Medications – make your own decisions, take control

Everyone has the right to decide about their own healthcare, including what medications they take. But, all too often, the opinions of doctors and other health care professionals influence us heavily. We can take responsibility for making informed choices for our own care, taking into consideration the benefits and consequences of our actions.

As substitute decision-makers for other people, we are sometimes also required to make decisions on their behalf.

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How I turned into a zombie

In my early seventies, a general practitioner diagnosed mild hypertension (raised blood pressure). I agreed to medication. A year or so later, I moved house and entered a particularly stressful period in my life. I found another GP closer to where I lived.

Each visit to the new GP seemed to result in an increase in medications of different kinds. Because I was anxious to improve my health, and most importantly to feel better, I didn’t query the decisions he made. Stressors in my life increased, and I suffered from increasing anxiety, poor decision-making, dizziness and abdominal cramping.

I’d worked as an advocate for older people, completed a PhD and published a book a few years before. Out with my daughter one day, I found myself holding on to a fence, dizzy and unable to walk further. I felt unable even to talk about what was wrong.

My daughter took me to a physician, whose first question,

‘Who’s in charge here?‘ alarmed and shocked me.

‘My mother is very much in charge of her life,’ my daughter responded for me. ‘But she’s ill and I’m here to support her.’

An emergency admission to hospital and cessation of all medications followed. Within days, I again became my articulate, competent, decision-making self. A week later, on fewer drugs and very small doses, I went home a different person. All these years later, I take tiny quantities of prescribed medication, three times a week. The regime serves me well. I exercise and eat well and remain fit and healthy

Since I discovered that chronic pain almost always occurs in response to childhood trauma and current stress, I rarely take even paracetamol. You can read more about that in my article, ‘Brain plasticity, new science and chronic pain.’

I’m careful, if not wary, of taking medical advice without proper consideration, and sometimes a second opinion. I’ve also become a passionate advocate for informed choices around health care.

All medications can be harmful

Of course, all medications have benefits and can improve our health and well-being. Some can be life-saving. Conversely, all medications have the potential to cause harm, especially for older people.

• They can have multiple, sometimes serious side effects.
• The danger can increase with dosage. A medication often has several names, and if more than one prescriber or pharmacy is involved, multiple doses can be taken by unwary patients.
• There can be unwanted interactions between drugs.
• They can impact on one’s day-to-day life because they cause drowsiness or dizziness.
• Medications can cause older people to fall and injure themselves, often seriously.
• Sometimes medications change thoughts or behaviour (eg. psychotrophics). These are occasionally used as chemical restraints in aged care facilities to control aggressive behaviour.

Questions to ask to be well-informed about medications

We have every right to ask questions about any medications suggested or prescribed for us. If the prescriber seems reluctant to answer questions, everyone in Australia can change their doctor. My blog, ‘Doctor shopping to combat ageism’ talks more about this.

The following list of questions to ask your health professionals. It comes from the pamphlet, ‘Medication: It’s Your Choice’ from the Older People’s Advocacy Network.

• What am I taking?
• How should it help me?
• Please explain the side effects?
• What could happen if I don’t take it?
• What alternatives exist (including non-medication alternatives)?
• When will my medications be reviewed?

How else can you make sound decisions about drugs

These sources may be helpful in the decision-making process.

• Your prescribing doctor should provide full information.
• You can ask for a second opinion or a specialist review.
• Pharmacists provide sound information and advice about the medications they dispense.
• If you or your loved one lives in an aged care facility or receives clinical home care, you can ask for a formal review of your medications.
• The member agencies of the Older Persons Advocacy Network provide free independent support. Contact details below.

Disclaimer

This article has not been medically reviewed. For more detailed information about rights and responsibilities for older people in Australia you can contact the Older Person’s Advocacy Network on 1800 700 600. As well, each of the States and Territories has its own older persons’ advocacy agency.

In Western Australia Advocare Inc provides advocacy and support. I’m proud to have been the first Chief Executive of Advocare, which started 25 years ago. Their phone number is 1800 655 566.