Medication Management in Senior Living

Best practices for helping residents in assisted living facilities stay healthy.

According to a 2019 report from the Lown Institute, a nonpartisan think tank dedicated to transforming the American health care system, our nation’s older adults have a drug problem. This problem, called polypharmacy, sees older adults increasingly prescribed multiple medications to control a variety of medical disorders.

Older adults who take between 6 and 9 medications have a 59% greater chance of death when compared to those who take no medications. Taking 10 or more medications is associated with a 96% greater change of death, according to a 2017 study in the Journal of the American Pharmacy Association.

Adverse Drug Interactions Are Common – and Dangerous

The Lown Institute reports that polypharmacy has reached “epidemic proportions. More than 4 in 10 older adults take 5 or more prescription medications a day, an increase of 300% over the past two decades. Nearly 20% take 10 drugs or more. When over-the-counter medications and supplements are included, the number of older people taking five or more drugs rises to 67%.”

With the addition of each drug, the chances of an adverse interaction between the medications increases 7 to 10%. Additionally, many seniors use over-the-counter medications and herbal and dietary supplements, which can further complicate the substance picture and lead to adverse reactions.

Older adults who live in CCRCs, independent living facilities or assisted living facilities do not always have access to medication management services. In some communities, seniors are expected to manage their medications and supplements – which may be prescribed by a variety of doctors and filled by different pharmacies – on their own with little or no intervention from facility staff. This can create a challenging situation that leaves seniors at risk of adverse interactions and other health consequences.

Adverse Interactions and Heightened Side Effects

It’s important to realize that older adults may respond differently to medications than younger people. Some medications can increase lightheadedness, dizziness, and drowsiness – effects that may be heightened in older adults who may not be as quick to metabolize the compounds that create these issues. This can lead to an increased risk of falls.

The Centers for Disease Control and Prevention reports that in 2017, falls resulted in about 3 million emergency department visits, 900,000 hospitalizations and 30,000 deaths among older adults.

Helping Residents With Medications

If you’re interested in better supporting residents with medication management, the following best practices guidelines may help you work with seniors and their prescribers for improved health outcomes:

• Know what medications residents are taking. If you know that a resident is taking a medication that could potentially cause dizziness, that information can help you keep an eye out for warning signs. Talk to your residents about what they take, and if something seems unusual or a resident suddenly is prescribed many additional medications, there could be potential problems in store.
• Educate and empower residents. Let your residents know that taking multiple medications can have risks and encourage them to talk to their pharmacists and doctors about what they’re taking. Especially if medications are being prescribed by a number of different doctors or being filled by different pharmacies, potential negative interactions might not be flagged as readily. Disclosure and open communication can help.
• Look to technology solutions to better manage it all. A central electronic health records system that tracks all medications taken by everyone in the facility can help your staff members stay on top of medication changes among residents. Such systems can also streamline administration of medication, so that seniors get their medications when they’re supposed to.
• Educate yourself. What are the most common medications being used in your facility and what are their potential problems? Can you identify a resident who might be experiencing an adverse event? If such an event occurs, do you know how to handle it? All of these questions can help guide you in setting up the right protocol for managing medication issues before they arise.
• Educate staff. Make sure your staff members who are involved with medication management are up-to-date on any and all certifications related to managing medications and are generally made aware of the potential for medication-related issues. A forewarned staff member is forearmed to appropriately deal with the situation.

Elaine Howley

Elaine K. Howley is a freelance journalist for various publications. An award-winning writer specializing in health, fitness, sports and history, her work has appeared in numerous print and online publications, including U.S. News, AARP.org, espnW, SWIMMER magazine and Atlas Obscura. She’s also a world-record holding marathon swimmer with a passion for animals and beer. Contact her via her website: elainekhowley.com.