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Opinion
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- Written by: Dr. Damanpreet Jamarai
As we age, it is not uncommon that taking prescription medications becomes a greater part of our health care regimen.
While the average number of medications taken by people aged 65 and older varies, data from the Kaiser Family Foundation suggests that nearly 90% of older adults regularly may take at least one prescription drug, almost 80% may regularly take at least two; and 36% may regularly take at least five different prescription drugs.
While older adults may fill those prescriptions and follow instructions, the U.S. Department of Health and Human Services reports that as many as 55% of seniors do not take their medications as prescribed by their care providers.
Medication management can be an important part of one’s overall health routine, particularly as we continue to age. Not taking medications as prescribed may have some short- and long-term consequences:
• Not getting better — Skipping doses, taking less than prescribed amounts, not filling prescriptions and not taking medications on time may slow progress and healing.
• Greater severity — Skipping medications may lead to more serious health complications such as stroke, heart attack, and blindness.
• Increase medication resistance — In the case of antibiotics, it is important to take them as prescribed to prevent get reinfected (known as a “rebound infection”).
Taking your medications as prescribed need not be difficult. Here are some ideas:
• Make a list – Include the medication name, what it is for, the dose, when to take it, how to take it, the prescribing care provider and when it was first prescribed and most recently refilled. Share this list with your primary care provider and caregiver. And remember to include over-the-counter medications, vitamins and other supplements, as well. Give the list to your care provider and caregiver.
• Make part of your daily routine – Store your medications in a place where you routinely start and/or end your day such as beside the coffee pot or on your nightstand.
• Write It Down — Purchase a standard wall calendar with space to write down the prescription medications you need to take and when for each day. After you have taken your medication, cross it off. Be sure to include all medications – ones in your pill organizer, any in their original bottles and even the ones in the refrigerator.
• Use an app — Apps can help you keep track of what medications you need to take, sending an alarm to your phone or other smart device when it is time to take your medications. According to a 2019 study from the National Institute of Health, people who use apps are nearly twice as likely to take their medications as prescribed. The wall calendar/app combination may help ensure greater adherence.
• Shop around for a pill organizer — Gone are the days of one-size-fits-all pill holders. Depending on how many medications you take each day, the timetable for taking those pills (morning, noon, evening, bedtime) and the size of the pills you are taking may determine what size and how many you may need. If medicines must be stored in their original containers and/or refrigerated, you may want to list them on your wall calendar or app.
Some older adults may face other challenges beyond just remembering to take medications. Your doctor, pharmacist and caregiver can play a vital role in addressing these concerns:
• Reach out to your care provider — Be honest about issues and concerns you may have about your medication regimen (drug interactions, side effects, drug costs, physical limitations, timetable) so you can address them together. Always let your care provider know what vitamins and supplements you are taking as these may interact with your prescriptions. Taking medications multiple times a day? Talk to your care provider about ways to help simplify your medication regimen.
• Talk to your pharmacist — Ask about refill reminders, automatic refill programs and extended fill options. Having trouble opening pill bottles, reading labels or giving yourself injections? Having trouble affording your medications? Or transportation to the pharmacy? Your pharmacist may have solutions to any physical limitations and may be able to speak to your care provider about other concerns.
• Let caregivers help — Let them know what medications you are on to help ensure you are taking the right drugs at the right time. Caregivers may also help if there are questions or concerns about your medications, including the cost of these drugs, and can help reach out to your care provider or pharmacist, as needed.
Medications work best when they are taken as prescribed. Understanding the importance of each drug you are taking; adhering to your daily regimen; and raising questions all contribute to staying on track with — and getting the most benefit from — your prescription medications.
This information is for educational purposes only and is not a substitute for the advice of a doctor. Consult your doctor prior to making changes to your lifestyle or health care routine.
Dr. Damanpreet Jamarai is Medicare and retirement chief medical officer for UnitedHealthcare of California.
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- Written by: Dr. Damanpreet Jamarai
As we grow older, we begin losing bone density and mass, which may make us more susceptible to bone-related conditions, including osteoporosis and injuries. Falls are a leading cause of injury among older adults, often resulting in fractures and other serious health issues according to the U.S. Centers for Medicare and Medicaid Services, or CMS.
