Do you take your medications as required?

One of the workshops I deliver is about the misuse of medications by Seniors. It is a major problem, not just  for seniors but  for all ages, yet this is a problem identified as Seniors do not take their prescribed medications as they should.  This is identified by the medical profession as no adherence. Adherence can be defined as the extent to which medication administration coincides with medical advice and instructions.  

The following is taken from an article from NICE. NICE is an international network of researchers, practitioners, and students dedicated to improving the care of older adults, both in Canada and abroad. Their members represent a broad spectrum of disciplines and professions, including geriatric medicine, gerontological nursing, gerontological social work, gerontology, rehabilitation science, sociology, psychology, policy, law and older adults themselves and their caregivers.

30 to 50 % of the ambulatory population does not adhere with their medication directives and non-adherence can be as high as 60% in the elderly.

Adherence varies with the disease state; number and type of medications taken; characteristics of the patient; the nature of communication between practitioner and patient; and economic factors.

Elderly patients not adhering with medications results in 10% of hospital admissions and 23% of nursing home admissions

Adherence in Seniors may be a result of:

•       Not filling the prescription

•       Not refilling the prescription

•       Prematurely quitting the medication

•       Taking more or less of the medication prescribed

•       Not taking the medication according to the dosing schedule

•       Not taking the medication according to special instructions such as taking on an empty or full stomach (can affect absorption or cause stomach problems)

•       Taking medication not prescribed (sharing medication) that do not have symptoms in the early stages of their natural history have high rates of non-adherence because patients assume if they do not have pain or other symptoms they must not be ill

Patient education is critical, explaining in lay language the consequences if the disease is not treated in the early stages. Example: stroke and heart attack for uncontrolled hypertension.

Explaining the pathophysiological change in the body when medication is not taken helps the patient understand the role medication plays in prevention.

Multiple medications with complex dosing or administration schedules can be problematic because the elderly may have memory problems, diminished eyesight, hearing, arthritic hands that make opening bottles or administering medications difficult. Some ways to help would be to

•      Counsel family members or caregivers to monitor medication taking if possible

•      Use pill organizers that can be filled weekly

•      Use special bottle caps and large print

•      Simplify the regimen of taking medication by eliminating duplication 

•      Prescribing extended release medications or medications in alternative formulations that require less frequent administration

The World Happiness Report 2016 Update

The World Happiness Report 2016 Update, which ranks 156 countries by their happiness levels, was released in Rome in advance of UN World Happiness Day, March 20th. The widespread interest in the World Happiness Reports, of which this is the fourth, reflects growing global interest in using happiness and subjective well-being as primary indicators of the quality of human development. Because of this growing interest, many governments, communities and organisations are using happiness data, and the results of subjective well-being research, to enable policies that support better lives. Below are the top 15 happiest countries in the world, from 2012 to 214 and from 2013 to 2015.  Where does your country rank?

How The Toilet Changed History

This is a fascinating little documentary on the commode, throne, privy, latrine, potty, whatever you want to call it. It is not as new an invention as you might think and no, it was not invented by Thomas Crapper (isn't that too bad.)

All work and no play

As I listened to the participant in my workshop talk about how important it was for us as we retire to pass on our wisdom to younger workers, I remembered this saying, All work and no play makes Jack a dull boy. When I went home, I looked up some variations on this theme and here are a few I like:

• As if a man's soul were not too small, to begin with, they have dwarfed and narrowed theirs by a life of all work and no play; until here they are at forty, with a listless attention, a mind vacant of all material of amusement, and not one thought to rub against another, while they wait for the train. Robert Louis Stevenson
• There is no such thing as work-life balance. Everything worth fighting for unbalances your life. Alain de Botton
• You may try your experiment for a week and see how you like it. I think by Saturday night you will find that all play and no work is as bad as all work and no play Louisa May Alcott
• It is better to rise from life as from a banquet - neither thirsty nor drunken. Aristotle
• A time for everything: A time to relax and a time to be busy, a time to frolic and a time to labour, a time to receive and a time to give, a time to begin and a time to finish. Jonathan Lockwood Huie

If you are thinking of retiring, in 10 years, 5 years, or 1 year, the time is now to consider whether there is balance in your life between work and leisure. Developing a healthy balance between work and leisure before you get to that point will position you to enjoy your post-retirement days and may even make your work years more enjoyable and productive

For many works is what they do for money, I was lucky, I did what I loved and I was paid and I was able to live within my needs. For most people, the economic reality is they NEED money to survive, to live and to have some fun. When we are paid, that paycheque is used to balance between living for the now and providing for your future.

Since many of us do not look very far ahead, (economist calls this our time horizons), if we have a short time horizon (which most of us do), we think about providing our future in short-terms such as a week or six months. However, as we get older a change happens for most of us so about 10 to 15 years before we retire, we start to consider our future after work.

For many playing is what is done outside of work. In a traditional working environment, it’s what you do in the evenings, weekends and on your vacation time. Play can be interpreted as anything you want, it may be about sports, travel, hobbies, socialisation, meditation, self-actualization, the list is endless and personal.

We see retirement as a time when we are playing more than working (that’s the traditional retirement concept). But before we can get there, we had to work first and we had to put money aside so we could live and afford to play. Retirement used to be an ‘off the cliff’ event where you worked and then you retired. Today, more and more people are experiencing a transitional or phased retirement where they make keep working but they may work less and play more.

This idea of a phased retirement is important because as I have said, we do not know how to transition from work to retirement. So how do we start? While here are a few ideas:

• Start introducing "time outs" into your schedule. This may begin with lunch out of the office. This sounds simple, but you need to take time away from the office, with no work multi-tasking. Join a gym or a team or a club and make time to go.
• Make "dates" with your spouse or significant other. Begin the discussion of what you want your retirement to be. You may have different ideas, but when you talk, you can work out a plan so each of you has the retirement you want.
• Set boundaries. With the prevalence of smartphone and instant internet, you can always be on duty unless you turn off your phone and ignore messages at night or when you are busy.
• Find something you want to try, explore it, and enjoy it - without making it a job. It is never too late to develop a new hobby or change your ways, but if you are obsessive about work, you may approach hobbies the same way to become a fishing or photography zealot. You need to work to change your patterns.
• Take vacations, starting with some long weekends, where you leave your job behind. Remember, when you retire, the company/job will continue without you. No matter what your job, you are able to be replaced.
• • Many of us do not like that idea but it is very true. Good planning can help make this work. When you return to work and find the place still standing, you will build the courage to take more time off - and leave the office behind when you shut out the lights.

All your working life, you worked smarter, lived better, played harder, and worked hard. As you retire, you have to learn to let that life go and find new adventures, new goals, new dreams. I recommend that you start this transition about 10 years before you retire so that retirement transition is smooth for you. It may not be what you want to hear but it’s my truth.

I have been lucky and I have met a lot of successful people in my time and I can’t think of one that got to where they are without working hard.  The lucky ones found their passion and do not see what they are doing as hard work.  But for many of us, life was about hard work. We believed that life is about paying our dues and we also believe that we all have to pay our dues.  We all have to contribute by working to make a better world.