My friend is worried about her aging mother. At close to 90, the mother was still walking, energetic, and very involved with the lives of her children and friends. But my friend is concerned because the family has noticed a change recently. The mother has fallen 3 times in a month, she’s started to use a walker, her energy is low and she’s depressed with thoughts of longing to die. I asked if she had new medicines or if regular ones had been changed. A few months ago her mother had complained of overwhelming anxiety to one of her specialists. He’d written a prescription for Lorazepam.
I’m just a consumer, so I turned to the Internet. I discovered the Beers Criteria of potentially inappropriate medication use in older adults. It’s put out by the American Geriatrics Society and is the standard reference for docs caring for older/geriatric patients. The NIH reviewed the updated Criteria from 2012 and stated: “The new AGS Beers Criteria were carefully and thoughtfully developed based on the current best evidence.”
These listings are available to the public and I’m just reading through them for the first time. Some drugs that have been used for decades, like Lorazepam, Demerol, Valium, Xanax and Librium, are on the list to be avoided for older patients because the effect is either different, more intense or longer lasting.
And it’s not just prescription medicines. I was shocked that 65+ should not get Tylenol PM Or Benedryl (they can cause confusion, blurred vision, constipation, problems urinating and dry mouth.)
Here’s the link to a short list: Ten Medications Older Adults Should Avoid or Use with Caution. It’s based on Beers Criteria by HealthInAging.org and on that website is a longer, more detailed explanation of drugs to be avoided.
Lorazpam is on the list: Older adults are especially sensitive to the category of medicine it’s in. These drugs may increase risks of mental decline, delirium, falls, fractures, and car accidents in older adults.
It cannot be emphasized enough that the list is a guideline only. Each patient is different and a doctor might make a decision that is right for the patient at that time that violates the list. Also, the list is only for generally healthy adults, not for palliative or hospice care.
Tomorrow my friend and her mother will meet with the primary care physician. The anxiety still needs to be addressed. But with the Beers Criteria in hand, my friend can participate more intelligently in the health care decisions she and other family members will make together on behalf of their Mom.