edication ai Elderly may mix unhealthy combinations Brady Fotheringham Contributing Writer MEDICATION misuse and substance abuse by the elderly is a growing concern on the North Shore. It's not talked about much and it’s a touchy subject among many socal workers, doctors and pharmacists. It’s difficult for many fami- lies to come to grips with the facta parent or loved one’s diminished mental faculties or recent “fall down the stairs” is the result of taking too many tranquilizers, sleeping pills or worse — mixing alcohol with both. Medication misuse can happen when an_ individual mixes prescription medication with over-the-counter drugs without reading the warning labels or when pills are com- bined with other medication against the instructions of a pharmacist or doctor. The popularity of herbal medicines such as natural anti- inflammatory drugs can com- pound the problem. Herbal pills are often overlooked as having little or no side-eftects when combined with preserip- tion medication. Cough syrups and flu remedics, all available without a prescription, can easily fill a medicine cabinet without rhe knowledge of a pharmacist. Many seniors are on _ pills for heart problems, blood pressure and diabetes. Most take their medication with no complications, Some, howev- er, take major tranquilizers like benzodiazepine which helps with anxiety and is problemat- iz especially when combined with alcohol, Trish Hunt, health director for the West Community Health Centre in West Vancouver, acknowledges the problem that exists within the North Shore's growing elderly population, “Substance misuse is a sig- nificant problem that goes undetected or is sometimes undiagnosed, sa we know it’s a significant health issue out there,” Hunt said. Whether seniors live on their own or in care facilitics, the symptoms of over-medica- tion can be difficult tor family members to detect. Bumping into things and getting bruised is often dis- missed as a sign of failing health in the elderly — not the side-effects of too much med- ication. ’ Eating habits can became. neglected, which leads to mal- nutrition, ” especially if alcohol is a factor. At the extreme end of consequences are automo- bile accidents resulting from alcohol mixed with pills. The — Geriatric Mental Health Team, which operates out of the West Community Health Centre, often decals with seniors who are dual diagnosed. “(Some seniors) have a psy- chiatric or mental health issue as well as substance abuse issue and it’s becoming extremely common. We're seeing lots of that requiring fairly complex and intensive treatment which is what we want to avoid,” ‘Hunt:said. . use troubl NEWS photo Brad Locwidge TRISH Hunt, heatth director for the West Community Health Centre, at right, dis- cusses drug awareness for seniors with Cindy MacLeod, community health nurse specializing in geriatric services on the North Shore. “The goal is to do as much prevention with people carly on in their lives. ” Pharmacists who have access to a computerized reg- istry system for medication are trained to watch for prescrip- tions thar may conflict with other medication that patients are taking. Peter” Wong, a London Drugs pharmacist for 10 years, said pharmacists monitor the medication of seniors who have known medical condi- tions such as Alzheimer’s dis- vase and impaired — lan- guage skills. “If a patient comes in for a refill coo late or too early, we will question them and ask why chey are early,” Wong said. Some seniors wog ot oh Alzheimer's dis- case cana mistake a heart pill for a viramin. Compound this problem with the tendency for some seniors to ask for pre- scriptions for minor ailments and vou end up with preserip- tions taken in combination that shouldn’t be. Pharmacists and physicians have a huge responsibility when administering preserip- tions, but are limited by not knowing what goes on at home. loved ones ora family member is crucial in keeping a senior’s the mental health positive. Steve Gian-nopoulos, who works with Seaview Drug and Alcohol’s adult outpatient counselling program, stresses the issue of family involve- ment. “When family members are “(Some seniors) have a psychiatric or mental health issue as well as substance abuse issue...” The involvement of involved same of the issues of loneliness seem not to be there as much and for some people thar is a positive effect,” Giannopoulos said. Seaview focuses primarily on clients who have alcohol abuse or medication misuse problems. Seaview’s STRIVE pro- gram works in’ conjunction with social: workers, doctors and families to help those over the age of 55 who have devel- oped a problem or abusive pattern with alcohol and med- ication, ‘The pro- gram_oaims at teaching seniors medical aware- ness and taking responsibility for themselves, Seniors who are referred by doc- tors or family to Seaview usually have become so over-medicated that they neglect their se general appearance as their medical problems worsen. “Eventually something, gives and that person is brought to the attention of the hospital or the family physician or family members and they take the initiative to find out what has been causing the problem and then the appropriate referral is made,” Giannopoulos said. The hidden problem is among seniors who don’t end up in the hospital from falling down or a car accident but whose mental clarity diminish- es, slowing their response and reaction times. The best preventive mea- sure is family knowledge of all mei on an elderly relative is taking. Said Hunt, “The real issue is getting people to the point in their lives when they are ready for change and that’s the harder issue. “E believe there is a strong tendency to want to cover up (those problems).” Seniors who have questions about any medication — pre- scription, over the counter or herbal medication — can call the B.C, SMILE (Seniors Medication Information Line) at 822-1330. It offers tree advice by =~ pharmacists. Inquiries about medication management programs offered by home-care nurses can also be directed to one of several community health cen- tres on the North Shore at 983-6700. 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