Saturday, January 30, 2010

Aging Parents: One Size, Of Course, Doesn't Fit All

We all know that one size doesn't fit all. Does that relate to medications? Does a big man take the same dose of medicine (the dose marked "For Adults" on the bottle) as an 80-year-old woman or a petite 50-year-old woman? Do older adults--aging parents whose whose physical bodies have often shrunk since their younger days-- require the same "adult dose" as when they were younger adults?

Being a very instruction-abiding person (I worked in schools remember), I've mulled this question over many times since my husband is big and I am rather petite. Taking the "adult dose" on a bottle of nonprescription pain killer works for him. I don't need that much. I have learned to take less.

Thus I read with special interest the Tuesday, January 26th, New York Times Science Section, "Vital Signs" column. It had a segment, "Tailoring Drug Doses to a Patient's Size," that to me is such common sense I'm surprised someone didn't put it in major headlines a long time ago. &st=cse.

Now we read that two doctors, one in Athens, Greece the other a professor of medicine at Tufts Medical School in Boston, have addressed this subject in a medical journal, The Lancet.

In my November 3 post, "Old Parents vs. Vacation Plans," I write about my unplanned return to the US from Italy because my mother was supposedly dying. I was able to get her quickly to a geriatrician who ordered lab work and x'rays while we waited at the teaching hospital. It turned out, after looking at the results and the medication list I brought, that medications--too much and some unnecessary--caused the seemingly urgent problems.

From then on, whenever medications were discussed, I respectfully mentioned Mother's small size and low weight and asked about the minimum dose she could take and still get the necessary results.
Actually I discuss this with my physicians today. And I know they take my relatively smaller size into consideration, especially if an antibiotic is involved.

The "one size doesn't fit all" concept seems very important when it involves aging parents and their medication. Yet I think it has merit for adult children too. If we don't stay healthy and so we can be there for our aging parents, who will be?

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