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Ida Canapp insists she would take her five medications and two vitamin pills every day, whether or not a nurse's aide came to her Parkville home to monitor her.

[Jane Geer_RN]

Very fine article...everything that was said seems accurate. Poly-pharmacy is an enormous issue for seniors.

[Judith dePonceau]

Not mentioned in the article are two other hazards. With MediCare D, the plans change their formularies at will, requiring new drugs to replace accustomed meds that presumably do the same thing as the old. But differences exist in side effects, and more dangerously, the ongoing changes in the appearance of a person's medication can be confusing. Similarly, when generics are used, the pills or capsules look different from time to time, depending on what the wholesaler happens to be providing.

I take eight small-dose dispersible tabs of one medication at one time. When the shape of one of my generic blood pressure meds changed, the shape and color of the two drugs were almost identical. I came close to taking eight of the bp med. instead of eight of the others. This would have been fatal. Because I check and re-check, I caught it just in time. My mind is as sharp and my familiarity with my medications as good as any nurse who is going to come; she could make the same mistake.

I was fearful that in spite of my care I might make the fatal mistake. Fortunately, right now I am taking the same bp generic from a different company, and their appearance is totally different....now they look just like another med I take, but an accidental switch would not be fatal.

[ESTSELLA M DAVIS]

PERSONALLY, I DON'T FEEL SENIORS ARE ANY DIFFERENT THAN THE REST OF THE POPULATION AND WE STAY CONNECTED TIL DEATH, ANYWAY. I DON'T SEE WHY TAKING YOUR MEDICATIONS ACCORDING TO DIRECTIONS SHOULD BE A PROBLEM ANY MORE THAN THE REST OF YOUR INDEPENDENT LIVING. ARE YOU LIVING, INDEPENDENTLY IS THE QUESTION TO ASK. TOO MANY IRONS IN THE FIRE WILL CAUSE UNNESCESSARY CONFUSION ABOUT ANYTHING, NOT ONLY PRESCRIPTIONS. IF YOU CAN SPELL THE WORD, PHARMACEUTICAL AT ANY TIME, DAY OR NIGHT, YOUR ARE PROBABLY THINKING CLEARLY ENOUGH TO MIND YOUR OWN PRESCRIPTIONS AND DOSAGE, ON THE OTHER HAND, IF YOU ARE NOT THAT ALERT, MENTALLY, THEN YOU MIGHT NEED HELP WITH YOUR MEDICATIONS AND YOUR DOSAGE.

I WORKED FOR SOCIAL SECURITY ADMINISTRATION IN RICHMOND, CALIFORNIA AND AGAIN IN GARDEN GROVE, CALIFORNIA. I FEEL THE INSURANCE COMPANIES CAUSE MORE CONFUSION THAN THE ACTUAL MEDICATIONS, THEMSELVES OR THE PATIENTS, THEMSELVES. WE HAVE DRUGS IN DRINKING WATER. DRUGS ARE A PART OF US, WHETHER WE LIKE IT OR NOT, THEY ARE HERE TO STAY, IT'S WHO WE ARE TO A POINT. LIFE WOULD BE A LOT SIMPLER IF WE WOULD ALLOW CERTAIN NESCESSITIES TO FALL IN PLACE. THE MORE YOU TALK NEGATIVELY ABOUT SOMETHINGS THE MORE WE WILL YEILD TO THEM, BE THEY GOOD FOR US OR BAD FOR US. CMS, CENTERS FOR MEDICARE AND MEDICAID SERVICES, DOES NOT SEEM TO BE A PROBLEM, BUT, AS BEFORE STATED, I FEEL THE INSURANCE COMPANIES CAUSE MOST OF THE CONFUSION ALONG WITH AARP AS A LOBBYIST IN WASHINGTON THANK YOU ESTELLA DAVIS, AUTHOR, RHYME REASON REVERENCE.

[Susan Jones]

I recently moved from TX to SC because of this very reason. My mother had multiple falls with the ensuing EMT calls and 19 stitches.I was unaware of the seriousness of problem because my parents "were taking care of the problem themselves."

The first thing I did when I got here was to go through her many prescriptions and throw out the ones that were out-of-date. Then I made her sit beside me and tell me what each pill was for and which of the 5 sleeping pills she actually took. Any prescription not in current use was discarded. I also did not allow her any alcoholic beverages until she had a few weeks for everything to clear her system.

Miraculously her health improved. The sparkle came back to her eyes, her appetite improved, and she even started going out in public again after being a shut-in for several months.

Then last Thursday reality came back in a big way. She slipped and fell in a restaurant on an unlevel, waxed floor and bruised her arm, ribs, knees, and chin. The next morning was spent getting x-rays and a prescription for Hydrocone-APAP for the pain. By Sunday morning she was almost impossible to wake and literally turning blue; hands, ears, nose, and feet. My step-father thought she was depressed. I didn't.

