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The A.M. Post

An eNewsletter for Aging Magnificently — VOLUME 1

At Lifespark we’re all about helping you stay healthy at home, navigating your health options with confidence, and living a fuller, more independent life. That’s what The A.M. Post is all about, too. Read on — we hope you enjoy!

What’s your number? Understanding the pitfalls of polypharmacy.

Are you taking more than five prescriptions each day? You’re not alone. Adults aged 65 and older make up just 14% of the US population but they account for 1/3 of outpatient spending on prescription medication*.

Are you taking more than five prescriptions each day? You’re not alone.

Adults aged 65 and older make up just 14% of the US population but they account for 1/3 of outpatient spending on prescription medication*. The use of multiple medications by older adults isn’t new — as medical research and medicine have evolved over time, the conditions to be treated have evolved as well. Living longer has given rise to the phenomenon of polypharmacy. And while it’s understandable, it’s also a problem.

Defined as the simultaneous use of five or more medications, polypharmacy can cause serious adverse events, including dangerous drug interactions, debilitating side effects, increased emergency room visits and hospitalizations, lower quality of life, and a higher risk of mortality.

According to a 2021 National Institutes of Health article on adverse drug reactions, people aged 65 or older accounted for 25% of ER visits attributed to adverse drug-related events and 49% of events requiring hospitalization.

“In the United States, we’ve been taught to expect that there’s a pill for everything, and modern medicine has often delivered on that expectation,” said Dr. Nick Schneeman, Lifespark Chief Medical Officer. “It’s also contributed to the rise of polypharmacy, a massive problem for older people, especially those who are frail or have complex health concerns.”

Appropriately prescribed drugs are not the problem, Dr. Schneeman said. It’s the cascading effect that causes harm.

To illustrate, meet “Ella,” not an actual person but a good example of the problem: “Ella is an 85-year-old woman who lives alone, has very few health problems beyond some mild memory issues, and is active in her community. At her annual checkup, her blood pressure is a little elevated, so her doctor starts her on a medication that has good efficacy but causes some swelling.

“Her blood pressure comes down, but now she has edema – fluid pooling that causes swelling – in her ankles. Her doctor refers her to a cardiologist who prescribes a medication called a diuretic to treat what might be heart failure. The drug, frequently known as ‘water pills,’ reduces her edema but causes urinary incontinence, so Ella goes to a urologist who puts her on a drug that reduces bladder contractions. It helps, but it makes her profoundly confused and delusional.

“This concerns Ella’s son who brings her to the hospital where she’s put on an anti-psychotic. In a period of six months, this previously healthy woman goes from no medications to four. Her health plummets and she never recovers.”

While this scenario might sound extreme, Dr. Schneeman said that it happens in clinics and hospitals every day. “No one wakes up in the morning intending to do harm, but we’re all participating in it,” he added.

In the past, doctors and pharmacists had more opportunity to act as a chain of checks and balances when it came to medications. There were fewer medications to check against and more time to ensure that seniors were protected from drug interactions and side effects.

Today, primary care physicians generally have about 15 minutes to spend with each patient which means that usually acute symptoms are the focus at appointments, leaving no time for an in-depth medication review.

From there, new prescriptions are sent on to the pharmacy for fulfillment and Pharmacists are typically siloed from both practitioners and clients. This forces them to rely on established guidelines rather than provide individualized medication guidance, breaking the chain apart even further.

How do you minimize the risk in this situation, and can it be fixed?

There are a few ways to address it. First is oversight. Transitions care is one of the key areas to watch. The change from hospital to transitional care or a shift in health condition, are high-risk periods for medication-related adverse events. Medical team collaboration with a pharmaceutical consulting organization like Consonas Health is one opportunity to catch a problem.

The key to this is having a team with geriatric pharmacology skills. The way pharmaceuticals interact with the body as one ages can change and thus affect the way the drugs interact with each other. Active collaboration between a medical team and pharmaceutical consultancy with an education that includes geriatric medicine can make a world of difference for seniors.

Another way to combat the problem is though a medication review with your physician. The appointment is specific to your current medication list. And will be most effective if you send your complete list of medications – including iver-the-counter medications and supplements – in advance so your physician has time to review it all in advance of the appointment.

Polypharmacy is an issue that isn’t going away on its own and is likely to get worse before it gets better. With the number of people over age 65 expected to grow from 46 million today to 98 million by 2060, it’s an issue that needs to be addressed.

One of the best means to change the narrative is to advocate for yourself. Look for providers who are engaged in understanding the needs of aging adults and take steps to avoid getting caught in the crosshairs of medication interactions.

*Click to view reference

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Aging in the news:

We’re always looking for the latest information on aging — from lifestyles to trends to health and in medicine; there’s always something new to learn. Here’s where we’ll share these fascinating finds with you

The Science of aging:

When does 'old age' begin? Public perception may be skewing later

Why we die

and how we can live longer, with Nobel laureate Venki Ramakrishnan

ask ethel

Ask Ethel

When should I go on hospice?

