By not adhering to an often complex combination of treatments, patients can unwittingly expose themselves to a number of health risks.
Compliance, or adherence, to a medication regime can prove to be a problem for your elderly loved one, for a variety of reasons. But when elderly people don't take medication that has been prescribed to them, problems can arise for both their long-term and short-term health.
Consciously deviating from the medication schemeThere are three main reasons for consciously deciding not to take certain medication:
1. Perception of negative effectsMany people don't think that the drug works, especially for preventive treatments. For instance, a daily dose of an anti-platelet drug that prevents blood clots won't have an immediate positive impact on their health, and it's easy to underestimate the longer term benefit the drug provides. Furthermore, if the drug in question causes negative side effects, it's likely the drug will be perceived as more damaging than beneficial.
2. Fear of addictionCertain drugs, especially anti-depressants, have a reputation for being addictive. As they are normally prescribed over a long period of time, it's often thought that a person can become totally dependent on the medication and struggle when the treatment stops. This is not actually the case. But these elements could cause your loved one to stop taking their medication regularly, as they fear they may become addicted. Whilst antidepressants are not known to have any addictive potential, rapidly stopping antidepressants can cause unpleasant side effects, which may be mistaken for withdrawal.
3. CostFor many patients, certain treatments aren’t easily affordable. In the UK this effect is less pronounced because of lower NHS prescription costs, but nonetheless, affordability can have a negative impact on compliance.
Unconsciously deviating from the medication schemeThe effects of complex medication regimes, cognitive decline and depression often have an impact on taking medication regularly.
1. Complex medication regimesYour elderly relative will typically require more complex medication schedules as the number of long-term conditions they have is likely to increase with age. This can cause problems relating to the intervals and timings of the medication. Not only can this be confusing, but they can also grow tired of their daily routine being dominated by constant interruptions.
2. Cognitive declineCognitive decline, which may range from mild cognitive impairment to full dementia can affect short-term memory. In the UK there are approximately 3 million people with mild cognitive impairment and forgetfulness is often the most common symptom. This can lead to:
- Forgetting if they've taken their medication
- Forgetting why they're supposed to take their medication
- Taking too much or too little of their medication
3. DepressionDepression, low mood and anxiety can also affect activities relating to daily routines. Lack of motivation, preoccupations, tension and social withdrawal are common behaviours. It is well recognised that depression is less commonly reported in older people for a variety of reasons such as stoicism and social isolation. However, lack of motivation can lead to a loss of interest in maintaining health and medication can be 'forgotten'.
How do you avoid these issues?The solution has to be tailored to the cause. If a person chooses not to take a medication due to a seemingly irrational belief, the best course of action may be to change treatment so that the perceptions can be addressed. Dealing with such a large number of medications can be a daunting task for families, and to provide a tailored solution the GP and the patient will need to work together. It can be helpful to prepare a list of problems and document which medications have been causing the most problems, so that the doctor can be well informed during a brief consultation. When the cause is the complexity of treatment and cognitive state of the individual, prompts or assisted living aids can help. For instance, using a printed version of the medication combined with dosette boxes in a daily routine is one way of preventing mistakes and forgetting certain doses. If depression is the cause and the person is failing to take antidepressants, it can be helpful to think of other approaches to improving moods, such as gentle exercise or regular social contact. Find out more:
- How to use a dosette box
- Automatic pill dispensers: what are the options?
- Battling the loneliness epidemic
- Elderly tech solutions for peace-of-mind
- Top gadgets for self-care