With many older adults wanting to live independently as long as possible, good overall health is crucial. Maintaining strong bones and preventing falls can help.
Osteoporosis is often called a ‘silent’ condition, according to the National Institute of Health (NIH), especially for men. Osteoporosis in men is often under-screened, underdiagnosed and undertreated. An estimated two million American men currently have osteoporosis and an additional 12 million are at risk for developing the disease, as reported by the NIH. It’s important that osteoporosis not be regarded as a primarily women’s disease.
Know Your Numbers – Up to one in four men over the age of 50 will break a bone due to osteoporosis. Men 75 and older might consider discussing the option of a bone density scan, also known as a DEXA scan, with their health care providers. Testosterone levels and other changes impact bone health. The bone scan measures the mineral content, particularly calcium, to determine bones’ density. Based on the results, providers may recommend treatments. This test is generally covered under Medicare and other health plans.
Understand Your Risks – While bone density naturally decreases over time, the amount, speed, and impact of loss may be slowed so take stock of what you eat and drink, and how much you exercise and move. Also, review your family’s health history to determine what health conditions may be hereditary. Be sure to share this with your physician.
Eat Right and Exercise – Consider including foods high in Vitamin D and calcium as part of a well-balanced diet. New to exercise? Start slowly and try exercises like beginner's yoga; every extra movement may help you improve your strength. If you are already participating in a routine such as walking, jogging, and balance coordination exercises, consider adding weights to enhance your workout.
Make Your Surroundings Fall-Proof – Look around your home – inside and outside. Can you safely pass by tables, chairs, and other furniture? Are all the rugs and floorboards secure? Are there grab bars and handrails? Are bare floors slippery, even when dry? What about outside your home? Are there holes, cracks, uneven spots? Address these obstacles and other worries to make your home safer inside and out.
Dress for Safety – In addition to ensuring clothes do not drag on the floor – a potential trip hazard, be mindful of what you are wearing on your feet. Wear rubber-soled shoes or sneakers, or slip-proof socks or slippers. Specifically designate these as “inside wear only” if you do not want to track the outside dirt and grime into the home.
Stay Aware – Maintaining your annual well visits may help address health issues and concerns early, including bone health. And if something seems not quite right, say something.
While we cannot prevent all injuries no matter how careful we are, maintaining strong bones, gaining strength, and improving balance may lessen the impact of a fall and speed recovery – even from other injuries. So, bone up on your health for a stronger future.
This information is for educational purposes only and is not a substitute for the advice of a doctor. Consult your doctor prior to beginning an exercise program or making changes to your lifestyle or health care routine.
Dr. Damanpreet Jamarai is chief medical officer for UnitedHealthcare Medicare & Retirement of California.
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- Written by: Teresa Frankovich, M.D.
As adults, many of us put vaccines in the back of our minds after finishing our childhood immunizations. But the truth is that vaccines save lives at every age.
Whether you are a healthy, young-to-middle-aged adult or a senior citizen, getting routine vaccinations can help protect your life and your health.
The Tdap vaccine protects against three different diseases — tetanus, diphtheria and pertussis. The bacterial infections diphtheria and tetanus can lead to severe illness and even death.
Thanks to the effectiveness of the Tdap vaccine, you have probably never met anyone who has had either of those diseases.
Unfortunately, infections caused by pertussis, also known as whooping cough, are far more common and have been surging in California this year due to fewer people being vaccinated.
While deaths in adults from pertussis are rare, infants and young children can become sick enough to need hospitalization, and some die. When you receive a Tdap vaccine, you are protecting yourself and the people around you.
While influenza (flu), which circulates every year, may seem like not much to worry about, it is important to remember that thousands of people in the U.S. die every year from influenza and its complications. Infants and young children, those with certain chronic health conditions, and seniors have the highest risk. A simple yearly flu vaccine helps to protect not only you from serious illness but also those most at risk in your community.
