Ask doctor if all those medicines are needed

The consequences may be as simple as a rash or as complicated as disorientation and confusion, which masquerades as dementia and gets Anna’s family thinking there’s a need for in- residence nursing care.

I’m fairly certain Anna, with her strong and independent spirit (her nephew calls her "feisty"), doesn’t need nursing care. She does have needs, though. She and her family definitely need to query her health provider about the number of medicines she’s taking. "Is it possible that she doesn’t require three for hypertension?"

Perhaps Anna should ask her physician, "If I change my diet, will that affect the number of medications I take?" Ideally she’d have asked when the medicine was prescribed. Sometimes, we can make diet-related changes that positively affect our health — less salt, fewer saturated fat, more nutrient-dense foods.

Anna definitely needs to let her doctor know she understands that older adults require one-third to one-half the dose and ask, "Is it possible I’m taking too high a dosage?" She may also want to arrange a consultation with her pharmacist (your most accessible health provider) to discuss possible reactions or interactions.

But what Anna needs most is money to cover the cost of her medications. She’s considered "one of the lucky ones" because she has health insurance to supplement her Medicare coverage. It covers her medicines, although her insurance premium keeps going up (and there’s an annual ceiling on allowable costs). Her nephew helps with the co-pay. In her words, there’s "no way" she could afford that, too.

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Ironically, insurance coverage makes Anna ineligible for existing pharmaceutical company subsidies. Even if she were eligible, there’s no single plan that would cover all 18 medications. And every available subsidy requires extensive paperwork and can be short-lived (a pharmaceutical company provides financial assistance with a group of drugs, but then may elect to stop and subsidize another group of drugs). Quite a maze for an 84-year-old. And remember, she’s "one of the lucky ones."

I know many older adults whose situations parallel Anna’s, or are much more challenging than hers. I know something else — through a local collaboration among health and human service experts, there’s information available to assist with medication management — simple-to-understand, useful information, including ideas about how to reduce costs.

Best of all, for six weeks starting in mid-April, I will have an Oregon State University College of Pharmacy intern (a student about to get his doctorate) working with me full time, available to talk with people like Anna.

"My" intern (I’m quickly possessive) and I will offer classes and information on medication management. A little help with the medication maze … guaranteed.

Sharon Johnson is an assistant professor in family and community development at OSU Extension and a member of the Senior Advisory Council. Reach her at s.johnson@oregonstate.edu.

Call her at 776-7371, Ext. 210, for more information on getting help with medications this spring.