from medication mishaps and ensure they remain safe, comfortable and thriving. Contact us to learn more about our Sun City home care and all of the areas we serve by calling (602) 504-1555.

Medications that are capable of affecting the mind, emotions and behaviors are called psychotropic medications. These include commonly used pain medications called opioids as well as medications used to treat depression, anxiety, mood disorders, sleep problems, dementia and other mental illnesses. When given to older adults, psychotropic medications are typically intended to improve quality of life and ability to function. The doctor must assure, however, that the patient is accurately diagnosed, that the dose is correct, that harmful side effects don’t occur and that the psychotropic medication doesn’t interact badly with other medications that the patient is taking.

At Nightingale Homecare, the top provider of home care in Paradise Valley, we want to help seniors and their caregivers better understand the types of psychotropic medications they may be prescribed, how they can help, and the effects they may experience.

Some examples of psychotropic medications include:

• Depression medications (e.g. Zoloft, Paxil, Elavil, Effexor, Wellbutrin)
• Anxiety medications (e.g. Valium, Xanax, BuSpar, Ativan, Halcion)
• Mood stabilizer medications (Depacote, Lithium)
• Antipsychotics (e.g. Risperdal, Haldol, Zyprexa, Seroquel)
• Stimulants (e.g. Adderal, Ritalin)
• Anti-dementia medications (i.e. Aricept, Namenda, Exelon, Cognex)
• Sleep medications (e.g. Ambien, Sonata, Lunesta, Remeron, Desyrel, Pamelor,)
• Opioid pain medications (e.g. Percocet, Vicodin, OxyContin, Morphine, Meperidine, Hydromorphone, and Fentanyl)

The use of psychotropic medications and opioids has increased steadily in older adults over the last ten years. In the United States, people over the age of 65 represent just 13 percent of the population, yet this age group takes over one-third of the drugs prescribed in this county. What is even more disturbing is that a recent study found that the number of older Americans who take three or more brain-affecting medications has doubled in the last ten years. For adults age 65-80, nine out of ten have prescriptions for psychotropic medications written by a doctor that is not a psychiatrist.

Although they can be beneficial at times, psychotropic and opioid medications can also be dangerous when taken by older adults, especially when taken long-term. The elderly are more sensitive to the effects of these medications because most drugs are eliminated from the body through the kidneys and liver, both of which may work less efficiently in later years. Another age-related change is an increase in the amount of body fat. Seniors are at high risk for “drug toxicity,” or the result of drugs accumulating in the body because the drugs are often stored in fat. Drug toxicity is very serious and can be fatal.

Even though there is a well-known connection between the use of psychotropic medications in older adults and the potential toxicity from them, health care professionals often do not recognize what is happening. More than likely, they attribute the symptoms of medication toxicity to some sort of new health condition or worsening of an existing health condition.

Side effects from psychotropic drugs are more frequent and severe in older adults, especially feelings of sleepiness or being “out of it.” Memory and movement problems are also very common and can lead to falls, fractures and other accidents.

Most older adults who take psychotropic medications also take other prescribed and over-the-counter medications. Because of this, careful evaluation is needed to make sure that unwanted, uncomfortable or dangerous side effects and interactions are not occurring. Bad medication reactions commonly include: hallucinations, confusion, dizziness, constipation, drowsiness, weakness, slurred speech, lack of balance or coordination, slow and shallow breathing, poor judgement, falls with broken bones, addiction and even death. In addition, a recent study found that use of benzodiazepine (or anti-anxiety medication) results in a higher risk of developing Alzheimer’s disease.

Hospitalization due to bad drug reactions occurs about four times more frequently in older patients than in younger ones – and, these bad reactions could have been prevented in almost 90% of cases!

Due to the risks involved, psychotropic medications should only be prescribed by a senior’s doctor after very careful consideration, and only after trying medications or treatments that pose a lower health risk.

When considering treatment foranxiety, depression, psychological distress, sleep disorders and chronic pain,non-pharmaceutical strategies are often considered preferable to drug options in the elderly. These include:

• Exercise
• Meditation
• Physical therapy
• Acupuncture
• Thai chi
• Cognitive behavioral therapy
• Yoga
• Biofeedback
• Chiropractic therapy
• Guided imagery
• Progressive muscle relaxation
• Hot and cold treatments
• Deep breathing
• Relaxation training

When it comes to pain management, there is a perception that opiate pain medications are the best treatment, but studies have determined that there is no advantage to using opioid pain medications for the treatment of chronic pain in older adults when the pain is not caused by cancer. For non-cancer pain, opioids are recommended for a maximumof 3-7 days, and some over-the counter pain medications may actually be more effective.
Nightingale Homecare is committed to keeping seniors safe and well through trusted in-home care services, skilled nursing care, and more. Contact us today at (602) 504-1555 for further information on psychotropic medications or for set up a consultation for home care in Paradise Valley and the surrounding area.

Prescription medications are meant to help heal us, relieve pain or other problematic symptoms, or manage chronic conditions, but did you know they also account for well over 100,000 deaths and 10% of all hospitalizations each year in older adults? That is, when they’re taken incorrectly – which startlingly, occurs as frequently as 50% of the time. With statistics such as these, what exactly are the reasons seniors are reluctant to take medications as prescribed – and how can we, as caregivers help? The Phoenix home care experts at Nightingale Homecare have answers to both of these questions!

Top Reasons for Senior Medication Mismanagement:

• Cost. While Medicare and supplemental insurance plans help with medication costs, there are a number of exclusions, and some older adults are either unwilling or unable to cover costs out-of-pocket. And with the typical senior taking anywhere from 14 – 18 different medications, it’s easy to see how cost quickly adds up! Seniors may try to ration medications by less than what’s been prescribed, to avoid having to pay for refills as frequently. And at times, a senior may feel as though the medication isn’t that helpful anyway, and decides to simply forego the doctor’s orders.
  • How you can help: Remind the senior of the importance of taking medications exactly as prescribed. Talk with his or her medical team to make sure they’re aware of the situation, and to see if a lower cost generic version of the medication is an option. You can also look into the Social Security program, “Extra Help with Medicare Prescription Drug Costs” to see if your loved one qualifies for additional assistance.
• Feeling healthy. This is an all-too-common scenario: a senior is prescribed a medication that’s so effective, he or she feels better, and therefore assumes it’s ok to stop taking it. However, since many medications are preventative in nature, and are used to keep a condition from worsening, it’s imperative that they be taken to avoid serious complications.
  • How you can help: Again, speak with the senior’s physician so he or she is aware that medications are not being taken as prescribed. Request that the doctor talk with the older adult and share the potential risks of discontinuing meds, as this may carry more weight with the senior than hearing it from you or other well-meaning family members.
• Medication avoidance. Sometimes, older adults simply have an aversion to taking any kind of medication. They may prefer a more natural approach to health care, such as changing their diet or taking over-the-counter herbal supplements. Taking prescriptions may also provide a daily, unwanted reminder of their health issues.
  • How you can help: A healthy diet should certainly be encouraged, but in tandem with doctors’ recommendations; and supplements should never be taken without first consulting a physician. Having a Nightingale Homecare nurse talk with the senior can be a great first step to overcoming barriers and in helping him or her to understand the risks vs. benefits of taking prescribed medications.

If your senior loved one struggles with medications for any reason, give us a call at (602) 504-1555 to speak with a member of our Phoenix home care team. We can help transport and accompany seniors to doctor visits to help bring resolution, pick up prescriptions, and provide medication management services to help older adults stay healthy and well. Contact us to learn more!