Medicine and the Elderly, a Double Edged Sword
The journey through life brings its own unique set of challenges, especially as one enters the golden years. Among these challenges is the inevitable necessity for medication. As age advances, preexisting medical conditions often worsen, and new ailments emerge, demanding attention and care. The art lies in balancing the benefits of these treatments while minimizing their adverse effects.
To navigate this complex landscape, a few practical approaches can be adopted. Always adhere to the doctor’s prescribed regimen, avoiding any changes without consultation. It’s crucial not to discontinue medication based on temporary improvements or personal whims. Despite the respect and authority commanded by doctors, unsolicited advice from relatives or acquaintances can sometimes sway individuals into making unwise changes. It’s equally important to avoid sharing medications, regardless of good intentions, as each person’s medical needs differ.
Among the elderly, two major issues stand out: compliance and polypharmacy.
Compliance
Compliance refers to whether individuals follow their prescribed medication dosages, timings, and sequences correctly. This adherence is vital for the body’s absorption of the drug, ensuring effective treatment. Interestingly, gender differences play a role in medication compliance. Elderly men often exhibit stoicism, delaying doctor visits until seriously ill, and may neglect follow-up appointments once recovered. Conversely, women are more likely to seek medical advice earlier and adhere strictly to prescribed treatments.
Educating patients is the cornerstone of improving compliance. Misinformation can be as harmful as ignorance. There is a common misconception that Traditional Chinese Medicine (TCM) is not actual medicine. In reality, both Western medicine and TCM are chemical agents designed to enhance health or treat diseases. Western medicine consists of synthetic or modified chemicals, while TCM uses naturally occurring substances. Both can be beneficial when used correctly and harmful if misused.
All medications, whether Western or TCM, are absorbed through the gut, processed by the liver, and excreted via bile or urine. Therefore, they carry the potential to damage the liver and kidneys if taken improperly. Scientific studies have shown that certain combinations of Western medicines, such as ACE inhibitors for diabetics with high blood pressure, can protect against further complications. TCM also combines herbs for treatment and body protection, and should always be obtained from qualified practitioners. Because the precise chemical content of herbs is often unknown, it is prudent to avoid simultaneous intake with Western medicine. If necessary, TCM should be taken at least two hours apart from Western drugs. Certain Western medications, like oral anticoagulants such as Warfarin, should never be combined with TCM due to risks of enhanced or reduced effects, leading to potential bleeding or ineffectiveness.
Polypharmacy
Polypharmacy meant that the person is taking far too much medicine. Although this may be necessary in view of the multiple medical problems the person has, more medicine could mean an increased risk of drug interactions and development of adverse side effects.
Some medicine may be toxic to certain organs of the body, like the liver or kidneys. When a few medicine that are toxic to the kidney are taken at the same time, this toxic effect would be multiplied.
Common side effects of polypharmacy might include constipation, diarrhea, loss of appetite, drowsiness or even confusion.
Therefore, one should always inform your doctor what medicine you are already taking, so that he can review the medication list, remove those which are no longer needed and ensure there is minimal drug to drug interactions or side effects.
By understanding these dynamics and adhering to medical advice, the elderly can manage their medications effectively, ensuring their well-being while minimizing risks.