Philips to acquire BioTelemetry, Inc. for USD 72.00 per share; implied enterprise value of USD 2.8 billion (approx. EUR 2.3 billion)
Acquisition is a strong fit with Philips’ strategy to transform the delivery of healthcare: combination of Philips’ leading patient monitoring position in the hospital with BioTelemetry’s leading cardiac diagnostics and monitoring position outside the hospital
With 2019 sales of USD 439 million, BioTelemetry annually monitors over 1 million cardiac patients remotely; its portfolio includes wearable heart monitors, AI-based data analytics and services
Combination will result in significant synergies driven by cross-selling opportunities, geographical expansion, portfolio innovation synergies, and productivity gains
BioTelemetry business is expected to deliver double-digit growth and improve its Adjusted EBITA margin to over 20% by 2025; acquisition will besales growth and adjusted EBITA margin accretive for Philips in 2021
Amsterdam, the Netherlands – Royal Philips (NYSE: PHG, AEX: PHIA), a global leader in health technology, and BioTelemetry, Inc. (NASDAQ: BEAT), a leading U.S.-based provider of remote cardiac diagnostics and monitoring, today announced that they have entered into a definitive merger agreement. Pursuant to the agreement, Philips will commence a tender offer to acquire all of the issued and outstanding shares of BioTelemetry for USD 72.00 per share, to be paid in cash upon completion. This represents a 16.5 percent premium to BioTelemetry’s closing price on December 17, 2020. The implied enterprise value is USD 2.8 billion (approximately EUR 2.3 billion), inclusive of BioTelemetry’s cash and debt. The board of directors of BioTelemetry has approved the transaction and recommends the offer to its shareholders. The transaction is expected to be completed in the first quarter of 2021.
The acquisition of BioTelemetry is a strong fit with Philips’ cardiac care portfolio, and its strategy to transform the delivery of care along the health continuum with integrated solutions. The combination of Philips’ leading patient monitoring position in the hospital with BioTelemetry’s leading cardiac diagnostics and monitoring position outside the hospital, will result in a global leader in patient care management solutions for the hospital and the home for cardiac and other patients. Philips’ current portfolio includes real-time patient monitoring, therapeutic devices, telehealth and informatics. Moreover, Philips has an advanced and secure cloud-based Philips HealthSuite digital platform optimized for the delivery of healthcare across care settings. Every year, Philips’ integrated solutions monitor around 300 million patients in hospitals, as well as around 10 million sleep and respiratory care patients in their own homes.
From their EHR workflows, clinicians will have a centralized system enabling them to order and prescribe apps, devices or other digital therapeutic tools for virtual care management.By Mike Miliard December 11, 202002:57 PM
Cerner announced Thursday a new offering developed through the investment it made this summer in digital prescription platform Xealth.
It will now offer its customers a centralized digital ordering and monitoring system, delivered right from the electronic health record, to help providers more easily deploy and manage digital tools and smartphone applications for their patients.
The tool enables clinicians to see an array of digital therapeutics and apps in the Cerner EHR, assess their cost and clinical value, and prescribe them for patients from within their workflows. HIMSS20 Digital Learn on-demand, earn credit, find products and solutions.
Additionally, it can help them track how well the connected health tools are working as part of a telehealth, remote monitoring or other virtual care program.
Among the tools on offer via Xealth’s platform: Babyscripts, Glooko, SilverCloud Health and Welldoc.
The platform, by linking digital health tools such as these with EHR data, allows clinicians to monitor how the apps are being used and can send care plans to patients’ smartphones.
THE LARGER TREND
Cerner announced its $6 million investment in Xealth, a Providence spinoff, back in August.
Among the use cases that can be tackled when the tool is deployed in the EHR and in the patients’ own portal: chronic disease management, behavioral health, maternity care and preparation for surgery. As telehealth and remote patient monitoring continue to be major modalities of care during the pandemic, digital tools and app prescriptions will offer enhancement treatment options for those areas and others.
Since then, Phoenix-based Banner Health has been one of the first Cerner customers to put the platform to work within its physicians’ workflows.
“Banner Health is known for providing leadership and embracing technology to improve patient care in this rapidly transforming health care environment,” said Scott Nordlund, chief strategy and growth officer for Banner Health, in a Cerner statement. “Our patients expect to be treated like consumers. Mindful of that expectation, we are utilizing new capabilities and expanding our formulary to make digital health easier for our doctors to deploy and monitor.”
“Xealth offered the ability to integrate with our Epic EHR, sending content seamlessly from the platform, where providers already are used to working,” said Dr. Glenn Updike, medical director of clinical informatics for the women’s health service line at UPMC. “Providers would feel like they are sending materials from Epic, but Xealth would actually be collating information from vendors and UPMC alike into one streamlined package.”
He added: “While patients are not required to download additional apps to access their educational information, one of the successes of our Xealth implementation is our ability to prescribe monitoring apps for patients to better track their individual pregnancy experience,” he continued. “Xealth has allowed us to rapidly scale the prescription of this type of content because of the integration into the EHR.”
ON THE RECORD “As digital tools are increasingly included in care plans, health systems seek a way to organize and oversee their use across the health system,” said David Bradshaw, senior vice president, consumer and employer solutions at Cerner. “Digital health has extraordinary potential to reshape the way we care for patients and, working with Xealth, we are answering the need and helping providers create more engaging and effective patient experiences.”
“Now more than ever, extending care teams to meet patients where they are is critical,” said Mike McSherry, CEO and cofounder of Xealth. “As digital health programs roll out, they should elevate both the patient and provider experience. Cerner, building out a digital formulary, with Xealth at its core, is listening to its strong clinician base by delivering tools to enhance patient care, without adding additional steps for the care team.”
