Coalition for Senior Medication Safety in New Haven helps with managing the meds

The Coalition for Senior Medication Safety says medication misuse causes needless sickness, even death; and wants us to know that managing our medications properly is serious business.

The Coalition, based at the Consultation Center in New Haven, recently completed a year-long study, which is part of an ongoing campaign on medication safety funded by the Agency on Aging of Southern Central Connecticut and the Connecticut Department of Mental Health and Addiction Services. The Coalition, led by gerontologist Donna Fedus and pharmacist Sean Jeffery and comprised of representatives from pharmacies, social service agencies, hospitals, home-care organizations and consumers, developed an educational campaign with the goal of promoting senior medication safety.

With the help of seven cooperating senior centers and housing facilities where the average age of participants ranged from 55 to older than 85, participants were asked a series of questions about their medication usage. Most participants took 5 prescriptions and from 2-10 nonprescriptions daily, and only 15 percent of those surveyed received help with their meds (not surprising since 68 percent of those surveyed live alone.)

One of the questions on the survey, which also was an educational goal, had to do with having everyone carry on their person a complete and up-to-date list of all their medications. On a personal level, this made me recognize the wisdom of my own cardiologist, Dr. Steven Jacoby, who at regular intervals has asked me to bring in all the actual bottles and blister packs of everything I am taking, and he makes sure they are in the correct amount, not expired, and that there are no conflicting ingredients.

Follow up questions were later asked of the same groups, with improved results in their medication management. The Coalition suggests that even if you don’t have a particular question, review your medication, the type and amounts, prescription and nonprescription, and then talk all of these over with your doctor; either during your annual checkup or make a special, separate appointment.

I learned some additional good pointers at the recent Connecticut Health conference from Shelia Molony of Connecticut Community Care:

DO’S
Keep A Record (All medicines and vitamins, supplements, and over-the-counter meds.)nAsk Questions — Make a list for your health-care provider and ask your pharmacist.nSome good questions for your doctor are Why do I need this medicine and are there any alternatives? What are the risks and benefits? What are some side effects? What should I do if I miss a dose? How do I take this medicine? With food? At a certain time of day? nPartner with your healthcare provider. Follow directions carefully and share any symptoms such as dizziness, change in appetite or sleep, fatigue, etc.nRead Labels. When you refill the prescription and before taking medicine. You can request large-print labels or information sheets. Use caution with over-the-counter medicines;read the warnings, dosage and expiration dates.nAvoid Problems. Use one pharmacy. Use organizers and reminders such as charts or pill boxes. Ask for easy-open-caps (if no children come into your household).

DON’T
Take more or less medication than prescribed.nStop taking antibiotics before the full prescription is finished.nSuddenly stop a medication without checking with your doctor.nStore medications in the bathroom.nMix alcohol and medication without first checking with your healthcare provider.nBorrow, loan or share medications.

Finally, two helpful websites are Medline Plus where you can learn all about your prescriptions and over-the-counter meds and the Consumer Reports site that details the best buys in drugs. That site is www.consumer reports.org/health/best-buy-drugs/index.htm

Questions or information re: the Coalition for Senior Medication Safety, should be directed to Donna Fedus, director of elder programs, at the Consultation Center, Yale University School of Medicine, 203-789-7645.

Contact Jean Cherni, certified senior adviser for Senior Living Solutions and Pearce Plus, a helpful, full-service program for seniors contemplating a move, at jeancherni@sbcglobal.net or 49 Rose St., Apt. 510, Branford, 06405.

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Cancer survivor ‘e-Patient Dave’ has a bit of advice for all of us

“Healthcare is not a spectator sport,” according to “e-Patient Dave” a cancer survivor and fascinating speaker and author. An “e-Patient” is a patient who is empowered, engaged and enabled. When Dave deBronkart was diagnosed with what the doctor thought was terminal kidney cancer, he was determined not to be a passive patient. He collected whatever information he could find online about his condition and possible treatments. He shared it with his online readers and his doctors, consulted parts of his own medical records online and, through his doctor, found a good online patient community where he got invaluable advice and emotional support from his patient peers. Dave narrowly escaped death, saved by a rare treatment, many never hear about, but happily was effective for him. Out of that experience, came a book and a mission in life to empower patients. The old model of the authoritative doctor needs to be replaced by a partnership model. The reality is that there were 800,000 new articles published in medical journals in 2010, so not even your doctor can possibly know everything.

Patients and their families (who are also the caregivers) need to understand a disease or a treatment, and they need to feel free to ask questions. New regulations will make access to our records a reality. Last year in a study called Open Notes involving three leading medical centers, patients were given unrestricted access to their physicians’ actual notes. Not only did 89 percent of the patients love it, they said it would definitely affect what health provider they would choose.