Two more vaccines to highlight are the shingles and pneumococcal vaccines. Shingles infections occur when the chicken pox virus, which can live quietly in your body for years after infection, becomes active. This can cause a very painful rash.
About one to two out of every 10 people who get this infection develop persistent pain that may last for weeks, months, or even years. Risk of this infection increases with age, so the shingles vaccine is routinely recommended for adults age 50 or older.
The pneumococcal vaccine provides protection against infections — particularly serious and invasive infections — from bacteria called pneumococcus. While these bacteria cause common problems, like ear and sinus infections, they can also cause more serious infections of the lungs (pneumonia), blood stream (bacteremia), and of the brain and spinal cord (meningitis). Fortunately, research shows that getting vaccinated can decrease the risk of these serious infections by 60-70%.
Vaccination recommendations may vary with age, health conditions, and even with pregnancy. Please talk with your health care provider often about the vaccines needed, at every age, to help protect you, your family, and your community. Vaccines are time-tested, safe, and effective. Make the healthiest choice: Get vaccinated.
Dr. Teresa Frankovich is an associate medical director at Partnership HealthPlan of California, a community-based, safety-net health care organization that contracts with the state to administer Medi-Cal benefits. Partnership provides quality care to over 900,000 Medi-Cal members. Starting in Solano County in 1994, Partnership now serves 24 Northern California counties – Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Nevada, Placer, Plumas, Shasta, Sierra, Siskiyou, Solano, Sonoma, Sutter, Tehama, Trinity, Yolo, and Yuba. Learn more about Partnership at PartnershipHP.org.
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- Written by: BERNIE BUTCHER
On Nov. 5, the American people voted for a change in national direction — reduced immigration, a move toward traditional values, less government spending and regulation, stronger support for domestic manufacturing, and a retreat from foreign entanglements. Like many elections before it, the people voted for a pendulum swing — not a revolution.
But what Americans did NOT vote for was a rejection of our constitutional democracy.
The people did NOT vote to abandon the republican form of government outlined in the Constitution — with its careful balance of powers and its deep respect for the rule of law. And the people did NOT vote to discard the ideals expressed 249 years ago on July 4 in a hot Philadelphia courthouse, when the Founders declared independence from a king.
That declaration — the foundation of our national identity — warned of the dangers of concentrated power. It told of a “long train of abuses and usurpations” by a single ruler, King George III. The kingly abuses are different today, but some of the warnings of our Founders still ring true.
From the Declaration of Independence (bolded phrases are from the original text), here are just a few “abuses and usurpations” that resonate today:
He has kept among us standing armies without the consent of our legislators.
— Today, we see the National Guard and Marines in the streets of Los Angeles without local approval and a budget for a massive expansion of an ICE federal enforcement force.
He has dissolved representative houses for opposing his invasions of the rights of the people:
— Today, we see executive threats to shut down departments like Education and USAID without Congressional consent. Public universities, the press, and the legal profession are being intimidated for exercising institutional independence.
He has made judges dependent on his will alone:
— Today judges face physical threats while duly convicted insurgents and allies of the administration receive pardons.
He has sent hither swarms of officers to harass our people:
— Today we see mass firings of civil servants by un-elected officials, indiscriminate ICE raids in the dead of night, and agency closures with no effective oversight.
He has cut off our trade with all parts of the world:
— Today the world is subject to sudden whimsical tariffs and trade barriers imposed without Congressional approval.
He has transported us beyond seas for pretended offenses:
— Today we see mass deportations without due process or adequate legal representation.
He has excited domestic insurrections among us:
— Today we see pardons for Jan. 6 insurrectionists and rallies, speeches and posts that demonize opposing viewpoints and widen the partisan divide.
Our system was built to withstand moments like this — but only if the people stand up. The ballot box remains a path to redress, but we must not wait for 2026 or 2028 to defend our democracy.
The time to act is now. Our democracy has successfully pursued change — even bold change — without handing the power of a king to any one individual.
The Founders wisely rejected a monarch in 1776. And we don’t need a new king now.
Bernie Butcher writes on behalf of Indivisible Lake County CA. To hear him read this editorial, visit here.