For more than two decades Elsevier, a global information and analytics company specialising in scientific and medical content, has supported clinical research with its electronic data capture (EDC) software. Its latest development is Veridata EDC, a cloud-based platform designed to simplify the process of data gathering, analysis and compliance.
Here, Elsevier’s commercial manager Philip Dunlop talks to Pharmaceutical Technology about the challenges of compliance in clinical research, how COVID-19 is disrupting the sector and how Veridata EDC can help businesses manage compliance.
Q: Why is compliance so important to clinical research?
The simple answer is patient safety, with regulations in place to ensure that everyone participating in a clinical trial conducts themselves ethically and safely. It is also vitally important to learn from past mistakes, particularly in instances where clinical trials were not as safe as they should have been, or where patients were endangered in accidents or by trial organisers acting in financial self-interest.
Even though regulations add significant overheads to a clinical research programme, they do help make it very clear where a failure has occurred and what needs to be done so it never happens again. Veridata EDC has been designed to keep those key safety aspects while reducing time spent on data entry, analysis and compliance.
Q: What makes data compliance such a challenge in clinical research?
Whenever I think about compliance, I’m always reminded of GDPR. The world was shocked by how much extra work was required but in clinical trials, researchers have needed to meet many aspects of GDPR’s high level of scrutiny for many years. Compliance is a difficult thing to get right because regulations are so often set to a very high standard. One of the major reasons for this, in clinical research, is that a study needs to be repeatable.
Q: What compliance hurdles do clinical research companies tend to face?
There are regulations around how data is stored, so obviously that has to be secure. There must also be checks and balances on the person who is entering the data, to determine if they are who they say they are, and that their account hasn’t been compromised. And then there’s the audit trail. If data has ever changed in the system, we know who has changed it, when they changed it and why they changed it. Veridata EDC makes all that easier.
Q: How can Veridata EDC help clinical research projects with their compliance?
Veridata EDC helps businesses meet their compliance requirements in several ways. Firstly, the software has been assessed by NHS Data Security and Protection (DSP), meaning that it is held to a very high standard. It is also ISO 27001-certified, which is the international standard on how to manage information security. It is also compliant with GCP, FDA CFR 21 Part 11, HIPAA and GDPR.
The software is also intuitive, in that it makes running clinical trials, studies and registries easier to manage, and in turn there are fewer opportunities for human error. Its API-programmable design allows interoperability with existing systems and it’s designed with our MACRO system in mind, which has been in operation for more than twenty years. We have taken our experiences over twenty years and updated them for the modern software application, making collecting clinical trials data simpler and more accessible.
Q: How has COVID-19 changed things from a compliance perspective?
COVID-19 has changed the way clinical trials are conducted in that some of the rules seem to have been relaxed or adapted. In the past, some participants would finish a clinical trial and not receive another call for a decade. But COVID-19 has changed this attitude, with patients now constantly monitored over much longer periods. We’ve also seen an acceleration of experimental treatments with shortened timescales within each phase of the study.
The pandemic has also driven collaboration between universities, hospitals and other clinical research institutions. Together, they’ve formed strong partnerships in joint quality research. Regulatory sign-off on new treatments has accelerated too, to cope with the need for a quick, effective and safe response to COVID-19 globally.
Q: What does the future hold for EDC software in terms of compliance?
At Elsevier, compliance is one of the main focuses of the Veridata EDC team. We continually adapt to the requirements of regulators to guarantee patient safety.
As the world of clinical trials changes due to COVID-19 – with patients visiting hospitals and clinics far less often (if at all) for non-critical care, for example – continuing clinical trials has been a challenge. However, with the use of technology, we’ve overcome many obstacles.
We continue to listen to our customers’ problems and respond with easy to use and accessible solutions, that are both compliant and of high quality.Free Whitepaper
Excel vs EDC: The myths and realities of capturing clinical trial data
Many researchers depend on tools such as Excel and Google Forms to capture, manage and analyse trial data. Based on the findings of a 2019 study, Excel is used by 78% of CROs to study startup processes, despite 60% believing that the use of spreadsheets and manual processes should be reduced. There are a number of factors that are pushing the decision not to switch to electronic data capture (EDC) solutions, such as it is perceived as harder to use or it is less secure, but these are myths.
This whitepaper outlines the myths behind manual spreadsheets and how researchers can navigate the truths and falsehoods of excel and EDCs.
Enter your details here to receive your free whitepaper.
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Introduction: Why Is Eye Care for Seniors Important?
As we age, there’s nothing more important than our health, specifically the wellness of our five senses. Vision is no exception to the rule, yet it can be difficult to feel like you’re doing enough for your eye care as you get older. According to the American Academy of Family Physicians, approximately one in three elderly people experiences some type of vision reduction or eye disease by age 65.
Regular, preventative eye care screenings ideally are already a part of your annual or biannual health check-ups. Sure, it’s normal for prescriptions to change. As you grow older, normal changes to vision are bound to happen. Your 20/20 vision may fade. You may find yourself trying on reading glasses at the pharmacy these days. Seeing your eye doctor (ophthalmologist) once in a while may seem like enough of a preventative measure but for seniors, it’s critically important to go the extra mile.
Eye health can affect your holistic physical and mental health. Many seniors experience slips and falls that otherwise could be mitigated by successful eye surgery. Seniors with eye conditions may get back functionality and independence when they seek professional treatment.
For example, successful eye surgery may lengthen the time one can continue to drive a vehicle. Vision is a beautiful part of life, and no one who can have relief from symptoms should settle for less than great eyecare.
