This Grandma’s grandchildren heal almost in the blink of an eye. Young 20s and 30s ails took little longer to heal. So go the decades. However, what I seem to see is that in the 60s, it is better not to have two things to go wrong at the same time. The body has to have the stamina and strength to fight two ailments at the same time, like a broken limb and a bad cold. It is better to hold off on a shot when you have something wrong with you as it seems to take longer to heal when you have one thing wrong and more than double the time to heal when you have two things wrong. It also seems that you can more easily catch something, so I see that immunity weakens with age. And this Grandma is still “young old.”
Then, applying all this personal observation to what GG (great grandmother) says is “old old,” when you are about 84 years of age and older, with less immunity, more difficulty healing, even less stamina and strength to fight more than one ailment at a time, the delicate balance of good health can become precarious.
You read a lot on the Internet about the dangers of medication and the need for us to monitor medications of the “old old” beloved parents we Boomers have remaining with us.
What you don’t seem to read a lot about is that one precipitating ailment requiring hospitalization can start a downward spiral for that “old old” loved one that is so quick and inexplicable, it can make your head spin.
It seems from what you read on the internet that there is not enough research yet for the experts to be able to actually say what we Boomers are seeing with our GGs. In the article, “Digging in on Issue of Overmedicated Seniors, the author, Barbara Peters Smith , in the on line Herald-Tribune, Saturday, May 17, 2014 talks about the lack of research on those “old old.”
“For older Americans, the days of ending every visit to the doctor with a new prescription could be ending. Studies show the average 75-year-old American takes more than 10 drugs for various ailments. But overmedication of elders has been linked to falls, kidney failure and even heart attacks, and discussions at the American Geriatrics Society’s annual scientific meeting here this week suggest that physicians are getting serious about paring down older adults’ drug regimens.”
“One challenge they’re learning how to share with their patients: In a new health care environment where treatments must be based on good medical evidence, there have been few studies of how prescription drugs – including some potent painkillers – actually work in older adults.”
“Research on their safety and effectiveness has been limited to middle-aged patients who don’t have the overlapping health complications that can cause dangerous, even fatal, drug interactions.”
“I would submit that the long-term risks and benefits in older populations remain unknown,” M. Carrington Reid, a geriatrics professor at Weill Cornell Medical College, said at a conference session on opioids for chronic pain. “We’re in an evidence-based era, and yet we don’t have sufficient data to warrant long-term use.”
There is a story well told that helped me understand how a vibrant, healthy adult, even for one “old old,” could enter the hospital for one problem and end up with problem over problem, such as now happening with our GG, I found on Parent Giving site.
“Overmedication in the Elderly: Polypharmacy a growing problem among seniors”
“It is undeniable that drugs do save lives, but few prescription medications are completely free of risks or side effects. Naturally, the more drugs that are taken at the same time, the greater the risk of adverse interactions and potentially devastating side effects. This problem of “overmedication” is increasing to almost epidemic proportions among the elderly. Take, for example, a recent Washington Post article that described an 83-year-old grandmother who wished to remain anonymous.”
“The woman had been hospitalized for an asthma attack. In the hospital she was prescribed steroids for the asthma, which made her blood pressure too high and caused vertigo. So the hospital prescribed a blood pressure medication, which made her dizzy. While in the hospital her ankles began to swell, so she was given a water pill, which in turn caused her level of potassium to bottom out, so the doctors added potassium supplements. To top it all off she was given a drug to treat osteoporosis, which eventually lead to gastric bleeding. The article quoted the grandmother as saying, “I came out sicker than I went in.”
“According to pharmacists, her situation is far from unique. “I see this all the time,” said pharmacist Art Weinstein, owner of a Chevy Chase, Maryland pharmacy. Weinstein eventually was able to reduce the number of drugs the grandmother was taking and return her to better health. Overmedication, or polypharmacy, as it is more technically referred to, is more common among the elderly. As we age we are prone to more chronic conditions that require medication. At the same time, an aging body tolerates drugs differently and metabolizes drugs more slowly than it did when we were young, making drug interaction a greater concern. Many seniors mix over the counter drugs and dietary supplements with prescription drugs in the mistaken belief that they will have little or no impact because of their nonprescription status.”
