Taking Care of Your Loved Ones, Young and Old

If you take care of a spouse or partner, kids and/or aging parents, you know how complicated health matters can be. And given that four out of five Americans who visit the doctor leave with a prescription, knowing how to use medicines safely is an important part of protecting your family’s health.

To help guard against potential medicine use problems, there are some things you need to keep in mind, especially when it comes to children and aging adults or if you are pregnant or nursing.

Children are naturally curious, so it’s important to keep medicines out of their reach and — when they’re old enough to understand—teach them responsible and safe medicine use.
Older adults are more likely to live with chronic illnesses, take multiple medications and experience serious adverse drug events, which can result in additional illness, drug-related hospitalizations and even death.
And if you or someone you know is pregnant, planning on becoming pregnant or breastfeeding, certain medicines should be avoided to avoid risk to the baby.

Read on for tools to help you keep track of your family’s medicine use, as well as special considerations for kids and aging loved ones.

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Keeping a Family Medical Record

Keeping track of each family member’s medicines can help protect them from harm. So, get organized to stay on top your family’s medicine use and adopt habits that promote safe medicine use. Print out one or more copies of this worksheet Make Notes & Take Notes: before, during and after my doctor’s visit to start your family’s medical record.  This worksheet will also help you communicate with your healthcare providers about safe medicine use and your concerns.

Your family’s health team — the Make Notes & Take Notes worksheet will help you keep a list of your family’s healthcare providers. Your family’s medicines — A new worksheet can be filled out for each family member to record the names of OTC and prescription medicines, as well as any dietary supplements and herbals, the reason each is taken, the prescribing doctor, how often the medicine is taken, whether refills are needed and any problems or side effects that you notice.

Take this worksheet with you every time you visit your healthcare provider. Make a copy for each healthcare provider you or a family member visits.

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Special Considerations: Children, Pregnancy and Older Adults

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Children & Medicines

Whether it’s to treat a fever, an ear infection, asthma, allergies or to manage diabetes, your child may need to take an OTC or prescription medicine. While they can help your little one feel better, medicines can also make them very sick if they’re not used properly. In fact, accidental ingestion of medicines by young children account for a large percentage of visits to emergency departments each year.

As a parent, it’s up to you to create a medicine-safe home by taking these simple steps:

Keep all medicine out of children’s sight and reach. If you have a toddler, don’t forget to install safety latches and locks on cabinets and dresser drawers, just in case there are ointments or other medicines or dangerous substances within reach.
Use child-resistant caps, and never leave containers open.
Set a good example for proper and safe medicine use. Kids learn by watching you, so treat medicines with care and take them only when necessary. If you have young children, avoid taking medicines in front of them so they don’t try to copy you.
Talk openly with your children. Teach them about the hidden dangers of taking medicines and encourage them to ask questions. If your child has a medical condition such as asthma or diabetes, encourage the pediatrician or nurse to talk directly to your child about medicines, so he or she starts to develop the skills and know-how to take them appropriately. This will help them take an active and responsible role in their self-care.
Know when to ask questions. Don’t try to guess your child’s symptoms and, in turn, what medicines he or she might need. Ask your doctor or pharmacist so you can be sure that you are giving the right drug and the correct dose.

Remember, children are not “mini-adults” (their bodies respond differently and they breakdown medicines differently), so don’t try to calculate what the dose should be based on an adult dosage.

Dispose of medicines safely, so pets and kids can’t get to them.
Post the National Capital Poison Center number near a phone in the event of an accidental overdose or poisoning. It’s 1-800-222-1222.

Always check with the doctor before giving a child new medicine or more than one medicine at a time. Some medicines, including iron supplements, are very toxic to children.

Also ask about medicines that have alcohol in them, as some cough and cold syrups do, as well as aspirin products. If your child is recovering from chickenpox or the flu or has had symptoms of the flu (nausea, vomiting or fever), do not give him or her aspirin as this can increase the risk of Reye syndrome, a rare but serious disease.

Click here for more useful medicine use tips for parents.

Do your homework. Did you know that many pediatric medicines have only been tested in adults, and are formulated or packaged to deliver smaller doses to kids? And many prescription medicines don’t have specific FDA approval for use in children. So, you need to ask your family doctor and pharmacist lots of questions to make sure your child is taking the right medicine at the right dose. Make sure to tell the doctor how your child reacts to certain medicines, as well as any known allergies.

Note: there is ongoing safety evaluation by the FDA of cough/cold medicines in kids under age 6. In 2007, it was advised that these products not be given to children under 2 years of age. For more information, visit www.fda.gov/consumer/updates/coughcold011708.html.

Have a teenager in the house or at college? Prescription medicines are fast becoming the new drug of choice among teens. You may not want to think about your teen getting high from prescription medicines--easily found in your or friends’ medicine cabinets--but this is the latest trend.

Teenagers today are more likely to have abused prescription and OTC medicines to get high than illegal drugs like ecstasy, cocaine and methamphetamines, according to the Partnership for a Drug-Free America.

The organization reports that kids who learn at home about the serious risks of drugs are up to 50 percent less likely to use drugs than those who are not taught about the dangers (for example, dependence, slower brain activity, irregular heartbeats, high body temperature, heart failure and fatal seizures). So take time out to talk openly with your kids.

For more information and to recognize the signs of prescription drug abuse, read “Talking to Your Kids about Prescription Drug Abuse.”

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Pregnant or Nursing Moms & Medicines

If you or someone you know is pregnant or nursing, it’s important to consult a doctor before using OTC or prescription medicines.