It’s important to understand that an eye disease or eye condition does not always indicate that you will experience vision loss. Often, vision loss occurs when symptoms are beyond surgical repair.
In this guide, you’ll learn eye care best practices, discover warning signs of age-related conditions, and know what to expect when you get a preventative eye exam. When you’re armed with knowledge about symptoms and treatment options for eye conditions like glaucoma and cataracts, you’ll make smarter, logic-informed decisions for disease prevention.
What Eye Conditions Should You Look Out For?
There are four critical diseases of the eye that affect seniors:
Diabetic Eye Disease
A cataract is a medical condition where the lens of the eye starts to become visibly cloudy, causing blurred vision and decreased coordination due to lack of clarity.
Specifically, proteins in the eye accumulate and eventually prevent the retina and the lens of the eye from sending clear images to one another. Developing a cataract is considered a standard age-related condition, and the main treatment option available for cataracts is surgery.
A) Early Signs and Symptoms of Cataracts
Cataracts tend to develop slowly over time, but there are common signs beyond cloudy vision you can watch out for.
Double vision or seeing halos
Difficulty seeing in low light
Noticeable changes in prescription or vision, especially if in between appointments with your eye care practitioner
Loss of vibrancy when seeing color
B) Who Is Most at Risk?
Ophthalmologists generally refer to cataracts as an age-related condition of the eye. However, there are some lifestyle and health decisions that can increase your risk of developing cataracts, such as:
Smoking or excessive consumption alcohol
High blood pressure
Sustained, regular, unprotected sun exposure (specifically to UV radiation)
Previous injury to the eye
If you’re not interested in eye surgery and prefer to manage cataracts alternatively, talk to your ophthalmologist about stronger lenses or other ways to live with your cataracts.
However, in most cases, your eye doctor will recommend surgery to remove the cataract so you can return to daily activities and maintain your eye health for longer.
The National Eye Institute reports a 90% efficacy rate, where 9 out of every 10 people who get the surgery have better vision afterward.
Cataract surgery tends to be an outpatient procedure that takes an hour or less. The eye will receive an anesthetic, and the patient will receive a mild sedative to place them at ease.
Macular degeneration is the thinning of the “macula,” which is the part of the retina that makes vision clear and detailed. The Gavin Herbert Eye Institute defines “age-related macular degeneration” (AMD) as progressive eye condition that affects as many as 15 million Americans, with 200,000 new cases each year.
Though macular degeneration is classified as incurable, there are varying degrees of severity. AMD happens gradually, and there are three stages of the disorder:
Early AMD, where vision loss has not yet occurred. Your eye doctor can still discover macular degeneration during this stage, especially if you are getting examined regularly.
Intermediate AMD is where you may experience some vision loss, but perhaps not enough to notice or worry you.
Late AMD, where vision loss is recognized.
A) Early Signs and Symptoms of Macular Degeneration
Symptoms will vary based on the person, but a few things a macular degeneration patient may experience are:
Diminished vision in one (or both) eyes
Difficulty adjusting to changes in light, or work in dim light
Blurred vision, whether when interacting with people or reading
Uncomfortable brightness in situations that aren’t as bright as perceived
B) Who Is Most at Risk?
According to The Mayo Clinic, smoking nearly doubles your risk of developing AMD. Studies suggest that obesity and cardiovascular disease may predispose someone to macular degeneration as well. Your eye doctor will also always take family history and genetics into consideration. Most patients with AMD are over the age of 50.
Unlike glaucoma, there isn’t a medical treatment for macular degeneration. The best measures against AMD are preventative ones, such as following a diet dense in fruits, vegetables, healthy fats, and omega-3s. Quitting smoking or avoiding smoking is another way to reduce your likelihood of macular degeneration.
Protecting the eyes from sun exposure such as harmful UV rays or blue light is another key prevention tool.
Glaucoma is an eye condition where the main nerve to the eye—also referred to as the “optic nerve”—becomes damaged. Vision becomes patchy.
While scientists aren’t completely sure why this happens, glaucoma can lead to sudden and complete vision loss without showing major signs or symptoms. Early detection is the only way to prevent glaucoma from affecting vision. Any vision loss associated with glaucoma can’t be recovered. Glaucoma Research Foundation reported research from The Eye Diseases Prevalence Research Group that in the U.S., more than 120,000 are blind from the condition.
Regular eye exams can make the difference between glaucoma detection and missing a diagnosis. There are multiple types of glaucoma, according to the International Glaucoma Association, such as primary open angle glaucoma, secondary glaucoma, and others.
A) Early Signs and Symptoms of Glaucoma
The tricky part about glaucoma is that it usually doesn’t have symptoms at first, which can make detection difficult. Signs of the disease worsening include loss of peripheral (side) vision. Glaucoma can occur in one or both eyes.
Some other symptoms of glaucoma include blurred or distorted vision, eye pain, loss of peripheral vision, and headaches.
B) How is Glaucoma Diagnosed?
Glaucoma is typically diagnosed through a dilated eye exam, which is painless for the patient.
C) Who Is Most at Risk?
According to the National Eye Institute, glaucoma can affect anyone, but those who are over the age of 60 are the most susceptible. If you have a family history of glaucoma, you’ll want to be extra vigilant about getting regular complete eye exams.
The American Optometric Association reports that African Americans over the age of 40 and Hispanics over the age of 60 present a higher risk of developing glaucoma.
It’s worth noting that glaucoma doesn’t only affect seniors; it can happen at any age. Developmental glaucoma is when newborns or young children experience the disease.
