A Hard Pill to Swallow: An SLP's Guide to Managing Medications and Cognitive Changes
A 68-year-old man named Gus embarked on a frustrating journey over three years, seeking help from twenty different doctors to address a myriad of health conditions and the unpredictable side effects that accompanied them. By the end of this arduous journey, his cognitive abilities had deteriorated so profoundly that his daughter lamented how he could no longer engage in even the simplest conversations with his delighted five-year-old granddaughter, who would cling eagerly to his hand and gaze up at him with innocent expectation.
In a similar but equally heart-wrenching tale, an elderly woman struggled under the weight of 27 different prescription medications. Her cognitive decline was so severe that one moment she would be sitting upright in her chair, and the next she would slip silently to the floor, oblivious to her surroundings. This alarming descent into confusion led to a misdiagnosis of dementia. However, the truth was far more insidious: she was suffering from drug-induced cognitive impairment—a fog that clouded her once-vibrant mind. It wasn’t until a compassionate team of attentive healthcare providers took the time to meticulously review her extensive list of medications, eliminating some and adjusting others, that she finally began to reclaim her life. Miraculously, she transitioned from a state that resembled late-stage dementia back to complete independence, as if she had been released from a medically-induced prison. This transformation underscored the vital importance of vigilant medication management—her escape made possible only by the keen eyes of professionals who recognized the missing key to her health.
These poignant stories serve as powerful reminders of the devastating effects that medication-induced cognitive impairment can impose on individuals and their loved ones. Yet, amidst the challenges, there is hope. Speech-Language Pathologists (SLPs) can offer invaluable support in managing and mitigating these critical issues.
The SLP's Role
ASHA's Code of Ethics and Scope of Practice emphasize the importance of SLPs' competence in reviewing medical records and collaborating with the interdisciplinary team to provide quality care. This includes recognizing and addressing potential medication-induced cognitive changes.
Why So Many Medications?
Several factors contribute to the rise of polypharmacy:
Aging population: Older adults are more likely to experience health conditions requiring medication.
Increase in chronic illnesses: These conditions often require long-term medication use.
Cultural reliance on medication: Quick fixes and pressure to manage complex conditions can lead to over-prescription.
The Dangers of Polypharmacy
The more medications a person takes, the higher the risk of adverse drug reactions and interactions. These can lead to a cascade of further prescriptions, creating a vicious cycle. Older adults are particularly vulnerable due to age-related changes in how their bodies process medication.
What Can SLPs Do?
Identify high-risk patients: Those who are frail, elderly, have baseline cognitive deficits, multiple medical conditions, and are on polypharmacy.
Learn about medications commonly associated with cognitive changes: This includes anticholinergics, antipsychotics, benzodiazepines, and opioids.
Track cognitive changes and communicate with the medical team: Use the MED guideline (Monitor, Excavate, Discuss) to address potential medication-induced cognitive impairments systematically.
Interdisciplinary Collaboration
SLPs are an integral part of the interdisciplinary team. Our unique perspective on patients' cognitive function allows us to identify and communicate potential medication-induced changes. We are perfectly positioned to make a huge difference for patients with medication-induced cognitive impairments.
Remember:
Polypharmacy is a serious issue, especially for older adults.
Many medications can cause cognitive changes.
SLPs have a responsibility to recognize and address potential medication-induced cognitive impairment.
By staying vigilant and working collaboratively with the interdisciplinary team, SLPs can help to improve the quality of life for older adults affected by polypharmacy. It takes time, effort, and a colony of dedicated teammates, but it can and needs to be done.
Want to learn more about this topic? Check out my new course…
Here's what you'll gain:
Become a Medication Detective: Learn to recognize the common medications that can cause cognitive changes, and uncover the hidden culprits often overlooked.
Develop a Plan of Action: Gain practical strategies to address these medication-induced issues with the prescribing team.
Advocate for Your Patients: Empower yourself to champion your patients' cognitive well-being and ensure they receive optimal care.
This course goes beyond lectures:
Real-life Case Studies: Analyze real patient cases to solidify your understanding and apply your knowledge.
The MED Guideline: Incorporate a clear framework for addressing medication-induced cognitive impairments with the medical team that will help your patients immediately.
Direct instructor support: I'm here to answer your questions and provide guidance throughout the course.
Money-back guarantee: If you don't find this course valuable, you can have your money back. No questions asked.
Ready to protect your patients' minds? Get a taste of the course with a free lesson: A Hard Pill to Swallow
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