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Answering the call

I’m sure I’m not the only one who panics when the phone rings late at night. I consider myself a pretty “half-full” type of person and typically don’t assume the worst will happen. However, when that late night call comes, I can’t help but jump to the conclusion that something is horribly wrong. 

My adult children still stay out way too late, as far as I’m concerned, even though they are reporting in at their own homes now, not mine. I’m sticking to my theory my dad taught me that “nothing good ever happens after midnight!”  (Can’t you just see those daughters rolling their eyes at me right now?) 

And now, also, my thoughts not only go out to my daughters, but of course to something that may be going wrong at my parents’ home in the middle of the night.

It’s the midnight call that can strike terror in the hearts of so many who are caring for or serving older adults. Maybe it’s that mom has suffered a stroke. Or dad has taken the wrong dose of medicine and gets sick. Perhaps you are a senior care professional who encounters an older adult who doesn’t know what medications she is on. Or a senior who doesn’t remember if he has a living will. An emergency with an older adult can happen at any time. Seniors are at particular risk because of the large numbers of medications they are taking.

Here’s a statistic: Older adults represent just over 13 percent of the population, but consume 40 percent of prescription drugs and 35 percent of all over-the-counter drugs, according to the American Society of Consultant Pharmacists.

What’s worse? Many family caregivers who live in fear of getting “the call” don’t have the information they need to help their loved ones. In fact, research has confirmed this.

A survey of future family caregivers — those who are expecting to be family caregivers within the next 10 years — performed by Home Instead Senior Care showed that less than half (47 percent) say they are knowledgeable about their parents’ medical histories. And about half (49 percent) are unable to name any of the medications their parents are taking each day. Furthermore, 36 percent of those future caregivers don’t know where their seniors’ financial information is located.

This survey was no surprise. We’ve seen the turmoil that such a situation creates. We’ve also witnessed how much smoother it can go when families are prepared.

Family caregivers need to be better prepared for that emergency call that their senior loved one needs help. Family caregivers need to keep important information at their fingertips. They should have ready access to such information as a senior’s doctors, pharmacy and insurance company, medications and dosage details, as well as allergies and other important documents. Please see sidebar to this article for lists of what should be included in information that should be readily available.

Much is at stake for seniors and their family caregivers. According to the ASCP, adverse drug reactions are responsible for 28 percent of hospitalizations of the elderly. The focus of the problem is really the sheer volume of prescription drugs that most older adults are taking. Here’s what Thomas Clark from the ASCP, who served as the expert source for the program, said: “Medication issues are big topics for seniors. On average, seniors ages 85 and older take 34 prescriptions, including refills, per year. The average number of unique prescriptions for that group is 6.3.”

Wow! No wonder seniors encounter so many problems. The same survey revealed that older adults have a number of risk factors when it comes to their meds. These factors, combined with this high volume of medications, can create the perfect storm. 

For instance: Those future caregivers said that nearly half of their parents (48 percent) have three or more factors that put them at risk for medication-related problems. The top risks were receiving prescriptions from more than one doctor (52 percent), living alone (41 percent), and vision problems/poor eyesight (37 percent).

In fact, here’s a heart-breaking story that a pharmacist shared. Because of macular degeneration, a condition that impairs the eyesight, this man’s 89-year-old dad couldn’t see that the color of one of his pills had changed. He accidentally overdosed on blood thinner for three weeks. As a result, he is permanently paralyzed from the waist down. These issues can be very serious.

Another problem is that seniors sometimes don’t ask their doctors or pharmacists the right question such as:

• What is the name of this medication and why do I need it?

• What is this medication supposed to do?

• What is the correct dosage?

• How does this drug interact with other medications I am taking?

• How do I take it? With or without food?

• When do I take it, a.m. or p.m.? 

• What are the benefits and risks of the medication?

• What are the side effects of the medicine, and what do I do if they occur?

• What food, drinks, other medicines or activities should I avoid while taking the medicine?

• How often must the doctor check the medicine’s effects? For example, checking your blood pressure if you are taking a medicine to lower it, or having a laboratory test done to make sure the levels of medicine in your blood are not too high or too low.

• Do I need a refill and how do I get one?

• Is there written information I can take home about the medication? (Most pharmacies have information sheets on prescription medicines.)

Family caregivers can be important advocates for seniors at the doctor’s office or pharmacy. It helps to have a family caregiver go with the senior to ask questions and to make sure that any instructions from the doctor are reinforced and followed. Family caregivers should look to others to help if they are unable to be there to assist their loved ones, either at the doctor’s office or at home. Assistance can help older adults prevent accidents and maintain their independence. That support is one of the best ways that family caregivers can be ready for an emergency.

To my family members out there that are rolling their eyes at my worry about that late night call (and if it was an accident that you dialed my cell phone that late, what were you doing still out?) I’ll repeat — being prepared with the right information and being supportive is one of the best ways family caregivers can be ready for an emergency. Family caregiver to me is defined as being the mom. Family caregiver to me is defined also as being the daughter. Whoever fills that role as family caregiver, be ready to answer the call.

DEB CRANNY is the executive director at Home Instead Senior Care in Brainerd.