Eye conditions like glaucoma are highly variable, and eye doctors determine specific treatment based on factors like the damage to the optic nerve, corneal thickness, and how much the glaucoma is affecting peripheral vision. There are three main forms of glaucoma treatment today:
Eye drops, which lower the pressure of the eye to lessen optic nerve damage
Laser treatment, also called Selective Laser Trabeculoplasty, creates better drainage in the eye to relieve intraocular pressure (IOP)
Surgery was previously the least common treatment type, but is gaining popularity in newer studies. Glaucoma specialists will recommend surgery when laser treatment and eye drops aren’t helping your symptoms. The typical recovery period for eye surgery lasts between 3-6 weeks.
Diabetic eye disease is also called “diabetic retinopathy,” occurring when blood vessels of the retina are damaged. Poor regulation of blood sugar can increase your risk of diabetic eye disease. The longer you’ve been living with diabetes, the higher your chance of developing retinopathy.
There are two main types of diabetic eye disease:
Nonproliferative Retinopathy, which is where capillaries in the eye form pouches that affect vision and is the most common of the retinopathies
Proliferative Retinopathy, which causes the development of new, weak blood vessels as they try to increase blood flow to the struggling eye.
The best thing patients with diabetic eye disease can do is closely monitor both their vision, diabetes, and health. Working with multiple healthcare practitioners for a holistic practice is critical to slow its progression. Diabetic blindness can occur when the disease is left to its own devices.
A) Early Signs and Symptoms of Diabetic Eye Disease
In the early states of diabetic eye disease, symptoms may be very mild or difficult to connect with your diabetes. You may experience:
Those with patterns of high blood pressure, cholesterol, and blood sugar
Those with diabetes who opt not to get an annual dilated eye exam, which can ward off the advancement of the disease
Milder cases of diabetic eye disease can be maintained with careful monitoring of diabetes and blood sugar. Once blood pressure and blood sugar are controlled for several months, repair can begin to naturally occur, according to Harvard Health Publishing.
More serious cases of diabetic retinopathy mean that the retina has sustained damage that require surgery. Laser treatments, injections of medication into the eye, and surgery on the retina are common treatment options for this category.
The retina can detach from its proper place, so an eye doctor may recommend a laser surgery to shrink the rogue, weak blood vessels causing the detachment. Injection of a medication to the eye that blocks the growth of blood vessels in the eye is another course of treatment that has seen an increase in efficacy according to the American Society of Retina Specialists.
Always ask your eye doctor which treatment is most appropriate for your case of diabetic eye disease.
Wear sunglasses outdoors to protect the eye from harsh UV lights
Wear protective eye gear during activities where the eye may sustain damage or get hurt
Don’t overwear contact lenses, which can cause infection of the eye
If you do wear contact lenses, follow cleanliness guidelines and your eye doctor’s instructions for how often to discard them
We’ve all heard the old wives’ tale at the kitchen table: “Eat carrots to improve your vision!” Unfortunately, it’s not as simple as a carrot a day keeps the cataracts away. Though carrots do contain essential vitamins like Vitamin A, which protects the eye by strengthening its surface.
There are dietary best practices that can better your eye health in the long-term; for example, Real Simple recommends following a diet that’s dense in leafy greens like kale and spinach, squash, and, essentially, sticking to a colorful diet.
Medical News Today also provides dietary suggestions such as increasing intake of antioxidants and omega-3s, as well as recommended daily intakes from the American Academy of Ophthalmology.
Eye Check Up Protocol for Seniors
Why Do You Need an Eye Exam?
Eye exams are the only method we have of identifying early onset eye conditions.
It’s important to get eye exams on a regular basis the same way that you’d put gas in your car if the tank was running low, or visit the doctor annually for a physical exam.
For those over 60 years old, regular eye exams can make a difference in the future health of your eyes and your vision.
How Often Do You Need an Eye Exam?
According to Prevent Blindness.org, how often you should get your eyes checked varies based on your age range and pre-existing health conditions.
Those between 40-64 should get a complete eye exam every 2-4 years
Those 65 years or older should see their ophthalmologist every year
Those with pre-existing eye conditions or concerns about family history should ask their eye doctor how often they’d like to see them
Do You Need An Eye Exam If You Have Good Vision?
The short answer is: yes! Just because you have good eyesight doesn’t mean you may not have underlying conditions that can’t be seen with the naked eye. Regular eye exams, just like going to the dentist or your primary care doctor, are preventative and can identify warning signs of eye disease or vision issues before symptoms appear, or worsen.
What to Expect at an Eye Exam for Seniors
Even if you have good vision, you’ll still need to have your eyes tested. Eye exams can be as simple as the standard inspection ophthalmologists use to prescribe glasses. Early detection is the key to preventing vision loss.
With advancing technologies, videos of different eye conditions make it easier to understand potential conditions and diagnoses. You don’t need to be in medical school to benefit from learning some eye anatomy.
You may hear a lot about corrective surgeries like Lasik, but remember—your ophthalmologist would never recommend an exam or treatment that they truly didn’t believe you need.
Why Do I Need a Dilated Eye Exam?
Dilation is the widening of the pupil to increase light to the eye. Dilated eye exams are one of the only methods of detection for glaucoma or macular degeneration. According to the Mayo Clinic, dilation can also identify health issues like high blood pressure and diabetes. After dilation, which is a painless process, you will generally experience blurry vision or some extra light sensitivity.
If you do have a dilated eye exam during your visit with the ophthalmologist, it’s recommended that you avoid driving or operating machinery for at least several hours until the pupil returns to normal dilation.
