Now let's talk about the unique
challenges to the older adult.
The first one that we have
to talk about is Polypharmacy.
Polypharmacy means poly,
many; pharmacy, drugs.
Because older adults are the favorite
customers of every drugstore,
CVS and Walgreens and
any drugstore on the planet,
because they're their largest consumer,
the elderly population is most
likely be on multiple drugs.
And if you're on 2 or more drugs,
you have a risk for
drug to drug interaction.
If you're on multiple drugs,
there's a significant risk of
drug to drug interaction.
So, one of the main unique challenges
to the older adult
population is polypharmacy.
The next is compliance.
Because of finances, or
how complex a plan of care is,
or side effects, or seeing multiple
doctors and multiple side effects,
sometimes it's really hard
for the patients to want to
or to be able to comply
with a medication plan.
Now, comorbidities, that's
a really long word to say.
They don't come with
just 1 disease process.
Often, by the time a patient
is elderly, they have,
maybe some heart problems
and some renal problems
and some liver problems,
they may be diabetic, hypertensive.
They usually have more than
one illness that they're dealing with.
the medication treatment plans
for multiple illnesses can
conflict with each other
and cause drug to drug interactions.
Now, the pediatric
population is at increased
risk for adverse drug reactions,
but so are the older adult patients.
Now there's a Beers Criteria.
You'll see that on the screen.
That's a list that's been come up by
the American Geriatrics
Society that tells us
that for inappropriate
medication use in older adults.
There are some medications that,
because of their pharmacokinetics,
the elderly population should
not receive these medication.
Now there's a list of them
in Beers Criteria,
and I encourage you to look
that up and see some of
the list of names that are
challenging for older adults.
Okay, now, it's your turn.
Answer these 2 questions
in the margins of your notes.
What does polypharmacy mean?
And how can a nurse minimize the risk
of polypharmacy for elderly patients?
Okay, good job taking the time
to think through these 2 questions.
Remember that polypharmacy
means multiple drugs.
Now, how can a nurse minimize the risk
of polypharmacy for elderly patients?
Well, one of the most important things
you can do is do anything
you can to get a complete
and full medical history of
medications that they're taking.
So when you admit a patient or
when you interact with a patient,
asking them questions that are helpful,
ask them what over the counter medications they take.
Ask them what supplements
or vitamins they take,
and then ask them how
many doctors they see.
In case they don't have
a complete med list with them,
that's some of the ways that you can
draw out the information that you need.
So one of the most
important ways a nurse
can minimize the risk of
polypharmacy for elderly patients
is help their patients come up with
a complete list of prescribed,
over the counter, and supplements
and vitamins that they
take on a regular basis.
Okay, now, let's talk about 7 medication
strategies for elderly patients.
Okay, the first one is
just what we talked about.
Be diligent to obtain a complete
and current medication list,
including over the counter
and herbal supplements.
a pharmacist to identify any
possible adverse drug reactions.
Use criteria to identify possibly
inappropriate meds for the elderly.
Remember, we talked
early about Beers Criteria.
Assess and accommodate
and physical changes.
So, knowing what you know about
the pharmacokinetic changes in absorption,
distribution, metabolism, and excretion,
you want to make sure that
you assess for those possible changes
and accommodate those.
Now as far as the physical changes,
elderly patients often
have problems with hearing,
vision, and actual manual dexterity.
So you want to assess that
and help them problem solve.
If the patient has
a difficult time hearing,
make sure you figure out
what is most helpful to them.
Some people have more
hearing loss on 1 side or the other,
so always speak to their
more effectively hearing side.
Vision problems. Don't provide
paperwork that has tiny,
tiny print. Make sure it's
a print that the font size
is large enough that
the patient can read.
And as far as manual
dexterity, work with a patient,
particularly if you're sending them home
with medications that
they can't open, or types
of administration routes
that they can't handle,
like if they have to give
themselves a SubQ injection
and they just don't have
the manual dexterity to do that.
So make sure that you
assess and accommodate
for age-related pharmacokinetic and
physical changes in your elderly patients.
The next important assessment
is to assess their ability
to follow the medication plan,
including their ability to actually
acquire the prescribed medications.
Some medications that are prescribed
are phenomenally expensive
and far outside the range of
elderly adult resources.
So help them narrow
that down and make sure
they can acquire those medications
that have been prescribed for them.
If they can't, work with a team member,
like a licensed case social worker
to help provide that medication for them.
Notify the health care provider so
another medication can be prescribed.
Look for other alternatives or
options that are appropriate
and work with the whole team to do that;
the health care provider,
the social worker, and the patient.
Utilize return demonstration in patient
education versus just talking at them.
You explain something in
person, that's very helpful.
You're already aware of their vision
problems or possible vision problems,
or hearing problems,
or manual dexterity problems,
but as you educate the patient,
it's not enough for them to just
tell you that, yes, they understand.
Most of the elderly
population is very compliant
when they're talking with a nurse.
And if you ask them if they understand
they will say, "Yes," just
because they want to
please you or they want to be polite,
or they're embarrassed
that they don't understand.
So return demonstration,
asking the patient to show you
how they would take that medication.
Asking the patient simple,
encouraging questions about their
program -- medication plan that
allow them to be successful,
will help you assess how much they truly
understand what we're talking about.
Now, I want you to think of
your favorite elderly person,
because this is what
nursing is all about.
You want to treat every
patient that you come into
contact like they're somebody that you
feel is your very favorite person.
You want that kind of respect
and care given to each 1 of them.
So, thinking of that favorite
elderly person in your world,
which one of these 7 strategies would be
the most helpful to keep them safe?
I just want you to
circle it in your notes.
Now, keep in mind, whenever
you take care of a patient,
that we should treat everyone with
that same kind of respect and care.
Thank you for watching
our video for Pharmacology
Across the Lifespan
for our elderly clients.