(This picture is my Dad, age 69, on a recent hike in Manning Park)
You may recently have seen news about the typical number of drugs that a person over 65 is prescribed in BC, and about how common it is to have our seniors on as many as 12 different medications. How did this “polypharmacy” come to be? I believe it is the result of the standard medical model of care when it comes to dealing with aging and chronic diseases. I also believe we can and must do better for our elders, and for our health care system.
One of the main problems with the standard model of care is that it “solves” every problem with pills. As we get older, and develop more problems, we therefore are given more pills to deal with those problems. Of course, each medication comes with complex drug-drug interactions, and side effects, for which more pills are given. It is easy to see how even a relatively healthy senior can end up on 5 or 6 medications.
For example, take my patient Ed. (His name has been changed for privacy). He is a generally healthy 75 year old, with high blood pressure (BP), and some osteoarthritis in his knees. He was prescribed up to 3 blood pressure medications which made him dizzy and imbalanced, as well as dehydrated from the diuretic, while not controlling his BP as measured in his MD’s office. Upon questioning, it turned out that he is afraid of his doctor and stressed by their appointments together, so his blood pressure was always very high while in the office. When he was asked to self-monitor his BP using a home machine, it was actually in the high normal range for his age. I suggested a change of doc, and he also chose to stop 2 of the 3 BP medications. I followed up with a natural product to reduce his BP, suggested dietary changes and stress management tools, and did acupuncture weekly. Soon his pressure was normal or even low-normal (again, for a 75 year old), and he was only on one medication, which did not give him any side effects.
When Ed got shingles, he was again given three medications, one of which he continued to take for months afterward for pain in his leg. Then he was given a prescription for anti-depressants, because the pain medication can cause depression as well as other more serious mental health side effects. Again, through investigation (not available in a 10 minute MD appointment), it was revealed that the pain was not related to the shingles, but was a recurrence of sciatica he had had previously. He was treated by a chiropractor and myself to cure the sciatica, and the “shingles pain” disappeared. He was then able to get off the pain med and refuse the anti-depressant.
What happened to Ed happens to seniors in our community every day. They are hurried through brief medical appointments and prescribed more and more pills. These pill regimes become onerous for seniors and their care givers, resulting in missed medications, terrible side effects, overdoses, and loss of enjoyment of life. Instead, I believe our elders need longer appointments, a more thorough medical history, and an emphasis on non-pill solutions which can fix or relieve many common complaints of aging. We also need to switch our thinking, from seeing aging as a terrible thing, to one which values our seniors and their contributions. Then we will help them live happier and healthier lives.