Fortunately, it didn't take much convincing to get her to the hospital. She had overdosed on narcotics because in addition to the painkiller, she had taken a narcotic sleeping pill and a pain patch (also a narcotic). The first was a current prescription the second was an old prescription that she had saved in case she needed it.

The doctor and I have agreed that in the future, if she has any new presriptions either the doctor or pharmacist will tell my mother (and me) which of her medications must not be taken with the new prescription.

I think I have safely disposed of all "old prescriptions" now, but I can't be sure of that. I'll just have to continue to be watchful.

[Susan Watson]

This problem will continue to grow. Medication management is critical for any patient that cannot remember when to take pills, or how to take them. In addition, the number of prescriptions should be reviewed to in order to decrease prescriptions to the absolute minimum. I am not convinced that drug drug interactions do not occur when one is taking more than 5 meds. Sophisticated computer software cannot take the place of a solid physical assessment and history.

[Darlene Shiplett]

I have been a registered nurse since 1992 and most of my experience has been acute. I always wondered why we, as a society, relied on a pill for everything. The physicians have been to blame for prescribing medications without evaluating if the patient really needs another pill or simply need something to change in their lifestyle, such as a dietary change. I now work for CMS doing clinical surveys in the long-term care arena and I see many residents with a total of 13-20 different medications. Alot of these residents have duplicate medications. Do the physicians not have enough time to evaluate if the resident really needs all these medications. Because they don't take the time to evaluate them, the pharmacist has to try to make that determination and then I have to try to evaluate why the resident is on three different antidepressants. Goofy huh?? I want to know why we treat our elderly so badly.

[kay Muldoon-Ibrahim]

As a photojournalism instructor, I would be interested in seeing other photos taken for this story and any of your featured stories
Kay Muldoon-Ibrahim

[liquid]

ESTSELLA M DAVIS wrote:

PERSONALLY, I DON'T FEEL SENIORS ARE ANY DIFFERENT THAN THE REST OF THE POPULATION AND WE STAY CONNECTED TIL DEATH, ANYWAY. I DON'T SEE WHY TAKING YOUR MEDICATIONS ACCORDING TO DIRECTIONS SHOULD BE A PROBLEM ANY MORE THAN THE REST OF YOUR INDEPENDENT LIVING. ARE YOU LIVING, INDEPENDENTLY IS THE QUESTION TO ASK. TOO MANY IRONS IN THE FIRE WILL CAUSE UNNESCESSARY CONFUSION ABOUT ANYTHING, NOT ONLY PRESCRIPTIONS. IF YOU CAN SPELL THE WORD, PHARMACEUTICAL AT ANY TIME, DAY OR NIGHT, YOUR ARE PROBABLY THINKING CLEARLY ENOUGH TO MIND YOUR OWN PRESCRIPTIONS AND DOSAGE, ON THE OTHER HAND, IF YOU ARE NOT THAT ALERT, MENTALLY, THEN YOU MIGHT NEED HELP WITH YOUR MEDICATIONS AND YOUR DOSAGE.
I WORKED FOR SOCIAL SECURITY ADMINISTRATION IN RICHMOND, CALIFORNIA AND AGAIN IN GARDEN GROVE, CALIFORNIA. I FEEL THE INSURANCE COMPANIES CAUSE MORE CONFUSION THAN THE ACTUAL MEDICATIONS, THEMSELVES OR THE PATIENTS, THEMSELVES. WE HAVE DRUGS IN DRINKING WATER. DRUGS ARE A PART OF US, WHETHER WE LIKE IT OR NOT, THEY ARE HERE TO STAY, IT'S WHO WE ARE TO A POINT. LIFE WOULD BE A LOT SIMPLER IF WE WOULD ALLOW CERTAIN NESCESSITIES TO FALL IN PLACE. THE MORE YOU TALK NEGATIVELY ABOUT SOMETHINGS THE MORE WE WILL YEILD TO THEM, BE THEY GOOD FOR US OR BAD FOR US. CMS, CENTERS FOR MEDICARE AND MEDICAID SERVICES, DOES NOT SEEM TO BE A PROBLEM, BUT, AS BEFORE STATED, I FEEL THE INSURANCE COMPANIES CAUSE MOST OF THE CONFUSION ALONG WITH AARP AS A LOBBYIST IN WASHINGTON THANK YOU ESTELLA DAVIS, AUTHOR, RHYME REASON REVERENCE.

Because it is different with someone that has dementia.

My mother thought that since Tic-tacks were looking like one of her medications and that they were cheaper that she would have that instead to do the same thing. So she threw out he medication and started tic tacks until I intervened. Now she's miffed with me and he doctor telling her what to take for medications.

So it's not that someone is a senior. It's that they have dementia and are denying it.