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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