Convincing An Elderly Family Member to See An Ophthalmologist
As family members and friends grow older, it may be tricky to convince them that going to the ophthalmologist is necessary—especially if they insist they’re healthy. You may be tempted to take a family member at their word, but eye issues can come on suddenly, and seniors may not realize the severity of their symptoms if they’re treating other major health problems in tandem.
Some don’t have eye insurance, which can add another layer of difficulty, especially if they’re paying out of pocket for all their eyecare. Exams, treatments, and surgeries can add up on top of existing bills and medical necessities.
However, the peace of mind that comes with knowing your vision is well-cared for and addressing any symptoms that arise far outweighs the alternative—missed diagnoses, discomfort, or even loss of vision.
EyeCare America, also known as the American Academy of Ophthalmology, provides information on no and low-cost eye exams.
The [no-follow]National Eye Institute compiled a list of applications and programs to help pay for eye care and low-cost alternatives.
According to Seniors Resource Guide, aging in place is defined as the ability for a senior to live in a home of their choice “safely, independently, and comfortably.” Income levels, physical ability, and age aren’t calculated into this definition. Most people hold this as the gold standard for senior living conditions; however, this isn’t achieved without some preparation and oversight. Keep in mind that 60 percent of senior falls happen in the home. In order to create a safe place to live and prevent a trip to the ER, seniors and their homes will have to undergo some changes. Here are some tips for helping a senior age in place while reducing the risk of falls.
Participate in Physical Therapy Physical therapy isn’t only intended for individuals recovering from an accident, injury, or surgery. This practice has the ability to help anyone improve their posture, range of motion, and stability. For seniors, physical therapy can aid in fall prevention. The reason so many seniors fall at home is due to their weakening muscles and brittle bones. Professionals can help correct these problems by working with seniors to improve their mobility and build up their musculoskeletal strength. When practiced regularly, physical therapy can work to prevent the kinds of falls that could make it impossible for a senior to age in place.
Invest in an Emergency Alert System Although aging in place allows seniors to live their lives independently, there are some inherent risks that come with this decision. It’s always a good idea to have an emergency alert system as a backup just in case something goes wrong. Even if you take all of the necessary precautions, there is still a chance that a senior may suffer from a bad fall. The best way to make sure this fall isn’t serious or life-threatening, you should invest in some sort of device that allows seniors to contact help immediately. The cost of these devices pales in comparison to the security and peace of mind it offers to older adults who wish to age in place.
Keep Lighting Even Throughout the Home Working to reduce the risk of falls doesn’t only involve home modifications. There are more subtle and affordable changes that can help achieve the same goal. For example, keeping a home’s lighting balanced can improve visibility and stability. As we age, our eyes have difficulty adjusting quickly to sudden changes in lighting, whether we go from darkness to light or vice versa. To help combat this problem, seniors should keep all rooms at the same brightness setting. This is especially important in hallways, staircases, and other tight places.
Remodeling Bathrooms for Greater Accessibility Bathrooms are tricky places for seniors to maneuver. And since these rooms are frequented more than once a day, it’s necessary to make some modifications to help reduce the chance of a fall. You can start by adding grab bars around the toilet and bathtub for greater stability and support. Bathtubs and showers with high entrances also pose a threat. If you can afford the renovation, a no-threshold entry makes it much safer and easier for a senior to get in and out. Aging in place is a goal for many seniors who want to maintain their independence, quality of life, and reduce their visits to the ER and doctor’s office. Since seniors are at a high risk of falling and sustaining permanent injuries, it’s necessary to make some lifestyle and home changes to help reduce this tendency and make it possible to age in place comfortably. Photo Credit: Pixabay
Given the risk of chronic disease increases for all of us as we age, it’s not surprising that two out of three older Americans have multiple chronic conditions. These conditions often involve complex treatments, like juggling a handful of different medications. That’s why we put together this toolkit. This medication management guide will empower seniors, caregivers, and family members with helpful information about medication use, storage, organization, and more.
In this guide, you’ll learn how age changes our response to medication, and how to keep track of the medication you’re taking. You can also find out how you can reduce your medication error and drug interaction risks.
Throughout this guide, you’ll find tips for becoming a more active part of your own health care. We believe education empowers you. Of course, it’s important to always check with your doctor or pharmacist before you take any new medication or make changes to your medication regimen, so be sure to ask your healthcare provider how the information in this guidebook can apply to your individual health.
Effective medication management requires teamwork
You’re an important part of your own health care—which is why you should educate yourself and be an empowered consumer. To be successful, you’ll need to partner with your healthcare team to keep them informed and work together to make the right medication adjustments. Instead of prescribing medication once and refilling it for the rest of your life, your doctor needs to be aware of health status changes that may affect or even eliminate your need for certain medications altogether.
“I would also recommend asking if there are any medications which are no longer needed,” says Erin Pitkethly, pharmacist at Robinsong Health Low Carb Clinic. “It is very common for meds to be added on, but it is uncommon for them to be stopped even when they are no longer needed. ”
Adding to the potential confusion, many seniors have a mix of different medicines, some of which are prescription and some that are not. Even if it’s just a medicine you take for a temporary condition, it’s important to read labels and understand why you’re taking every drug.
Regardless of the type of medication, it should have a label with basic information that can serve as your guide and starting point.
Reading medication labels
As you review your new prescription, be sure to read the label carefully for information on dosage, timing, interactions, and other important medication management details.
Typically, a prescription label has eight parts and types of information. Keep in mind that your own prescription labels may look somewhat different, but they will generally have similar content listed for you to reference. Learn to recognize these parts on your own medications:
Pharmacy information: Name and address, phone number, and other key details about the pharmacy that filled your prescription.
