Too many pills, too little thought

A few weeks ago, I wrote about hip fractures in the elderly. I did not disclose at the time I had someone specific in mind: my 93-year-old mother, Mrs. Gifford-Jones, wife of the late Dr. W. Gifford-Jones. I chose not to mention it then because hip fractures at that age are no small matter. They can mark the beginning of a rapid downward spiral from which many seniors never recover. My focus, and hers, needed to be on her immediate care.

Happily, I can now report better news. My mother underwent surgery, completed rehabilitation, and is back home recovering remarkably well. At 93, that is no small victory, but an element of her recovery has sparked our frustration with the medical community. We have a medical culture that now seems incapable of imagining treatment without reaching first, second, and third for another prescription.

Doctors are not asking, “Does this patient truly need this drug?” There is a term for this phenomenon: polypharmacy. It refers to the routine prescribing of multiple medications, particularly in elderly patients, often without sufficient consideration of how those drugs interact, whether they remain necessary, or whether the patient even wants them.

What stunned me was not merely the number of prescriptions. It was the absence of consultation with a very smart patient and four adult children.

No one asked about my mother’s health philosophy. No one discussed risks versus benefits. No one explored what quality of life meant to a 93-year-old woman. No one contacted the family physician. Decisions simply appeared as prescriptions and blister packs stuffed with pills.

There were new medications for heart function. Four of them. There were antidepressants. There were painkillers galore, and the horror, there was a statin, which would have had my father rolling over in his grave, given his life’s work to promote a natural alternative. See giffsown.ca to learn more about that.

Nutritional and vitamin support? Not what one would hope.

Pharmaceuticals should not be the main event in protecting health. Instead, at any age, nutrition, exercise and mobility, family involvement, and human judgment should be the primary concerns. For the elderly, problems such as those faced by my mother should result in rehabilitation, not drugs, drugs, drugs.

Read the warnings on drugs, and it should be observed that they can increase risks. Drug interactions. Dizziness. Falls. Confusion. Sedation. Memory problems. Constipation. Loss of appetite. Liver stress. Kidney stress. Dangerous drops in blood pressure. Reduced mobility. Reduced quality of life.

One of the great ironies is that many seniors are hospitalized not simply because of disease, but because of adverse drug reactions from the medications prescribed to help them.

My father used to joke that one doctor gives you a pill for a headache, another gives you a pill for the side effects, and before long nobody remembers what the first pill was for, but he would not be laughing now.

A 93-year-old patient is not merely a collection of lab values and risk calculations. She is a human being with a history, preferences, tolerances, priorities, and dignity.

What matters may not be another theoretical percentage reduction in cardiovascular risk ten years down the road. It may be walking independently to the kitchen. Sleeping well. Remaining mentally sharp. Enjoying grandchildren. Avoiding dizziness. Preserving appetite. Maintaining dignity.

My mother survived the fracture. She survived the surgery. She survived rehabilitation. What concerns me now is whether modern medicine has become incapable of recognizing when enough treatment is enough. Physicians once prided themselves on judgment. Today, too many seem conditioned to prescribe first and pass entirely on reflection.

This column offers opinions on health and wellness, not personal medical advice.