2. Age ≥ 65 = increasing population growth Elderly are estimated to consume approximately 1/3 of all prescription drugs Estimate elderly use 3/4 of over-the-counter drugs

3. “use of multiple medications” Results: Drug-drug interaction Adverse reactions Higher costs

4. Diminishes with increased age GI concerns Reduced stomach acid (HCl) GI absorptive surface area is reduced Prolonged gastric emptying rate Blood flow to the intestines is reduced Reduced muscle tone in the stomach and intestines

5. Water loss Muscle loss Fatty tissue increase Protein binding: decreased capacity

6. General decline as age increases Causes are obscure; possibly due to: Reduced blood flow to the liver

7. Measure creatinine function Blood flow to the kidneys reduced Renal function is reduced Loss of intact nephrons

8. Internal drug receptors may change Results in diminished or greater responses Close monitoring is required

9. Memory loss Sensory loss Multiple health problems Multiple medications at multiple times Use of multiple pharmacies (continues)

10. Economic factors Lack of education Communication problems Cultural considerations Diet therapy

11. Oral medications Position for administration: high Fowler’s Speak clearly and slowly. Offer the most important medication first. Have plenty of liquid available. Do not rush the elderly client.

12. Use ventrogluteal site. Avoid deltoid muscle. Avoid vastus lateralis because of loss of muscle mass.

13. Safe storage of medications Keep out of the reach of grandchildren and other young children.

14. Evaluate Communication: Does client understand? Drug action

15. Prevent infections. Improve nutrition. Encourage exercise and activity. Facilitate social interaction. Promote restful sleep.