What surprised me the most in both articles and studies is how strongly medications can affect older adults due to changes in their metabolism. Aronson (2019) describes a case where a once-healthy patient quickly declined, not from a disease itself but from the cumulative side effects of multiple medications, each one prescribed to treat the side effect of another. I often see older adults come in with six or more prescriptions, and I have always assumed that this was a result of their many health issues. What surprised me was realizing how easily one prescription can start a chain reaction of adverse effects that then require more medications and this is something that hasn’t crossed my mind once since I began working in the healthcare field.
Cruikshank (2013) explains that as our bodies age, we metabolize drugs more slowly, which makes older adults more vulnerable to side effects. Her solutions such as diet changes, exercise, chiropractic care, and other homeopathic approaches, stood out to me because they emphasize prevention and lifestyle over automatic pharmaceutical intervention. Her discussion reminded me that aging does not have to mean being dependent on multiple medications. It also eased some of my fears about growing older by showing that there are ways to maintain health outside of prescriptions.
Reflecting on Aronson’s conversation with Irina, I found it to be especially powerful. By asking about Dimitri’s medications, sheuncovered how one prescription led to another until he was overmedicated and nearly almost immobilized. She raised important questions about what Dimitri himself would want in such a state of life, pointing to the importance of patient-centered care rather than just medical management. This example also highlights the power dynamics between physicians and patients, patients often assume that more medications mean better care, but physicians must take responsibility for questioning whether treatments truly improve quality of life (Aronson, 2019).
Aronson’s discussion of dementia also added a valuable perspective to what I learned from the Memory Loss Tapes. She emphasized the importance of communication by pointing out that small adjustments in how we talk to someone with dementia can make them feel validated and respected. This reminded me of how in the Memory Loss Tapes, a trigger word could cause distress, but gentle communication could bring calm. At the conference, Aronson highlighted the social and relational aspects of dementia care, while many other researchers focused strictly on medical solutions. This balance reminded me that treating dementia is not only about science but also about dignity and connection.
The example of Gabow’s mother really stood out to me too because instead of pursuing costly surgeries, she and her family used noninvasive treatments at home (such as sewing up a forearm gash themselves). Within a week, she was walking independently, and they avoided more than $100,000 in medical costs (Aronson, 2019). I thought this was amazing, especially because I know older adults who were not aware of such options and ended up in extreme medical debt, sometimes over half a million dollars. What impacted me most was how much access to knowledge and resources shaped the outcome. Not everyone has that advantage, and unfortunately, physicians often default to medical routes without informing patients of alternatives.
My hope is that these conversations inspire us to rethink how we care for older people. Not just through medicine, but through compassion, respect, and understanding.
References
Aronson, L. (2019). Elderhood: Redefining aging, transforming medicine, reimagining life. Bloomsbury Publishing.
Cruikshank, M. (2013). Learning to be old: Gender, culture, and aging (3rd ed.). Rowman & Littlefield.
Hi Elvira,
I really liked how you pointed out the “chain reaction” that can happen when one medication leads to another. I also thought Aronson’s story about Dimitri was powerful because it showed how easily overmedication can take away someone’s quality of life. Do you think the healthcare system does enough to educate families about non-medication alternatives, or is that something we need to push for more?
Hello Elvira.
It also surprised me how quickly over medication can spiral out of control. I also thought that the multiple medication‘s older adults were on was because of the multiple health issues, older adults may be experiencing, but now how come to realize that the medication‘s older adults are on are to treat the symptoms of their original medications. I also liked your point on how health outcomes also depends on how informed clients and their families are about outside resources. There may be many resources out there to help older adult clients but they might just not be aware of them.
Hi Karley, I know the medical profession does not do enough to educate families about alternatives to traditional medical treatment. As a parent of a grown son on the Autism Spectrum, I am all too aware of this shortfall. In addition to purely prescription overdependence, I believe there is also too much of a push for surgeries that may not be required, since that is also a service which brings in a great amount of money for all practitioners involved, including hospitals. There is not enough preventive care being shared with patients and their families. I have been fortunate to be seen by an excellent Nurse Practitioner who I gladly will drive an hour to see where I used to live, who has been wonderful at suggesting alternative treatments, and nutrition that could help me address various ailments. I think the days have passed when we can rely on a practitioner to be the expert we think they should be, due to their diplomas alone. Finding out as much as we can about their interests and why they are in practice is important. I have had the privilege at times to use treatments that insurance would not cover. I’ve been able to limit surgical intervention in many cases, and improve my health in that way with fewer medications. Keeping options open should be the goal of insurance companies, and medical practitioners.
Elvira,
You did a good job on this post. You were thorough in your discussion s and I enjoyed your thoughts about how important these issues are and how we might make a difference.
I too was impressed by Gabow’s mother and the decisions they made regarding her care. I would caution us to remember that very few families and caregivers could handle or manage that level of care at home. As a physician, her daughter had significantly more knowledge and options.
Only one question – I don’t know if this is a problem with pasting your post into WordPress from WORD, but there are some typo issues and word and punctuation confusion. Just check it out before you hit submit.
Good job.
Dr P