...A question that my sister and I ask patiently three times a day, seven days a week via long distance calls. His reply is always the same..."What pills...oh yes, I think that I took them, but let me check". It is as though he's never been asked this question before. Our father is 85 years old and he is determined to remain alone in his home of fifty-three years.
With both daughters living in distant cities, the challenge we face is to insure that he takes the 19 prescription medicines and supplements not only in accurate doses but also in proper combination and at proper intervals throughout the day. We have discussed with his doctor Dad's confusion over the prescription directions and his forgetfulness that leads to both under and over medicating. Only to be told how common this problem is in seniors and that we may need to make "other arrangements".
The Problem
Distant caregiving is tough enough when worrying about the health and safety of a parent or loved one who is living independently. Add the responsibility of understanding and structuring a successful medication regimen so that medications are reliably taken two, three or more times per day and care becomes even more difficult to manage. Are some pills taken but not others? Are substitutions made or more than one dose taken when the person can't remember pill taking?
Compliance simply means accurately taking the prescribed amount and type of a medication at the proper time and with the appropriate dosing method (e.g. oral, injection, before, with or after meals, etc.). No medicine will have the intended effect if any of these variables are altered. The elderly are the segment of the population most prone to drug-related problems from adverse drug interactions and errors in drug administration. In addition, seniors may have further difficulty in following and completing medication routines because of a decrease in memory function, vision and manual dexterity.
Startling Statistics
Estimates are that people over the age of 65 comprise 12% of the population; but consume 30% of all prescription medications.
One of the primary causes of hospitalization and premature institutionalization of older adults is the inappropriate use of prescription medications, failure to properly take medication or unmonitored side-effects/drug interactions from medications.
The majority of seniors take one or more prescription medications; the use of four or more medications has been linked to an increased risk for falls and environmental/home accidents due to an adverse drug reaction.
As many as 80% of the elderly are on confusing multiple-drug regimens.
Medication non-compliance is as dangerous and costly as many illnesses. Studies have shown that non-compliance leads to 10-25% of hospital and nursing home admissions. In the words of The New York Times, this has become the world's "other drug problem".
The elderly have six times more hospitalizations from failed medication compliance and harmful drug interactions than the general population.
In the general population, 50% of all prescriptions are taken incorrectly; studies have shown that less than 30% of the aging population uses their drugs properly.
As people age and grow older, the ability to follow complex procedures for medication administration is diminished before other self-care tasks.
Why the didUmed Smart Rx Cap?
Non-compliance with
prescription instructions causes the death of 340 Americans per day. 125,000
annually. Nearly twice as many as caused by automobile fatalities.
Non-compliance leads to 10-25% of hospital and nursing home admissions and is
becoming an international epidemic.
New York Times, June 2, 1998
It is estimated that
50-70% of all prescription medications in the US are taken incorrectly.
U.S. Chamber of Commerce and the Institute of Georgia Southwestern College
Mothers over the age of 40
are least likely to comply with prescription instructions since they are
responsible not only for their own medication but also for their family and
frequently an older parent or relative receiving their care. In fact, 80-90% of
care giving in the U.S. is received from a family member or friend.
Parade Magazine
Non-compliance with
prescription drug instruction is considered America's other drug problem.
N.Y. Public
Television report on WLIW
"Drugs…if they are
properly taken, can actually reduce long-term hospitalization and other medical
costs."
President Clinton,
White House Press Conference, 1999
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