Medication Misuse Among Older Adults

Introduction
After working among the geriatric community within my field practicum I developed an understanding of the needs and struggles of older adults. A particular struggle for many of the clients at Senior Connections (an agency within Butte County Department of Behavioral Health) was the misuse of prescribed medications. With many of the clients in the program, a majority of them were having difficulty remembering when to take their medications or if they had already been taken. Extreme risks and dangers occur from misuse such as a decline in physical or mental functioning and even death. After much observation within my internship I found that this issue was not being addressed. I felt urgent to address this epidemic and provide ways in which to alleviate the misuse of medications among this geriatric population.

Although misuse is quite prevalent within the older adult community little has been done to educate this population of misuse and coping skills about this issue. I planned to inform the community of potential misuse by visiting agencies that serve older adults. This would be accomplished by presenting researched information and providing pamphlets to interested persons.

Statement of Problem
Older adults are prescribed numerous amounts of medications to prolong and improve their health. To this day medications have played an effective role in maintaining a healthy life and increasing life expectancy for an individual. As of 2000, those aged 65 years and older accounted for 10.6% of the entire population within California and 12.4% in the United States (Fedstats, 2000). According to Callahan and Murray (2002), at least 85% of older adults use one prescription medication while most use more than one. As a result, there has been the constant, re-occurring pattern of medication misuse among the geriatric population. After researching the proposed problem and discussing the topic with administrators, service providers and current clients within my field placement, a variety of factors were discussed that may lead to the misuse of medication, both intentional and beyond one’s control. According to an Administrator, many clients have trouble hearing and understanding specific drug regimens such as when to take the medication, how much at each time, what to take the medication with and what are the common side effects (anonymous, personal communication, October 8, 2005). Other factors include miscommunication, lack of transportation to retain prescribed medications, denial of diagnosed illness or sickness. This must be addressed to ensure older adults are provided with the tools to maintain medical adherence.

Description of Intervention
Informational pamphlets were provided to staff and older adult clients within agencies and service providers who work directly with older adults. Agencies involved were Independent Living Services, Passages Adult Resource Center, Butte County Department of Behavioral Health, and Veteran Affairs (VA) Center. Information was gathered through interviewing those who work with older adults, administrators, service providers and clients themselves. This information was integrated into a pamphlet. My plan was to provide outreach to the community by increasing awareness and information to the older adult population. This pamphlet was also intended to educate spouses, siblings of older adults, families, caregivers, and caseworkers. Included in the pamphlet were different factors discussing symptoms of medication misuse to enable caregivers and family to identify possible incidences of misuse. Also, an overview of coping strategies was discussed providing tools to older adults to assist in prevention. Additionally, I educated those professionals working with older adults and provided ideas as to how to work with their clients.

Evaluation of Intervention
Staff members, caseworkers and clients attended the presentations. Initially, before I began my discussion, I asked those who take at least two medications to raise their hand. At each agency, almost everyone did. By doing this activity, it involved the audience and demonstrated the potential high risk of medication misuse. When I presented the pamphlets many audience members were interested in the information. Some were able to relate to the side effects involved with medication misuse stating that they are continuously “tired, dizzy, lethargic, and have difficulty thinking”. Throughout the presentation many asked questions about their concerns in which I directed them to resources to research. Many audience members stated that they enjoyed reading the “coping strategies” section of the pamphlet because it was useful in preventing medication misuse. Overall, audience members gave positive feedback that the pamphlets and presentations were informative and helpful, however many felt that they would like to know more about the topic in order to increase awareness and knowledge. A few members stated it would be helpful to provide an internet website about medication misuse. This would provide concerned individuals an avenue to educate themselves and find resources or programs where they may get additional help. I did not have enough time to follow through with this idea but it is a possible project for the future.

Reflection on the project
I ran into several barriers that limited my community outreach. A few agencies were not interested in having a student educate their population about medication misuse for many reasons. The most common reason was breaking the confidentiality precautions discussed in the HIPAA manual. Having access to client’s names and their personal information concerned some agencies. Another potential problem was the sensitivity of the topic. Some clients did not feel comfortable discussing a topic that is so personal and confidential. Some agencies were cautious and concerned about having a stranger from the public come into their agency to talk about a controversial and touchy subject. However, informational pamphlets were distributed to these agencies without a presentation to provide a resource to these clients.

Although the intentions of this project were to spread awareness to older adults, I gained much knowledge of the struggles, needs, and concerns of this population. The audiences showed concern about this issue and expressed the need to be educated. Additionally, they were interested in the results, risks and coping strategies involved with taking numerous medications. I believe that through my brochures I was able to express the dangers involved with medication misuse, raise awareness and monitor certain symptoms. I have also conveyed the importance of communication with doctors, caregivers, caseworkers and physicians to inform them of side effects and potential risks. The populations I spoke to were overall intelligent concerned individuals who were interested in taking care of themselves.

References
Callahan, C.M., & Murray, M.D. (2003). Improving medication use for older adults: An integrated research agenda. American College of Physicians, 139, 5, 425-430.
FedStats. (2000). Population 65 years old and over. Retrieved 9/6/2005, from http://www.fedstats.gov/qf/states/06000.html