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Elder Management of Cholesterol

By Cheryl Ellis, Staff Writer

Mom cuts her cholesterol pill in half. At seventy-eight, she’s enjoyed a long life with little health trouble, except for “some cholesterol.” Medicare and supplemental insurance take care of approximately thirty days worth of medication. She dislikes paying for something she considers an unnecessary expense when her husband has to fill his blood pressure pills monthly, and sometimes more often when the dosage must be adjusted.

Caregivers may shake their heads and argue with their loved ones over monitoring cholesterol, but depending on age and situation, the effects vary. In patients over eighty years of age, there may be an increased risk of problems, more predominantly in women than men. Muscles can break down in a toxic reaction to some cholesterol medications, and increased loss of thought processes can also figure in as a down side.

Most individuals on cholesterol medication have “too much” or “the wrong kind” of cholesterol. Yet, some individuals manufacture smaller amounts, just as some people overproduce. While patients and caregivers may cheer at low numbers, there are studies out there which question typical findings. A University of Padua, Italy study (approximately 2006) reported that higher levels of LDL (low density lipoproteins, or “the bad one”) appear to be associated with a lower risk of mortality.

Caregoverning Instead of Giving

Loving the special individuals who have entrusted their lives to us often means we have to make and follow through with decisions. Putting health issues into the hands of medical personnel takes away some stress. At some point, we still have to educate ourselves on medications and their effects. We may disagree with a current course of treatment, but because it is medically necessary, we need to have the loved one follow through. This is where caregoverning takes over.

If the doctor has determined that Mom’s dosage of cholesterol medication is needed to get it into lower, safer ranges (and Mom won’t change her diet or cheats), we may need to insist on her taking the full pill. If arguments like money for medication come up, we can devote a 20-minute interval to checking around for cheaper prescriptions, or find out if there are three-month supplies available at lower cost.

Unless we’re responsible for administering the medication, we may not be able to determine whether our loved one is taking the correct amount. An important step toward finding that information out is listening to why the medication isn’t being taken correctly. Financial and mental rationalizations will vary, but accepting that they have validity is a step in the right direction.

Once we find out why the medication is being taken improperly, we can institute temporary guidance to make sure things are done properly, but still allow our loved one some autonomy.

A Solution For Every Problem

In some cases, timed dosage vials will work. Other options include weekly/hourly pill dividers. Caregiver and loved one can count the pills out together if possible, so the elder will understand where the medication is going. The remaining prescription can be placed safely away so that pills are not “returned” or taken more than needed.

Only in severe cases of high cholesterol and/or poorly compliant elders should the caregiver intervene and discuss medication changes with the doctor. If you cannot stop your loved one from cutting up the pills, ask the doctor if the next higher dosage is a compromise. Then, the pills can be cut while the correct dosage is taken. This is probably the most extreme measure, but some individuals ask their doctors for these types of prescriptions to save on cost. They will still receive a 30-day dose (dispensing 30 pills with the order reading to take one-half of a pill). By cutting the pills in half, the medication will last longer. Be aware that all insurances check between doctor’s notes and prescriptions, and this may not be an option.

Some physicians may be willing to incorporate “natural” supplements to decrease cholesterol, in conjunction with prescription therapy. Discuss the options of flax seed and other supplements before adding these to your loved one’s regimen.

The Goal is Cooperation

Remind your loved one how much they mean to you, and how important it is to everyone in the family that they stay healthy. Medication to lower cholesterol is relatively new, and some elders come from a time long before that. Enhance their cooperation by telling them how glad you are they are around, whether or not it is time for a pill.  

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