In answer to some experts who say, “Patients don’t understand this stuff,” Dave responds, “It’s perverse to keep people in the dark and then call them ignorant.” Patients and families can also help with quality and safety. They can check the chart and the meds being given, they can request that all who enter the room, wash their hands, and they should inquire about how much things will cost. Dave says there is a magic incantation we should say to all doctors we visit: “I’m the kind of a person who likes to understand as much as I can about my health. Can I ask some questions?” In his book, written with Dr. Danny Sands, Dave’s primary care physician, the authors say there is a wealth of online health information, but we need to learn how to identify good vs. bad websites using guidelines such as MLANET— The Medical Library Association website. (See their MLA User Guide to Finding and Evaluating Health Information on the Web.) Government departments of health also have excellent information. (MedlinePlusgov). Also Kaiser, the Veterans Administration and Mayo Clinic. The book also cautions that although nobody wants to talk about it, medicine can be dangerous. It is risky to cut someone open, and it is risky to put potent chemicals (medicines) in our bodies. In the best hospitals in America, 1 in 20 surgical patients die of a complication. In the worst hospitals, it’s 1 in 6. With this in mind, you might be inclined to ask about other options. Dave feels that people perform better when they are better informed.

He has part of a group that started the Society for Patient Participatory Medicine (http://participatorymedicine.org/), and you can also watch an excellent video of one of Dave’s talks at on.TED.com/Dave. Patient participation should:nImprove outcomesnReduce medical errornIncrease patient satisfactionnImprove cost of care

As responsible adults, let’s all take responsibility for living a healthy lifestyle, and then if medical issues arise, becoming responsible, involved patients.Note to fellow Branfordites: Monday at 6:30 p.m., there will be an important meeting at the Blackstone Library, 758 Main St., regarding the need for a new Senior Center now.

Contact Jean Cherni, certified senior adviser for Senior Living Solutions and Pearce Plus, a helpful, full-service program for seniors contemplating a move, at jeancherni@sbcglobal.net or 49 Rose St., Apt. 510, Branford, 06405.

I'm reading: Cancer survivor ‘e-Patient Dave’ has a bit of advice for all of us

We never use the words ‘sanity’ and ‘fashion trends’ in the same sentence

I have a brief, old credential as a fashion observer in that before my marriage I worked for a New York publicity firm where I covered the wholesale garment industry and then wrote about the new fashions I had viewed. I still love and appreciate beautifully made and well-designed clothes, but with the untimely closing of the wonderful department and specialty stores that carried clothes made in Europe to the store’s exacting specifications (yet still affordable), we have descended to a paroxysm of competitive designer labelling on everything from underwear to lipstick.

Bold initialing now substitutes for good taste. Glancing through the current issues of Vogue, Marie Claire and Vanity Fair, it seems that only prices have ascended to a higher level. Even the fashion copywriters have all adopted a similar, limited vocabulary. I would have been fired if my descriptive powers were limited to “Cool,” “Sexy,” “Wow,” “Hot,” “New” and “Must Have.” So maybe my views are outdated and old-fashioned, but as a consumer as well as a columnist, here goes:n Diane von Furstenberg is one of the few unchanging designers, still featuring her wrap dress, which I find as tiresome as my old bathrobe (which also comes undone at inopportune moments).n Shoes and boots are still both breathtakingly expensive and unwearable by anyone but the very young with a complete disregard for future foot problems. n Models for the Juicy Couture collections are so spread-eagled across the magazine pages, it is hard to tell what they are wearing. n All models, however, carry a huge designer handbag, usually held in front of them like a weapon or perhaps, a shield. You could certainly deal a fatal blow to any would-be pickpocket, judging by the heft of most of them. (A recent news article detailed one inventive New York pickpocket who visited fashionable watering holes in his wheelchair; handily lifting expensive handbags stored under the bar and on restaurant chairs.) n Ralph Lauren is in Russian mode, with elegant ball gowns featured with traditional Cossack fur hats. Did he foresee, perchance, Putin’s renewed popularity? n Exotic feathers and even more glitzy jewelry, vests and jeans studded with grommets, as well as colorful, patterned furs, all shout expensive excess. Skirt lengths are either very short or long with side splits to show lots of leg. Still in evidence are ankle socks worn with pumps; a look I still think is awful, even for the very young. n There are also little print-covered baby-doll dresses ... .a look you can duplicate if you happen to still possess any old, vibrantly colorful housecoats, preferably a bit too snug and short.n Many advertised items say, “Price upon request” which translated means, if you have to ask, you can’t afford it. This is the height of snootiness and exclusivity, especially today when the top 1 percent of the population earns 20 percent of the income. There is tremendous pressure on the middle class to purchase luxurious items, but what you buy should not determine your sense of self. Unfortunately, many young people have not yet absorbed that lesson.n I can’t even begin to touch on the men’s collections in this column; suffice to say, the male models all look like underfed teenagers with permanently clenched teeth. As for me, my fall fashion plans are to pull out former dependables, maybe add a new jacket or colorful cashmere sweater, succumb to a glitzy pin at a church bazaar and viola! I’m all set for whatever my calendar calls for. How about you?