Not all medicines are safe for you or your unborn or breastfeeding baby.
Most medicines have never been tested in pregnant women.
Hormones can affect the way medicines work in your body, and many can pass to your baby in the womb and through breast milk.
If you take medicines on a regular basis for a chronic health problem such as asthma, diabetes and depression, ask your doctor whether changes need to be made while you are pregnant or breast feeding.
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Older Adults & Medicines

Most older Americans live with one or more chronic conditions, such as arthritis, diabetes, high blood pressure or heart disease. If you care for an aging parent with one of these conditions, you know it can mean taking medicines on a regular basis. Click here for a useful tip sheet when caring for older adults.

Older adults are:
More likely to take multiple medicines, which can place them at greater risk for adverse drug interactions
More likely to consult multiple healthcare providers each of whom may prescribe medicines

Physical changes can complicate medicine use. Reduced liver and kidney function in older patients affects the way a drug is broken down and removed from the body. This means medicines may stay in the body longer, sometimes causing more severe side effects.

Memory problems make it more difficult to manage medicines. Not being able to remember when and how to take multiple medicines can also cause problems. There are many different types of memory aids that can be used by older adults to help them remember to take their medicines. Helpful strategies may include:

Taking medicines at a set time each day (at breakfast or bedtime)
Setting a timer
Placing pill bottles in an obvious location (although away from pets and grandchildren)
Using pill boxes for complicated regimens (especially for people who have difficulty opening pill bottles)
Posting a medicine checklist and schedule on the refrigerator

Some medicines should be avoided. Research published in the Archives of Internal Medicine in 2004 found that one in five older patients is prescribed what is considered to be a harmful medicine in this population. There are a number of drugs that are best avoided in older patients. For a complete listing of these medicines, visit http://www.dcri.duke.edu/ccge/curtis/beers.html.

A recent study led researchers at the University of North Carolina Chapel Hill to issue a list of prescription drugs that  increase the risk of falling for patients aged 65 and older who take four or more medicines on a regular basis. The medicines on the list cover a wide range of common prescription antidepressants, seizure medications, painkillers and more. The complete list is available at  http://uncnews.unc.edu/images/stories/news/health/2008/drugslist.pdf.

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Medication Use Safety Training for Seniors

By special arrangement, The Center for Improving Medication Management (The CIMM) is pleased to offer direct access to the complete range of educational resources from NCPIE’s comprehensive Medication Use Safety Training for Seniors (MUST for Seniors) program. This program promotes safe and appropriate medicine use by giving older adults and caregivers the tools and know-how to avoid medicine misuse, recognize and manage common side effects, and improve medicine use knowledge, attitudes, and skills to avoid medicine errors. 

This exciting program makes available a wide range of information and educational resources to support the online or community-based live presentation of the Medication Use Safety Training for Seniors (MUST for Seniors) program for older adults and their caregivers. 

Here’s What’s Available – MUST for Seniors —Each item listed below is available for download when you click on the indicated link!

MUST for Seniors PowerPoint Slide Presentation — Use these slides and the accompanying Notes to talk to seniors in your home or community. 
1. Notes for PowerPoint (PDF format)
2. PowerPoint (PPT format)
3. PowerPoint with Voice-Over (WMV format)  (Total Run Time: 19 minutes)
MUST for Seniors Video Stories —Real people talk about real medicine use problems and the search for solutions. Four different interviews are featured, including (click here  to order 4 MUST Video Vignettes)
1. Dr. James Richardson Discusses Patient and Healthcare Team Communication (Total Run Time: 7 minutes and 30  seconds)
2. Kim Discusses Cross Cultural Medication Issues Streaming_lowRes. WMV KIM TBP for download (TRT: 5 minutes and 51 seconds)
3. Ralph and Craig Discuss Medication Management and Caregiving Streaming_lowRes. WMV Ralph/Craig TBP for download (TRT: 8 minutes and 40 seconds)
4. Glenn Discusses Problems Caused by Mixing OTC and Prescription Medicines  Streaming_lowRes. WMV Glenn TBP for download (TRT: 5 minutes and 17 seconds)

MUST for SeniorsPublications available for download (multiple copy purchase)

MUST for SeniorsBooklet — Downloadable resource. The booklet summarizes the information contained in the Power Point Slide Presentation for reference at home. Pre-printed copies of the 12-page booklet (color) are available for purchase from NCPIE. (Click here to order packs of 20 and/or complete MUST for Seniors CD
MUST for Seniors Participant’s Worksheet (Color / Black & White ) — Downloadable resource. Complete this two-page Worksheet before participating in MUST for Seniors to check your medicine information awareness, or fill it out as you watch the Power Point slide presentation and video stories or read the MUST for Seniors Booklet.
MUST for Seniors 10 Steps for Success (Color / Black & White ) — Downloadable resource. One-page handout with 10 important tips for safe medicine use. Keep this handy item on your refrigerator, medicine cabinet mirror, or any other place where it can serve as a reminder to help you use medicines correctly.
MUST for Seniors Print Advertisements — Available in multiple sizes (1-column, ½ page, ¼ page) to newsletter and magazine space availability.
MUST for Seniors Feature Article—Older Adults — Who Are Especially Susceptible to Medicine Use Related Problems — MUST Take Time Out to Talk About Their Medications — This article covers the “5-W’s and H” about the MUST for Seniors program (who, what when, where, why, and how). The article can easily be adapted for local newspapers and newsletters.
MUST for Seniors Feature ArticleHelping Your Independent Older Parents Use Medicines Safely

Click on the links above or go to
www.mustforseniors.org and

for all these great downloads!