Serving Our Seniors Magazine July - Sept 2023

"Service you deserve - Experience you can trust" Bob & Patti VanScoy Call/Text: 419-357-3017 www.bobvanscoy.com in Buying, Selling, Relocation, and Estates 28+ YEARS COMBINED EXPERIENCE FIRST PLACE In May 2023, I interviewed Dr. Ardeshir Hashmi, Cleveland Clinic Endowed Chair of Geriatric Innovation. We discussed what older people ought to know when taking multiple drugs to treat a variety of diseases and other health problems. According to the National Institutes of Health, Polypharmacy is defined as the regular use of at least five or more medications. Today, it is common to see patients taking 10 or more medications per day. Hashmi said, “Prescribing multiple medications has regrettably become the norm.” Although each medication is studied for side effects individually, what most people don’t know is prescription drugs are not studied for side-effects when taken in combination with a variety of other medications. “We don’t know what side-effects take place under all circumstances.” There is something known as the Prescribing Cascade. To explain it, Hashmi gave this example. “A patient goes to their doctor because they feel their heart racing. The doctor prescribes a medication and it fixes the racing heart. At the follow up appointment, the patient tells the doctor the heart racing is fixed, but now the patient complains of feeling tired and depressed. The doctor prescribes an anti-depressant. The patient returns and reports he/she is feeling somewhat less depressed, but now has less of an appetite. The doctor then prescribes another anti- depressant and a vitamin to stimulate appetite. What is actually happening is the patient is experiencing consecutive side effects from each newly prescribed medication. As opposed to recognizing that the successive symptoms being reported are actually medication side effects warranting “deprescribing”, the clinician instead erroneously starts new medications for each reported symptom leading to even more side effects and so on… His advice to patients, who want to work with their doctor to treat their health problems, while minimizing side effects, is always ask their doctor: 1. What are the common side effects with this drug? 2. If I feel anything different, after taking this medication, I’m going to call you so we can discuss it. Is that OK with you? 3. Are there any alternatives to medications to treat the symptom / condition I am having? “By communicating in this way, the patient is saying, ‘I trust you, but this is my body. I am in control of this.’“ He went on to say, “There is no substitute for self-advocacy.” Geriatricians are specially trained in de-prescribing medications, which are not appropriate for advanced age. Geriatricians will work with a geriatric pharmacist to make recommended changes. However, geriatricians will not change a medication regimen without bringing the primary care physician and the patient on board with the medication plan. If you are on more than five medications, it is recommended that an older patient have a geriatric drug review one time per year. Are Taking Too Many Medications? By Sue Daugherty You are invited to attend a dinner forum, “Would You Feel Better If You Took Fewer Medications?” July 20, 2023, 2:00 pm - 3:30 pm at The 1058 Event Center, Sandusky Plaza, 1058 Cleveland Road – Sandusky. The Speaker is Cleveland Clinic Geriatrician, Dr. Kenneth Koncilja. Menu - Roasted beef sirloin, potato, vegetable and salad to be served at 4pm. A refundable deposit of $10, payable to Serving Our Seniors, by July 6th, is required to reserve your seat. Include your name, phone # and the name of this event. The deposit will be refunded immediately after the dinner for those who attend the entire event. 6