Your information: Name and address of the person the drug is prescribed to.
Prescribing doctor’s information: Physician or healthcare provider’s name and contact information are also included.
Drug name and strength: Medicine’s brand, chemical, or generic name along with the strength of one unit of the prescription in a measurement such as milligrams (mg).
Instructions: Instructions might read “Take one tablet twice daily, morning and night, by mouth” and explain how and when to take the medication. Always read the instructions section carefully for any new medication, and ask your doctor or pharmacist if you have questions.
Prescription information: Date your medication was prescribed, the date your medication was filled by a pharmacist, the number of pills or doses provided, how many times your prescription may be refilled, when your medication expires, and the number your pharmacy assigned to your prescription.
Pharmaceutical manufacturer information: Name of the company that manufactured your medication and a physical description of the drug. If it’s a generic version of a brand-name drug, the name of the branded counterpart may also be listed here.
Federal caution statement: Prescription warnings such as “Caution: Federal law prohibits transfer of this drug to any person other than the patient for whom prescribed.” Remember, you should never take someone else’s medication even if you’ve taken it before. It’s dangerous to take medicine that’s not prescribed for you and doing so could put your health at serious risk.
An over-the-counter medication you can purchase without a prescription has a different label, called a drug facts label. Here’s what that usually includes according to U.S. Food and Drug Administration (FDA) regulations.
Active ingredient(s): The therapeutic ingredients within your medication and the amount in each dose.
Uses: Any symptoms or condition the medicine is designed to treat or prevent.
Warnings: This section tells you when you shouldn’t use this medicine, lists possible side effects and drug interactions, lists any conditions that may require a doctor’s advice before taking the medicine, tells you when you should stop taking the medicine and see a doctor, and provides other critically important information about taking the medication. Read this section carefully. If you’re concerned about anything you see, talk to a healthcare professional.
Inactive ingredients: Other substances added that don’t have a therapeutic effect, such as colors or flavors.
Purpose: The medicine’s category or action is included (for instance, antacid or pain reliever).
Directions: Dosage information may offer different doses for different ages or symptoms. It may also direct you to ask a doctor.
Other information: Anything else the manufacturer wants you to know about the medicine. It may include information about how to store the drug. It may also list how much of an ingredient (such as calcium) the medication contains.
When you get a new medication, take a look at the label and jot down any questions you have for your healthcare provider. If you’re using medication reminders, add this prescription so everything is ready for the first day of treatment. If you encounter anything unusual or confusing on your label, check with your pharmacist.
Do keep in mind that your prescription is tailored to your health. Even if a friend or family member is taking the same medicine, your medication may work differently for you. This is one reason why it’s absolutely essential to refer to your healthcare team for medical advice and information instead of other sources (like the internet) meant for a broad audience. Only your healthcare provider can give you relevant guidance for how to take medications safely.
Aging changes our responses to medication
As we age, our bodies change how they interact with medications. Even very healthy people might respond differently to medications than they did in earlier years. Getting the most from your medications is possible with close cooperation with your healthcare team.
How does aging change the body’s reaction to pharmaceuticals? Here are few possible changes.
Metabolism: Your body processes each medication at a different rate. Over time, your metabolism of a particular drug may speed up or slow down. This can increase the risk of side effects or decrease the effectiveness of the drug.
Brain and nervous system: Many drugs impact the central nervous system (CNS) directly and aging can change this process. For example, seniors are more susceptible to the CNS effects of drugs like benzodiazepines and antidepressants.These effects can include increased dizziness or drowsiness for some people.
Kidney and liver function: Since these organs are responsible for filtering and cleaning, any age-related changes to kidney and liver function can adjust how well your body is able to remove medicines and toxins.
Weight changes: Many people gain or lose weight as they experience appetite changes. Some drugs are processed and distributed differently throughout the body depending on your body weight.
“Elders have less tolerance for medications than younger adults,” says Elizabeth Landsverk, MD, a board-certified geriatric doctor and founder of ElderConsult Geriatric Medicine. Dr. Landsverk notes that these changes in how our bodies process medication can lead to different side effects. The timing of new side effects may provide clues to the root cause, however. “If a symptom starts after a new medication, it’s likely a side effect from the new meds,” she says. “Seek the advice of a doctor or pharmacist, they will likely change the prescription. Do not change dosages or try a different medication based on something you read on the internet.”
Aging may also change the dosage you need before your medications are effective. So your healthcare providers should regularly reevaluate the medicines you’re taking to see if new prescriptions are necessary. According to Dr. Landsverk, many seniors gradually lose their appetite and experience weight loss that impacts medication dosage.
If you notice anything different or unusual during treatment, it’s important to bring this up during your next conversation with your doctor or pharmacist.
Medication safety tips and dosage information
Knowing how to manage your medications can be the key to benefiting the most from your treatments. Medicines have the potential to make life-changing improvements to your health. At the same time, your medications are only helpful if you know how to use them correctly.
Ultimately, your doctor or personal healthcare provider and your pharmacist should be your guide on how to use and track your medications. When in doubt, be sure to check with a qualified health professional. Only your healthcare provider or pharmacist knows how your individual health profile, health status, and history impact your medication needs.
Medication safety also means knowing where many seniors go wrong with medication management and how you can avoid those mistakes to protect yourself.
Common medication mistakes and how to avoid them
“The two key challenges that seniors face are polypharmacy (taking lots of pills) and remembering to take them,” says Dr. Ceppie Merry, who holds a Ph.D. in pharmacology. “It can be really complex to remember what to take and when to take them.” Merry also adds that any cognitive decline or complex conditions seniors have can make it even easier to make mistakes when managing your own medications.
