The difficulties of old people taking drugs

There is considerable interest in the problems of the elderly taking drugs correctly and appropriately. A recent survey (Parkin et al. 1976) showed that these problems that have long been known in geriatric practice have now been noted by general physicians. This review was undertaken when an occupational therapist in a geriatric unit team noted that, although patients and their relatives were taught methods of dressing, toileting, shaving, bathing, eating, walking, transferring to a chair, wheelchair mobility and communication by the occupational therapist, physiotherapist and speech therapist, no advice or teaching was given concerning the accurate taking of the drugs prescribed. The results of a detailed investigation are reported elsewhere (Atkinson, Gibson & Andrews 1978). Repeatedly, patients ready for discharge were handed a batch of drugs by a nurse at the last possible moment, even while sitting by their luggage awaiting the ambulance. Following this, special attention was paid to problems such as intellectual impairment, loss of memory and confusion, poor sight, inability to handle containers, failure to take drugs and lack of patient-education. During ward rounds, particularly when a geriatric health visitor was present, attention was drawn to special topics such as the number of patients who inadvertently kill themselves and the numbers needing readmission due to failure to take drugs, overdosage or underdosage or mixing of drugs (Wade 1972). Ferguson Anderson's comment (1974) that 7.15% of hospital admissions are due to drug reactions was also noted.