Dear Ethel, I have diabetes and congestive heart failure. I see people in my assisted living going onto hospice and it scares me.  Do you know how they qualify for hospice and get onto services?

A: As scary as the word hospice sounds – it can be something of a relief.  Hospice services focus on enhancing your quality of life, relieving symptoms, and taking steps to lessen your distress. A hospice team can help you and your family make the most of your remaining time together. Your Nurse Practitioner or Doctor can talk with you about an Advance Care Directive including whether you want to go to the hospital if you get sick and what can you expect with your age and your chronic conditions.

In fact, everyone should have an end-of-life discussion with both their NP/MD and family. Both your medical team and your family should have a clear understanding of your end-of-life wishes.

The NP/MD and Nursing team will determine whether you qualify for hospice; Medicare requires this.  Hospice is paid for under Medicare at 100% and has so many benefits, including the hospice team, equipment, medication and more.  The hospice representative will have that discussion with you and explain the hospice benefit.  After that, you will have a good picture of the next steps.

I highly recommend having that discussion and I’m wishing the best in health for you.

Have a question you’d like Ask Ethel to answer? Click to email us

driving 768x512

DID YOU KNOW:

Freedom’s just another word for … transportation

There is a transport service specifically created to help seniors get where they need to go. Lifespark GO! caters to the unique needs of older adults and those with health conditions. This private pay service gives seniors flexible and convenient transportation for multiple appointments and errands or single trips. Drivers also provide a door-to-door escort – great for spring excursions and shopping!

Learn more

What are the grandkids up to?

What are they saying now?

Generation Alpha is the generation of kids born between 2010 and 2024. This generation will outnumber Baby Boomers and many will live to see the 22nd century. Studies show that they will stay in education longer, start their earning years later, and stay at home with their parents until they’re a little older than their predecessors, Gen Z and Gen Y. In other words, they are the grandkids of today and the things they say, topics of interest for them, and how they view the world, are all a little different than the way we grew up. Every month we’ll explore some new territory in the world of Gen Alpha.

Every generation has their own lexicon and Gen Alpha is no different. In other words: Slang. Let’s learn some of the latest words and phrases of this younger generation.

Bop: A catchy and enjoyable song, often used to describe music with a great beat or rhythm. Example: “That new song by Olivia Rodriguez is such a bop, I can’t stop listening to it!”

Bussin’: Used to describe food that is exceptionally delicious or flavorful. Example: “These cookies my grandma made are bussin’! I can’t get enough of them.”

Cheugy: Outdated, unfashionable, or uncool, particularly in terms of fashion, trends, or aesthetics. Example: ” Skinny jeans are so cheugy.”

Delulu: Someone who is delusional or has unrealistic expectations. Example: “He thinks he’s going to win the talent show, but he’s totally delulu.”

GOAT: Greatest Of All Time, used to describe someone or something as the best in their field. Example: “LeBron James is the undisputed GOAT of basketball!”

Ghost: To disappear or stop communicating suddenly, especially online. Example: “Mr. King ghosted me when I emailed him about the final project. He never replied.”

Peep: To observe or notice something, often used in the context of discovering information or gossip. Example: “Did you peep the new sneakers they released today? They look awesome!”

Rizz: Charisma – charm or magnetism that captivates others. Example: “He walked right up to her and started talking with so much rizz, she was totally charmed.”

Salty: Feeling bitter, upset, or resentful, often over something minor or trivial. Example: “He was salty after losing the game, wouldn’t even shake hands with the other team.”

Slay: To excel or do something exceptionally well. Example: “I aced that presentation, I totally slayed it!”

Squad: Close group of friends or companions. Example: “We’re going to the movies with the whole squad this weekend.”

Stan: To be an avid and enthusiastic fan of someone or something. Example: “I’m such a stan of Taylor Swift, I have all her albums and know all the words to her songs.”

Sus: Short for “suspicious,” indicating skepticism or doubt. Example: “Those new mock test questions seem kinda sus, I wonder what the teacher is up to.”

Tea: Gossip or juicy information. Example: “Did you hear about what happened at the pizza party yesterday? Spill the tea!”

Vibin’: Relaxing and enjoying oneself, often to music or a particular atmosphere. Example: “I’m vibin’ to this new music, it’s got such a cool beat.”

Woke: Socially aware, progressive. Example: “That article about climate change was super woke, it really opened my eyes to the issue.”

Yeet: A slang term used to express excitement, approval, or emphasis when throwing something, both literally and figuratively. Example: “Someone just yeeted a football across the field and accidentally hit Ms. Wamble!”

Now you’re ready to start vibin’ with your squad next time you’re ready to spill the tea, you’ll show them that you’re the GOAT. Or something like that…

Click for source

kid slang

Aging Magnificently in Action

At 82, Joyce’s path to stay ‘on spark’ even as her husband’s needs changed, surprised even the kids she works with at Target. Watch the video below and get to know Joyce.