Medication errors can have serious consequences for your health. Many people accidentally take the wrong dose, miss doses, or take their medications incorrectly. Don’t panic if you use your medication incorrectly, but do call your doctor if you’re concerned. (If you are experiencing a life-threatening emergency, call 911.) The adage “better safe than sorry” applies here. This is why you should always keep important phone numbers like your doctor’s contact information nearby in case you need to call their office.
To stay on track with taking your medicines, it helps to have a medication strategy. Here’s what you can do to reduce your risk of a serious medication error.
Take medications consistently: Always take your medications at a consistent time. It also helps with consistency if you can associate taking the medication with a specific event like a meal. For instance, if you take a pill with breakfast at 8 a.m. one day, try to always take that medicine around 8 a.m. when you eat.
Use reminders: Forgetful about taking your medicine? Consider using a reminder app or setting an alarm for each dose.
Prevent interactions: Many medicines can’t be taken together or with specific foods or supplements. A lot of medications interact with citrus fruits, for example. Your pharmacist can help you identify any diet or medication list changes you need to make.
Get a medication review: With every new prescription, ask your pharmacist to review your medication and supplement list. Your healthcare provider may recommend ideas for how to take them together safely. Also, see if you’re eligible for your pharmacy’s medication therapy management (MTM) program. Your pharmacist will sit down with you for a comprehensive medication review at no additional cost to you.
Ask your doctor or pharmacist: If you’re prone to forgetting doses or taking an extra pill now and then, ask your healthcare professional what you should do if this happens. Sometimes, it’s not a big deal. Other medications might cause a serious interaction, side effect, or other serious damage to your health.
Read the literature and instructions: If your medication came with written information or your healthcare provider included instructions, be sure to read these carefully. If anything is unclear, don’t hesitate to make a note of it. Call your doctor and ask for clarification before you start taking your medication. It’s a good practice to read the instructions before you leave the pharmacy, so you can ask the pharmacist.
Have trouble remembering your medications? Here are a few ideas to try.
Use a dosage reminder or pill reminder app: Consider using a smartphone pill reminder app to remind you to take medication.
Set an alarm: Set an alarm for times during the day that you take your medicine. Be sure to keep track of what you’re supposed to take, too.
Make a list: Write down a list of your medicines and the time you take them so you can easily refer back to it later.
Ask for help remembering: If a family member, friend, or caregiver can help you remember, ask for their help.
Add it to your calendar or planner: Write down reminders in your calendar or planner.
Use sticky notes, send yourself emails, or post other reminders: Think about how you manage your time and how you use reminders. Choose a method that works best for you.
Use a pill organizer for medication storage: At most drugstores, you can buy an inexpensive pill organizer with compartments for different times and days. This works best if you take a small number of medications every day.
Keeping your medications organized may also prevent mistakes. Here’s how to get started with tracking and organizing medicines.
Organizing your medications and medication storage
Managing your medications is easier when you can fully account for everything you’re taking. With the help of a healthcare professional (if needed), gather all the medications and supplements you’re currently taking and start organizing them.
Consider these tips to help with medication management.
Create a medication list (if needed, use a medication list template): Write the name of each prescription you’re taking on the list. You can also add information about how often you take each dose and for what condition, but the important thing is to start with a complete list of drug names and doses so your healthcare provider knows where to look and what questions to ask.
Start with supplements: Since so many people don’t consider supplements to be medications, it’s not uncommon for some seniors to take supplements that interact with medications prescribed by their doctors (or contain unhealthy ingredients). Bottom line—your doctor needs to know. Make sure your personal medication list template covers supplements.
List all OTC (over-the-counter) medicines you take: Many seniors take drugstore medications that are sold over-the-counter without a prescription such as acetaminophen (the generic version of Tylenol) for pain relief or calcium carbonate antacids for managing heartburn.
Keep medication packaging: Hold onto the original boxes and containers for your medications so you can quickly refer to the package or label if needed. Package inserts or patient information leaflets are included with the medication so be sure to keep it with the original packaging. A shoebox-size plastic storage bin with a lid or a gallon-size plastic bag are great ways to store packaging and information for medicines you’re currently taking. Always store your medicinesand packaging away from where pets and children can reach them, even if your medicines have child-proof caps.
Pick one pharmacy: Ideally, you should only use one pharmacy so your pharmacist can easily review your other prescriptions and provide you with relevant information about contraindications. If you must use more than one pharmacy for any reason, be sure to provide complete information about the medications you’re currently taking, and make sure the pharmacist has access to this information.
As you organize your medications, don’t forget to check expiration dates and remove medicines you no longer take. Ask your doctor if it’s okay to discard old medication documentation.
Reviewing medicine with your pharmacist or doctor
Periodically, you should have a medication review appointment with your doctor. During these appointments, you’ll want to keep your doctor informed about how your treatment is going. This is also a good time to ask questions and express your concerns. Highlight any side effect you haven’t told your doctor about yet, and mention any frustrations or concerns you have with your medicines. Don’t forget to bring a list of questions with you. Since many doctor appointments are short, make the most of your time together by preparing a list of topics and questions beforehand.
By educating yourself and managing your medications properly, you may get better results from your treatment and you may avoid some of the common risks of using medicines. Your healthcare team is there to help you. Work closely with them and become your own healthcare advocate.
Your body goes through a number of gradual changes as it ages. Your sense of smell and taste are altered, the body loses some of its strength and flexibility, and memory and cognition may slowly diminish. Lifestyle changes and adaptations are often necessary during the later years, but your basic needs stay the same. You still need to exercise, eat nutritious food, find ways to keep your mind active, and pay close attention to your health.
