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Savvy Senior September 2007
Dear Savvy Senior,
Is mixing over-the-counter medicine with prescription drugs dangerous? My 70- year-old husband is currently taking six different prescription medications and two over-the-counter drugs. I’m worried he’s taking too much medicine. Any suggestions?
Most people, when they think about drug interactions or other problems concerning medicine, they think about prescription drugs. But each year, more than 500,000 Americans end up in hospitals because of unintentional over-the-counter (OTC) drug overdoses, or due to OTC remedies interacting with prescription medication. Here’s what you should know.
OTC Dangers - Just because OTC medications are available without a doctor’s prescription doesn’t mean they’re safe for everyone. OTC medicines (drugs that can help with coughs, colds, aches, pains, fever, allergies, heartburn and many other ailments) are powerful drugs that offer real benefits when used correctly and real risks when misused. Those most vulnerable to these risks are seniors because they typically take more medication (OTC and prescription) than any other age group, and the fact is, the more drugs you take the greater your risk for potential problems.
OTC Safety Tips - With more than 100,000 OTC medicines on the market today you need to be very aware of what you’re taking, and as always talk to your doctor or pharmacist if you have questions or concerns. Here are some tips to help you avoid potential OTC and prescription medication problems:
Always read the “Drug Facts” label on the OTC product and follow directions. It tells you what the medicine is for, how and when (and when not) to take the medication, the product’s active and inactive ingredients, possible interactions, side effects, warnings and more.
Choose OTC products that treat only the symptoms you have.
Use extra caution when taking more than one OTC drug at a time. Many OTC medicines contain the same active ingredients, which means you may be getting more than the recommended dose without even knowing it. Always compare active ingredients on the label and never take more than one drug with the same active ingredient unless specifically instructed by your doctor.
Don’t combine prescription medicines and OTC drugs without first talking to your doctor. Combining drugs can cause adverse reactions or one drug can interfere with the other drug’s effectiveness.
If taking an OTC medicine becomes more than temporary, or if your symptoms don’t go away, talk to your doctor. Most OTC medicines are only intended for short-term use.
Make a medicine chart (see www.fda.gov/usemedicinesafely/my_medicine_record.htm) of all the prescription and OTC medicines, vitamins and herbal supplements you take and share it with your doctor. Also make sure your doctor is aware of your health history, if you are being treated by another doctor for something else, and if you have any allergies or side effects from any particular medicines.
Don’t use OTC medicines after their expiration date.
New Warning Labels
To help ensure safety and ingredient awareness, the Food and Drug Administration will soon be requiring bolder new warning labels on hundreds of OTC products that contain acetaminophen, aspirin and NSAIDs (non-steroidal anti-inflammatory drugs). Here’s what to look for in the coming months:
Products containing acetaminophen: (Sold under the brand name Tylenol and in multiple generic versions too. Other products that contain acetaminophen are Excedrin, Dayquil, Nyquil, Alka-Seltzer Plus Cold & Sinus, Sudafed Sinus & Cold and many others.) The new warning labels will alert consumers of the risk of severe liver damage if taken in high doses or when consuming moderate amounts of alcohol. Labels will also warn patients not to take multiple medicines that contain acetaminophen.
Products containing NSAIDs: (Aspirin; ibuprofen, which is sold as Advil and Motrin and in generic form; naproxen, best known as Aleve also sold generically; and ketoprofen.) New labels will warn of the risk of stomach bleeding in people over age 60, or in those who have stomach ulcers, take blood-thinning drugs or steroids, use other drugs that contain an NSAID or remain on the medications for an extended period.
Savvy Tips: A great Web resource to check for drug interactions is www.drugdigest.org – click on “Check Interactions.” And for more information on OTC/prescription drug safety, visit www.checforbetterhealth.org and www.bemedwise.org.
Dear Savvy Senior,
Can you tell me about assisted living facilities and how to go about choosing one for my 83-year-old mother?
Assisted living facilities have become a popular option for elderly people who are no longer able to live independently but who don’t need nursing home care either. Here’s what you should know.
Assisted Living - Currently, there are more than 1 million residents living in around 36,000 assisted living facilities nationwide. While there’s no standard blueprint for how these facilities are constructed, the services they typically provide are 24-hour staffing, assistance with personal care (bathing, dressing, eating, going to the bathroom), meals, housekeeping, laundry, transportation, social activities and medication management. A growing number of facilities also offer special care units for residents with dementia.
Finding Good Care - When it comes to choosing an assisted living facility, many people make uninformed and rushed decisions. After you determine your mother’s physical needs and financial resources, here are some steps that can help you find a good assisted living facility and avoid a bad one:
-Make a list: Contact your Area Agency on Aging for a list of assisted living facilities. Get a list of five or six facilities that are preferably close to family and friends who can visit often. The national Eldercare Locator (800-677-1116, or www.eldercare.gov) can direct you to your local agency.
-Call your local ombudsman: This is a government official who investigates long-term care facility complaints. Ask whether there have been complaints with the facilities on your list and how to obtain inspection reports, if there are any. To find your local ombudsman, call your area aging agency or see www.ltcombudsman.org.
-Call the facilities: Once you have a list of facilities and checked them out with the ombudsman, give them a call. Find out if they are licensed by the state, if they provide the kind of services to meet your mother’s needs, what they charge and if they have any vacancies. Then, if you’re still interested, ask them to send you more information including brochures, pricing details, levels of care, resident’s rights, medication policies, discharge criteria and the contract or residential agreement. Once you receive the materials, read them carefully and write down any questions you have so you can remember to ask them when you go in for a visit.
-Tour your top choices: It’s wise to visit at least two or three facilities so you can adequately compare them. If possible, bring your mother along too. While you’re there, notice the cleanness and smell of the facility. Is it homey and inviting? Does the staff seem friendly and knowledgeable? Also be sure to taste the food, and check-out their monthly activity schedule to see what kinds of stimulation they’re providing.
-Evaluate the staff: Ask to meet the administrator. Find out about staff screening and training procedures and what the staff turnover rate is. Also ask how many residents each staff member has to care for (the smaller the number, the better).
-Talk to the residents: Ask how they like living there. Do they like the food, the staff, and the activities?
-Visit unannounced: An unannounced visit on a weekend or in the evening might be very helpful in making your decision.
Savvy Tips: If you need help finding a good facility, call in a geriatric care manager (see www.caremanager.org). These are professionals who can assess your mother’s needs and recommend some good facilities to meet them. The cost for an initial assessment is around $300 to $600. Another good resource is the Consumer Consortium on Assisted Living (www.ccal.org or 703-533-8121), which offers a consumers video and guide (for a small fee) on choosing a facility. Also see www.ncal.org and www.alfa.org.
Costs: Most people pay for assisted living themselves, some with the help of long-term care insurance. Monthly costs can range from $1,750 to $6,000 or more, depending on where you live, the facility you choose and the services provided (the national average is nearly $3,000/month). Shared rooms, if available, cost less. Medicare does not cover assisted living. In some states however, Medicaid programs pay for some services for residents with low incomes, but the majority of facilities accept private pay only.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” books.