Gina was worried; it seemed that every time her mother complained of a new ache or pain to her doctors, she was prescribed another medication. Yet the more drugs she took, the worse she felt. It got to the point where Gina’s mother was taking at least 10 pills a day for high blood pressure, anxiety, depression, constipation, high cholesterol, heartburn, low thyroid function, insomnia, and who knew what else.

“Mom, every medication has side effects,” Gina said. “Do all of your doctors know exactly what you’re taking and how these meds might interact with each other?”

This is an especially relevant question for seniors, the majority of whom have one or more chronic illnesses. They may take several medications that have dangerous side effects or can interact in a negative way with other drugs, or even with certain foods. The potential negative effects of anticholinergic medications like some antihistamines and incontinence medication are currently in the news after a new study appeared in the Journal of the American Medical Association. As a care manager, I always ask my clients about the medications they’re taking. Adverse drug events are a preventable cause of hospitalization, and taking multiple medications can cause side effects that are misdiagnosed for another condition. Some drugs can worsen – or their side effects can mimic – the symptoms of certain illnesses.
For example, many seniors who experience sleep problems, or anxiety, are prescribed a sedative or benzodiazepine, but these medications can cause grogginess, confusion, and problems with balance, increasing the risk of falls. Anticholinergic drugs, such as certain antihistamines, can cause daytime drowsiness. Warfarin, a blood thinner, can interact with antibiotics and other drugs.

Care managers can spot potential problems with a senior’s medications and bring them to the attention of physicians. Some examples are: questioning medications that are more apt to cause serious side effects in an older person, inquiring if an alternative medication or treatment would be safer, and asking about adverse drug reactions. Also, is the client receiving medications from multiple providers? It’s important for all of the senior’s doctors to have a complete, up-to-date medication list.

Equally important is making sure medications are taken as prescribed. Sometimes people will stop taking a prescription, thinking the problem has been resolved, when stopping suddenly can have health effects. Or the senior is taking so many pills a day at certain times, it’s hard to take them all and it’s hard to keep track.

In Gina’s case, I consulted with her mother’s doctors, who decided to pare back on her multiple medications and monitor her more closely. As I do with my other clients, I also helped Gina’s mother organize her medications, labeling them clearly and prefilling a weekly medication box. When it comes to the health and safety of an aging parent or grandparent, medication review and monitoring are quite possibly one of the most critical services a care manager can provide.

If your aging loved one is in the Northern Virginia or Washington D.C. area and you would like help with aging challenges you are facing from a group of geriatric / aging life care managers, with a background in nursing, please reach out to us at 703-723-3737 or


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