Contact Jean Cherni, certified senior adviser for Senior Living Solutions and Pearce Plus, a helpful, full-service program for seniors contemplating a move, at jeancherni@sbcglobal.net or 49 Rose St., Apt. 510, Branford, 06405.

I'm reading: We never use the words ‘sanity’ and ‘fashion trends’ in the same sentence

At Covenant Village in Cromwell, Prof. William Evans of Duke Research Center tells seniors of the importance of exercise

Millions of hours of research and millions of dollars have been expended on the quest to find ways to slow down the aging process. The billion-dollar cosmetic industry, “hope in a jar” is just one example of our never-ending search for the secret to remaining youthful.

While personally, I have very little faith in the expensive creams and lotions that have made Helena Rubenstein and Charles Revson multimillionaires, I could not resist going to hear Professor William Evans of the Duke Research Center in North Carolina, speak about “Slowing Down the Effects of Aging”.

Evans has been studying the problem for years; especially the prevention of muscle loss and the effects of protein and muscle metabolism. He has held positions at Penn State University, Tufts in Boston, has appeared on CBS and PBS and is the co-author of “Bio-markers … The 10 Determinants of Aging You Can Control.”

Surely, if anyone could advise me on staying younger, longer, it would be Professor Evans. Additionally, the talk was held at the Covenant Village of Cromwell, and gave me the opportunity to become better acquainted with this charming retirement community.

While genetics play a part in how we age, equally or even more important, is our lifestyle. One main contributing factor known as sarcopenia, is age-related loss of muscle mass. Muscle weakness causes a loss of independence. The less muscle we have, the fewer calories we need, but the weaker we become, and the less likely we will exercise and therefore become obese — a vicious cycle ending in an osteoporosis-related fracture for 1 in 2 older women and 1 in 8 men. Evans also pointed out that the risk of dying for a 50-year-old woman is as high from a hip fracture as it is from breast cancer. Obviously, then, exercise is of prime importance.

But, here’s the hard part. The kind of exercise matters very much, and progressive resistance training along with aerobic exercise is what made the difference in the many controlled studies of men and women, some in their 90s. That kind of exercise, combined with a low-fat, high-carb eating plan, resulted in participants losing 1 pound a week, even though they were eating as much food as they desired. Results were truly amazing. After only 10 weeks on the diet and exercise program, walking speed and endurance increased, participants were able to do stairs more easily, and they enjoyed higher overall energy levels and vigor.

A member of the audience pointed out that when he visited his doctor and had a stress test, he was only told that he had “passed,” but he never learned how he measured up for his age. Evans agreed, and said we need to know how we are doing on the following biomarkers:n Muscle massn Strengthn Basal metabolic raten Body fatn Aerobic capacityn Blood pressuren Insulin sensitivityn Cholesteroln Bone densityn Body temperature regulationn Cognitive functionn Immune function

While, overall, I found the lecture informative and interesting, I also came away slightly discouraged. The men and women in Evans’ study had some unique help. The proper food had all been prepared and ready for them, and they worked with exercise specialists who understood and could encourage them in resistance training.

Many seniors, especially those living alone, are not motivated to cook balanced, nutritious meals and be aware of eating low-fat, high-carb foods. While Local Ys and exercise clubs offer classes and equipment, very few also have well- trained instructors to make sure participants are doing the proper exercise and doing it correctly. If as a society, we want to help our seniors remain active and also cut down on our health-care costs, finding answers to the above roadblocks, should be of paramount importance.

We are fortunate in our area to have some excellent exercise programs at several senior centers and geriatric specialists at Yale who can advise. Get moving! Stay healthy! Feel younger!

Contact Jean Cherni, certified senior adviser for Senior Living Solutions and Pearce Plus, a helpful, full-service program for seniors contemplating a move, at jeancherni@sbcglobal.net or 49 Rose St., Apt. 510, Branford, 06405.

I'm reading: At Covenant Village in Cromwell, Prof. William Evans of Duke Research Center tells seniors of the importance of exercise