The Difficulties of Old People Taking Drugs

Abstract

There is considerable interest in the problems of the elderly taking drugs correctly and appropriately. A recent survey (Parkin et al. 1976) showed that these problems that have long been known in geriatric practice have now been noted by general physicians. This review was undertaken when an occupational therapist in a geriatric unit team noted that, although patients and their relatives were taught methods of dressing, toileting, shaving, bathing, eating, walking, transferring to a chair, wheelchair mobility and communication by the occupational therapist, physiotherapist and speech therapist, no advice or teaching was given concerning the accurate taking of the drugs prescribed. The results of a detailed investigation are reported elsewhere (Atkinson, Gibson & Andrews 1978). Repeatedly, patients ready for discharge were handed a batch of drugs by a nurse at the last possible moment, even while sitting by their luggage awaiting the ambulance. Following this, special attention was paid to problems such as intellectual impairment, loss of memory and confusion, poor sight, inability to handle containers, failure to take drugs and lack of patient-education. During ward rounds, particularly when a geriatric health visitor was present, attention was drawn to special topics such as the number of patients who inadvertently kill themselves and the numbers needing readmission due to failure to take drugs, overdosage or underdosage or mixing of drugs (Wade 1972). Ferguson Anderson's comment (1974) that 7.15% of hospital admissions are due to drug reactions was also noted.

Tablet taking by type 2 diabetics: Medication errors and poor compliance

“…Many of the patients in our survey were in receipt of several different medications, and this may have contributed to their much poorer compliance. Most patients cannot take more than three concurrent regular medications reliably (Ref 4).…”

“…It is human nature for many patients to make potentially serious errors in the taking of prescribed medications ( Refs 1,2). Elderly patients are particularly at risk, because of forgetfulness and confusion (Refs 3,4). Doctors often fail to explain how and when to take tablets and multiple medications compound this problem.…”

Appropriate use of drugs by elderly people

“…Various drug education and record cards which patients keep have also been designed (Atkinson et al 1977).…”

“…A number of surveys have shown that the elderly as a group are generally not aware of the implications of symptoms, or will attribute them to the effects of ageing. Mental deterioration, living alone, problems of mobility, social withdrawal and an inability to obtain help will increase the possibility of non-compliance, with adverse reactions and treatment failures developing undetected (Atkinson et al 1977, Barrowclough & Pegg 1982.…”

“…Various suggestions have been made regarding patient education, ranging from written and verbal instructions to suggestions about instructions to hospital patients controlling their own drugs for at least 1 week before discharge, using a container of the type used at home. Various drug education and record cards which patients keep have also been designed (Atkinson et al 1977).…”