Parish Nurse Blog
A welcome to Joe Flynn, PharmD, who will share our healthcare letters to the parish with Judy Gardner, Parish Nurse. Joe brings an up-to-date perspective on medications and how we can use them responsibly. We are fortunate to have his expertise published in the Communicator at various times during the year ahead. Welcome, Joe.
Medications in the Elderly
Taking medications should always be done with caution, weighing risks vs. benefits to ensure the best outcome possible. This is especially true as we age and our bodies do not process medications in the same manner. Below I will outline strategies that can be utilized to prevent common mis-steps with medications in the aging population.
Insist on starting low and going slow. As we age our body does not absorb, distribute, process, or excrete medications as well as in our youth. It is important that you advocate for yourself when it is decided to start a new medication. Request that your provider starts at the lowest possible dose and increases at a slow rate when deemed necessary. This will allow you to better understand how the medication will affect you and prevent unwanted side effects.
Help your provider avoid the prescribing cascade. Medications are started to help treat a symptom. Those symptoms can be due to a disease or infection but also from another medication. It is very important to analyze any recently started medications and their common side effects to prevent your provider from adding medication on top of medication. In many cases the issue can be resolved by removing a medication or decreasing a dose. (Example: have allergies > take Benadryl > causes urinary retention > get prescribed a new med which causes light-headedness > patient falls and breaks hip > bad situation).
Frequent follow-up and monitoring. This is important with both new and chronic medications you may have been on for many years. When starting new medications there may be physical changes that may be expected (mild muscle pain, dry mouth) but there are some severe side effects that cannot be detected without lab work (high potassium, blood too thin). This is why frequent follow-up and monitoring are very important to ensure safety and efficacy. Many medications are processed and/or excreted by our kidneys. Kidney function declines as we age, which allows the medication to linger in our system and cause increased side effects. Even if you have been on the same dose for 10 or 20 years the dose may need to be decreased because you are aging.
I cannot stress enough the importance of being your own advocate. Healthcare professionals are all human and humans make mistakes. Limiting these mistakes is of high importance to us all. One crucial way to limit mistakes is having an accurate and up-to-date medication and allergy list. This includes all over-the-counter and herbal medications one may be on. As your medication list grows, the harder it will be to memorize, thus the importance of having a paper copy (or giving one to your loved one) and updating it frequently as changes are made.
Together we can be a healthier community.
God Bless – Joe Flynn, Pharm D
Dear Members and Friends of the Church of the Holy Communion:
“Resolving to take it easier can be a healthier way to live”, quotes an article from The Magazine AARP. It purports that Gandhi once said, “There is more to life than increasing its speed.” But as we do things faster, are we not more efficient? On the other hand, don’t we sacrifice effectiveness and enjoyment for efficiency?
Please consider these ideas as you read the following Slow-Down Strategies.
Stretch in Bed
Don’t risk a fall by jumping out of bed quickly, becoming light-headed and stumbling. Better to stretch your legs, bend them toward you and move them side to side, thus loosening hips and hamstrings that get tighter with age.
Take Your Time Brushing
45 seconds is not enough time to brush your teeth. Dentists agree that you should brush for 2 minutes each time and floss regularly. Brushing quickly means brushing too hard against the gums. Research shows that gum disease is linked to heart disease and dementia.
Delay Your Morning Coffee
Caffeine boosts your natural Cortisol (your stress hormone). Because cortisol peaks about 30 minutes after you awake, delay your coffee a couple of hours. Then have another coffee break in mid-afternoon when you have another cortisol dip. Caffeine improves both cognitive and perceptual motor skills and helps older adults stay focused on a task, as well as navigating crowds.
Strength Training Crucial to Healthy Aging
Keep your muscles, bones and joints strong; improve your balance; and prevent osteoporosis by doing strength training. Using “negative training” (moving slowly and deliberately in easy exercises) works the entire joint structure and results in more strength, stability and range of motion.
Defuse Anger by not Fueling It
Cortisol and Adrenaline are stress hormones that your body pumps out when you’re angry. Slow it down by going for a walk, listening to music, or taking deep breaths. If everyone disengages for a time, there will be a better outcome. If you are vexed by an email or tweet, avoid responding quickly. Better to shut off the message and deal with it later. Impulse-control does wonders. Write down your thoughts and feelings, in long hand, on paper. Taking time to think helps you stay centered and healthier. And that, after all, leads to a longer, happier life.
With love and care, Judy Gardner, Parish Nurse April, 2016