What older adults, their families and friends need to know about… Medications

^{Adapted from Improving our Response to Older Adults with Substance Use, Mental Health and Gambling Problems © CAMH 2008}

Although adults aged 65 and older make up about 13 per cent of Canada’s population, they consume 20 to 40 per cent of all prescription drugs and 25 per cent of all over-the-counter drugs. Older adults are also more likely than younger adults to take more than one medication at a time. Less than one-tenth of older adults take no medication at all.

Older adults usually take medications as prescribed. However, problems can arise if they forget to take their medications, share medications with others or get confused about what to take or when. Some may try to treat their medical conditions on their own by taking more or less of a medication than prescribed, or by taking medications that are not prescribed.

How medications affect older adults

As people age, they become more sensitive to the effects of medications. Even when taken as prescribed or as indicated on the box or bottle, medications can affect people in ways that weren’t intended, for example:

When more than one medication is taken at a time, there is a risk of medication interactions. When medications interact, they may not work as well, or the interaction may cause other problems.
Most of the medications taken by older adults should not be taken with alcohol, even in small amounts. When taken with alcohol, some medications don’t work well and the health problems the medications were taken for won’t be treated properly. Other medications have an increased effect when taken with alcohol, causing slurring of speech, sleepiness, stumbling and falls. Drinking alcohol while taking medications can be dangerous.
The effectiveness of medications can also be affected by other drugs, such as herbal remedies, caffeine in coffee, nicotine in cigarettes, and other drugs, such as marijuana. It is wise to check with a doctor or pharmacist before mixing medications with other drugs.
All medications have side-effects. Some may be unpleasant, such as constipation, dry mouth or itchiness. Check with a doctor or pharmacist about possible side-effects before starting a medication. Since everyone responds slightly differently to a medication, it is important to report any side-effects you experience to your doctor. This way your doctor can work to ensure you get the benefits of a medication with as few sideeffects as possible.
Medications can have more serious adverse effects, which can be dangerous, such as causing unsteadiness and confusion and leading to falls, delirium or worsened depression. The risk of adverse effects may be highest when starting, increasing or stopping a treatment, or when combining treatments. If you experience any possible adverse effects, see your doctor immediately.
Long-term regular use of some medications prescribed for anxiety, sleep problems or pain can lead to drug dependence, also known as addiction. People who are addicted feel they need to take the medication, even when it causes problems in their lives; on the other hand, some people avoid taking adequate medication treatment because of a fear of becoming addicted.

What are the signs of medication problems?

Signs of medication side-effects, adverse effects, interactions or misuse include the following:

slurred speech
increased confusion
lack of energy or sleepiness
changes in mood
stumbling, falls
new medical symptoms following the start of a medication
not participating as much in activities you used to enjoy
neglect of personal care.

These signs are sometimes mistaken for signs of aging.

Taking medication safely

You can reduce the chance of having problems with medications if you:

take medications only as prescribed
get all prescriptions from the same doctor
have prescriptions filled at the same pharmacy every time
do not share medications with others
only take medications for the purposes for which they are intended
keep track by sorting all medications into a specialized pill container called a dosette or ask your pharmacist to put your medication in bubble packs
keep a list of each medication you are taking and what it is for.

Talking with your doctor or pharmacist

If you use different doctors or pharmacists, tell each doctor or pharmacist you see about every medication you take, including over-the-counter medications and herbal remedies.
Be sure you understand what the medication is for.
Tell your doctor or pharmacist about any new symptoms following the start of a new medication, such as feeling dizzy or lightheaded.
Ask your doctor about alternatives to taking medication, such as non-drug methods to help with relaxation or sleep or counselling for help with grief.
Ask whether you still need the medication you are taking; if not, ask if you can stop using it right away or if you should stop gradually.
Check with your doctor or pharmacist before taking alcohol with a medication.

It may help to write down your questions about medication to make sure you get all the information you need. Always ask your pharmacist for the medication information sheet and ensure you read and understand it.

Where can I find more information?

The best source for information about medications is your doctor or pharmacist. Information about medications can also be found online at HealthyOntario.com. Health advice or general health information from a registered nurse is available by calling TeleHealth Ontario at 1 866 797-0000. This free, confidential telephone service is available 24 hours a day, seven days a week.

For more information on addiction and mental health issues, please contact CAMH’s R. Samuel McLaughlin Information Centre:
Ontario toll-free: 1 800 463-6273
Toronto: 416 595-6111