Medicating the elderly in home health care

Abstract

MANLY, IF NOT MOST, home health /y/ care programs provide care to a growing geriatric population. Because the elderly are one of,the fastest growing populations in the United States, this trend is not likely to change. According to 1982 statistics, the number of elderly people (those over age 65) in the United States represents more than 11.8% of the population (approximately 27 million people). According to current proj ections, by the year 2000, more than 32 million people will be classified as elderly, and 45 million by the year 2020.T hose people aged 85 years and older represent the fastest growing segment of the population, with a doubling of that segment proj ected by the year 2000 to 5.26 million people and an increase by the year 2040 to 13.1 million people.2 Statistics show that at least 80% of those 65 years and older suffer from one chronic disease, and as many as 40% suffer from two or more chronic diseases.' The US Congressional Office of Technology Assessment' has stated that drugs are the most cost-effective method of managing chronic diseases. It is not surprising, therefore, that the elderly (12% of the population) use a disproportionately high percentage (31%) of all prescription drugs.3 3 Despite the beneficial effects of drug therapy, it has been well documented that elderly people are at high risk for experiencing a drug-induced adverse effect. Several factors contribute to altered effects from drug therapy in the elderly (see Box, &dquo;Factors Contributing to Altered Drug Effects in the Elderly&dquo;).'-8 An understanding of these factors and adherence to suggested guidelines for monitoring drug use can help maximize medication management in geriatric patients.

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