Nutrient-Dense Foods As your sense of taste changes, your food preferences may shift. Foods you once ate with gusto may have lost their luster., but the need for a diet rich in nutritional food remains. Your diet still needs to include vegetables and fruit (the more colorful the better); beans, seeds, and nuts; low- fat dairy, including milk, cheese, and yogurt; protein-rich meats, including seafood, poultry, and eggs; and whole grains, such as whole-wheat bread, brown rice, and oatmeal. Mindful Chef and Hello Fresh, two of Britain’s leading meal delivery services, offer delicious foods made from healthy ingredients, a valuable resource if cooking every day has become too difficult. If you’re looking for some easy and healthful recipes, why not enjoy a breakfast of scrambled eggs over red potatoes and a salmon wrap for dinner (salmon in a whole grain wrap with tomatoes and avocado)? Or, if you’re into really simple recipes, just whip up a can of pinto or black beans and serve with brown rice, oats, or barley. Technology Smart home technology is making it easier for older adults to age in place and live safely in their homes. For those with hearing impairments, smart doorbells allow you to see who’s at the front door, whereas external security cameras help keep your home secure from intruders. These high-tech advantages also let you check on your house from wherever you happen to be, and indoor cameras make it easy for family members to keep an eye on you.
Senior-Friendly Exercise Exercise is an important factor in one’s health no matter what age you happen to be. Even if mobility limitations make it difficult to engage in physical activity, there are many senior- friendly exercises that can be done easily in the comfort of your own home. Just raising your arms and legs slowly can help strengthen weakened limbs, and all you need to do toe raises is a straight-backed chair to lean on. If walking is your favorite form of exercise, start a walking group with friends so you can enjoy some social interaction as you exercise. However you like to exercise, bear in mind the National Health Service’s recommendation that seniors need to do two types of physical activity every week, involving both aerobic and strength exercises.
The NHS and Seniors The National Health Service works to help seniors remain as healthy and independent as possible, for as long as possible. That includes using early identification and self-management assistance to help reduce the period of time an older adult spends in ill health. Check out this online resource on healthy aging. The NHS emphasizes personalized care planning and provides information on maintaining a safe home environment. Older adults who suffer from Alzheimer’s disease or dementia can find support through Britain’s Alzheimer’s Society. Growing older doesn’t have to mean giving up on an active and enriching life. Your body may have changed, but you don’t have to settle for a sedentary lifestyle. The secret to good health remains much the same for seniors as it always has: exercise, eat a nutritious and well-rounded diet, and pay careful attention to one’s health and in-home safety. It’s a time to try new things, to see new places, and make (or renew) friendships.
Seriously Simple, and Smart, Ways to Plan Ahead for Long-Term Care
Why do you need to plan ahead for long-term care? If you have no clue how to answer this and you are planning for retirement, you could be in for a major financial surprise. Long-term care is expensive and most everyone needs it at some point, so it’s important to take these long-term care planning tips to heart before you finalize your retirement plans.
Be Aware of Medicare Limitations
If you’re looking forward to retirement, you may think you don’t need to plan for long-term care because Medicare will cover it. This is a huge mistake, however, because Medicare offers basically no coverage when it comes to paying for a nursing home, an assisted living home, or in-home care. That’s because this kind of care is considered custodial, rather than medical, and therefore is not included in the coverage that most seniors receive from Medicare. With long-term care, you are more likely to need help with daily tasks such as bathing or dressing, and this is why more involved care is necessary. Medicaid might cover some costs if you’re eligible, or you may be entitled to assistance from the VA if you have served in the military or are an eligible dependent. If neither of these is an option, you will need to come up with other ways to plan for care. However, try not to stress yet. If you are planning well ahead of time, you have some ways to prepare yourself for long-term care.
Make Healthier Changes to Your Life
There’s really no surefire way to prevent the need for long-term care. According to statistics, you may need long-term care at some point in your adult lifetime. You can, however, try to beat the odds by making some simple changes to your life and home. Falls can be a source of debilitating injuries as you get older. Those tricky stairs could lead to a serious fall in the future, so take steps to help yourself age in place at your own home. If you do have steps or stairs, have some secure railings installed on either side to provide support and reduce your risk of falling. You’ll also want to think about fall-proofing your bathroom as time goes on, by installing grab bars in slippery areas. Another simple change you can make is to add better lighting throughout your home. You can swap out to brighter bulbs or add fixtures to ensure areas are lit evenly. Finally, don’t underestimate the impact lifestyle choices can have on your long-term health. Regular exercise and diet can reduce your risk for serious conditions such as dementia and Alzheimer’s disease and give you a chance for a more independent life.
Research All Your Options for Paying for Care
Paying for long-term care can be a real financial burden, especially if the need comes up unexpectedly. Most American seriously underestimate long-term care expenses, which can run upwards of $100,000 per year if you need to stay in a nursing home. However, you have a decided advantage by choosing to plan ahead. For one, you can research just how much care could cost you, as well as how exactly you can pay for it. If you are in your 50s, for example, you may be able to snag long-term care insurance for much lower monthly payments than someone who is only a few years older than you. When long-term care insurance is not feasible, there are other financial avenues you can include in your long-term care plans. You could pre-pay, plan to receive care from a loved one, or you can get roommates to offset housing costs and allow you to tuck away more funds for care.
Planning for long-term care doesn’t have to be a headache. If you start planning early and going over all your options now, you will have more options to choose from and end up with less stress in the future if you do need some form of long-term care. So, don’t forget to add long-term care to your list of essential retirement planning steps.