Spills and Pills

Much of our health, for better or worse, depends upon how we look after ourselves. This is especially true as we age. With that in mind, we can try to prevent or lower the risk of many common conditions. This includes problems with falls and medications – which are sometimes related.

As part of the OMA’s Speakers Bureau, I recently spoke about “Spills and Pills” to a group of seniors at the Good Shepherd Parish in Thornhill. For the 14 million others of you across the province who couldn’t make my presentation, here are some tips that you might find useful!

"Spills"

• Most falls happen at home, and they can have long-lasting consequences. Several factors increase your risk of a fall, including:
• a previous fall
• cognitive impairment (confusion or dementia)
• a recent hospitalization
• visual impairment (or climbing the stairs with your reading glasses on!)
• muscle weakness and balance issues (more common in seniors)
• polypharmacy (a lot of medications, especially those that affect your blood pressure or alertness)

If you’ve had a fall, let your doctor know! Just by observing you walk and asking some pointed questions, your doctor may help you prevent the next fall. Some measures to lower your risk of a fall include:

• daily intake of vitamin D
• exercise and balance training, such as Tai Chi
• checking your vision, and wearing the right glasses at the right time
• wearing appropriate and non-slip footwear
• “fall proofing” your home (proper lighting, securing throw rugs, keeping the floor clear of things like your grandkids’ Lego, installing bath poles and bars, etc.)
• doing things just a bit more slowly, especially getting up from a lying or sitting position – so sit before you stand, and stand before you walk
• reviewing your medications with your doctor to assess if they might be adding to your risk
• getting an assessment from a “falls team” who can assess your risk from several points of view

"Pills"

Medications play a major part in our health care. They can prevent, control or cure numerous conditions. Is there a perfect pill, that is, one that is convenient, effective, inexpensive or “covered”, fast-acting, can be taken for just a short time, has a catchy name, and is free of side effects and interactions? Absolutely not!

All medications – be they prescription, over the counter, or “natural” – have potential side effects. Some are common, some are rare. Some may be transient, while others may not go away. Many can be anticipated, avoided or minimized. Side effects may be mild but a nuisance, while others are occasionally life threatening.

Seniors tend to be on more medications, for more medical conditions, and so they may be more susceptible to drug interactions and side effects, including the above-mentioned falls.

Sometimes a side effect can be mistaken for a new condition, especially if your doctor doesn’t know all the medications you’re taking. For example, the new blood pressure pill makes your ankles swell, so the doctor gives you a water pill which makes you pee. The next doctor now gives you an antibiotic for your alleged bladder infection, which results in an allergic reaction. Then you need something for the allergic reaction. This is called “cascading” so ask your doctor if your latest symptoms might actually be a drug side effect or interaction. It could save you a whole round of extra medications.

Here are some other tips to help minimize the risk of your pills:

• Learn the names (brand name and / or generic) and keep a handy list of all your meds, including over-the-counter and “natural” medications.
• Be acquainted with potential side effects and know what to do should something occur.
• Be aware of how to properly take your pills.
• Can your doctor “deprescribe” or cut down on any of your medications, especially those that might be causing side effects or serving no purpose?

There is much more to consider about your health, and we will touch on these in the future. For now, watch your step, and your pills!