Then, as seems to have happened with GG, blame goes to a possible stroke or more as the website article continues:
“Psychiatric side effects of overmedication in seniors”
“Perhaps one of the most insidious aspects of overmedication is its effect on cognition and the mental capacity of seniors. Overmedicated seniors have been mistakenly diagnosed with depression, dementia, and even Alzheimer’s disease. Such was the case of Nancy Burns, whose story was recently featured on CNN. One weekend Nancy was discovered by her adult children at home stumbling, confused and incoherent. They took her to the emergency room where doctors thought she had had a stroke. Later a neurologist diagnosed her with dementia or Alzheimer’s. But this did not sit well with her children, so they took her to The University of Oklahoma’s Department of Gerontology for another opinion. The doctor there said, “I do not think your mother has Alzheimer’s or [dementia] I think she is overmedicated.” Turns out the doctor was right. Apparently she had seen several different doctors for manic depression and each had prescribed a powerful medication, so that she was taking eight different ones. Now, down to four, she has recovered and is doing well.”
An epidemic! One that is not widely known. We hear about Ebola but not how millions of us are affected by this epidemic. This Grandma is trying to now understand and prepare for the ramifications of the unintended medical consequences of aging.
Our GG entered the hospital for a minor condition, seemingly overmedicated for the condition, and is not our GG right now. The doctors seem unknowing to us, who have taken to the internet, that, at her age, the drugs might not be metabolizing the same way at her age, causing her to now be incoherent most of the time. Sound familiar to the article on the website?
On top of all the snowballing problems, the hospital staff lost her dentures and she looks her age for the first time. It is frustrating that hospital medical professionals look at her age and think the way she is now is the way she was. It is frustrating that, due to “modern” medical care, her primary doctors do not go to the hospital to see her current condition so they could tell the hospital professionals what she is really like, intelligent, aware, feisty, with it, and lives on her own at over ninety, driving and caring for herself.
What we do not know is how and if GG can and will come back to us as she was, or at her age, if she now loses the will to live. Neither, it seems, do the medical experts.
It seems that, with our Boomer number, we grandmas only can offer our personal experiences until medical research catches up and protocols change when dealing with the medical issues of those “old old.” We Boomers are learning we have to be more vigilant than ever thought before.
It only takes one ailment requiring hospitalization of the “old old” beloved parent for a Boomer to have to become a “helicopter” adult child to try to prevent the second ailment caused by the treatment for the first ailment.
But, learning as one goes along, as we have had to, is not the best path. The family should communicate, divide responsibilities based on skill, time, and inclination, sooner rather than later.
The article on the website has some good suggestions:
“How to avoid overmedication”
“Doctors and pharmacists recommend a “brown bag review” – that is where you take all of the drugs you or your elderly loved one are taking to the doctor or pharmacist and screen them for appropriate dosages and potential interactions. When prescribed a medication do not be afraid to ask your doctor if you really need it. Nancy’s case underscores the need to always carry your medical history with you that includes all drugs you are taking, even OTC and supplements, and share it with all health care providers. In the resource links following this article, you can find a list of drugs commonly taken by seniors with potentially hazardous interactions, and a drug interaction tool.”
“When prescribed a medication, do not be afraid to ask your doctor if you really need it.” – The University of Oklahoma’s Department of Gerontology. “
We need to prepare all the information as set forth above, ask the questions above, research quickly, involve a gerontologist sooner rather than later, ready at all times to try to prevent the downward spiral. We realized we needed telephone numbers of all doctors and dentists, a list of all medications and dosages, and where everything is located in the home of the “old old” beloved one.
This Grandma really hates to admit this, but I think I must prepare this list now for my children about me, and update it annually. I am thinking that although I am in denial, and consider myself “forever young,” maybe I should consider switching my primary care to a gerontologist, sooner rather than later, . . . .one who can coordinate care so my medications are “pared down” as I age and who can come to the hospital should I need such care to compensate for the concerns I now have about medical care of our “old old” loved one still remaining with us.
If you are the child of a Boomer, get into action now and force the issues with those of us in denial of our aging, collect the data, research now the leading gerontology institutes and local gerontology doctors, and prepare.
With Little Joy,
Mema
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