For more information about the author, click to view their website: Dr. Don Murphy - Geriatrician
The
greatest challenge for all who practice geriatrics is reducing polypharmacy,
the addition of medications that either provide no benefit or cause harm to
seniors. Millions of seniors end up on
many medications that are not helping them and could be causing side effects. Geriatricians are the experts in what we call
de-prescription, cutting down on unnecessary medications.
The key reasons seniors end up on too
many medications are the following.
First, all physicians, including young geriatricians (as I was 30 years
ago), have hope that newer medications will actually benefit our seniors. The four medications we have used to treat
dementia turn out to provide no benefit at all.
We can’t appreciate this until we have been in practice for decades and
know how to review all of the studies that suggest there might be some marginal
benefit. Also, one must practice for many
years to understand how all medications, including over-the-counter
medications, can cause difficult to diagnose side effects. For the dementia medications, we had hoped
that they either alleviated symptoms, delayed the onset of dementia, or slowed
the progression of dementia. It takes
years of practice and experience to realize that these medications fail to help
our seniors.
Second, many primary care clinicians
(say, family medicine physicians) and specialists (say, cardiologists) tend to
overvalue medical benefit for medications used for the most common conditions. The best example would be blood pressure
medications. All geriatricians know that
we approach frail seniors differently than we approach a robust 70-year-old or
a healthy 45-year-old. Many clinicians
will treat everyone the same, such as trying to keep the systolic blood
pressure around 120 and the diastolic pressure around 80. Often, these pressures are simply too low for
frail seniors and even for some robust seniors.
The medications can cause lightheadedness, falls, and fractures (to name
just a few side effects).
Third, clinicians in traditional medicine
often fail to appreciate the value of alternative healing and the value of the
placebo effect. Let’s return to
medications for dementia. In recent
years, we haven’t seen any commercials for the four medications I referred to
above. We’ve seen many advertisements
for Prevagen and Neuriva. These
medications have not been studied extensively like the four that required many
studies and FDA approval. If seniors
feel more comfortable on these OTC medications, it’s probably from the placebo
effect. That is, they feel that they are
at least doing something to counter the onset or progression of dementia. The cost is affordable, and these individuals
don’t need a prescription from their doctor.
If the individual thinks Prevagen isn’t helping, or may be causing side
effects, he or she can stop it at any time.
They don’t need permission from their physician.
Fourth, the pharmaceutical industry has
specialized in direct-to-consumer advertising.
These are entertaining and convincing ads. It doesn’t matter what disease condition we
are considering. Every expert in
marketing knows that these creative, subliminal messages get through….and
result in more prescriptions.
Before sharing my suggestions for cutting
down on your medications, let me share a story about Elsie, a 90-year-old woman
I took care of in 1992. She was feisty
and funny. She was on the 6 medications
our team had prescribed for her. Benign
positional vertigo was one of her conditions.
One of my most memorable clinic visits was the one when Elsie reported
that she “followed that Harvard newsletter you gave me, Dr. Murphy, and it
worked.” She did this complex maneuver
all on her own, and it eliminated her dizziness. Then she added, “oh, and by the way, doctor,
I threw all those doggone pills in the garbage….and I feel great now.” So be
it. This approach worked well for Elsie,
but I don’t recommend it for others.
Here is what I suggest.
First, find the courage to question your
clinicians. It’s not easy when you have
put so much trust in your doctor’s recommendations. Try the soft approach. For example, you could say, “Doctor, I’m on a
lot of medications and I worry that one of them might be causing some
problems.” You could mention a symptom you’ve been wondering about. Then you ask, “could I cut down on the dose
of one of these medicines to see how I do?”
If your physician agrees with this trial of dose reduction, you could ask
which medication he or she would select to reduce the dose.
Second, you continue with the honest
communication you have established. You
don’t need to let your doctor know how you are doing a week or two later. However, you should report that you are doing
fine by calling the office staff that can document your success with the dose
reduction. Believe it or not, you are
educating your primary care office about the value of dose reductions.
Third, when you have more confidence in
the dose reduction approach, you can specify which medication(s) you would
eventually like to discontinue. You can
share feedback you’ve received from family members and friends or from the
research you or they have done.
Ever since the 1950’s we have been
moving from a paternalistic approach to health care (i.e., the doctor decides
everything for your health) to a more patient-centered approach to health care. This makes sense. You know what’s best for your overall health,
including physical, psychological, social, spiritual, and any other dimensions
of health. Your clinician’s job is to
reflect your preferences. Dose
reductions of useless or harmful medications is just part of this evolution in
health care.
Dr. Don Murphy, MD, FACP
The article was written by Dr. Don Murphy, Geriatrician and Hospice Physician who plans to run for Governor of Colorado. He can be reached at murphdoc@comcast.net, or calling 720-490-6757, or his main YouTube channel, TheCrazyMurphys5560.
As we age, taking medications often becomes a part of everyday life. Whether it's for managing chronic conditions like high blood pressure, diabetes, or arthritis, these medications are necessary to keep us healthy. But for many seniors, the cost of prescriptions can be a major concern. With a fixed income, paying for medications can sometimes feel like a financial burden.One solution that has been helping seniors save money is something called Cost-Plus Pharmacy. Let us explain what Cost-Plus Pharmacies are, how they work, and how they can make a big difference in lowering medication costs for seniors.What is a Cost-Plus Pharmacy?A Cost-Plus Pharmacy is a type of pharmacy that operates a little differently from the typical drugstore you might be familiar with. In most pharmacies, the cost of medications is marked upsometimes by a lot. This markup helps the pharmacy make a profit, but it also means youre paying more for your prescriptions than the pharmacy actually paid for the drugs.On the other hand, a Cost-Plus Pharmacy sells medications at a price thats closer to what they paid for them, plus a small, reasonable markup. The idea is to be more transparent and fair about pricing. This can help lower the price you pay for your medications, which is great news for seniors, especially those who take multiple medications.How Does a Cost-Plus Pharmacy Work?To keep things simple, think of it this way: lets say a pharmacy buys a medication for $10. A traditional pharmacy might sell that same medication to you for $20, marking it up by $10 in order to make a profit. But in a Cost-Plus Pharmacy, instead of doubling the price, the pharmacy may only add a small amountmaybe $2 or $3.So, instead of paying $20 for that medication, youd only pay $12 or $13. That small difference can make a big impact when youre taking multiple medications each month.One of the best things about Cost-Plus Pharmacies is that theyre open about their pricing. They usually show customers exactly how much they paid for each medication and how much they are adding as a markup. This transparency helps you understand exactly what youre paying for, making it easier to see that you're getting a fair deal.Why Is This Important for Seniors?Many seniors take several medications to manage chronic health conditions. The cost of these medications can quickly add up, and its not always easy to find affordable options. For those on a fixed income, like many seniors, paying for medications can become a financial struggle.For example, according to the Centers for Medicare & Medicaid Services (CMS), the average senior spends about $1,200 per year on prescription drugs. That number can be even higher for those who take multiple medications regularly.Medicare Part D can help with some of these costs, but it doesnt cover everything. Plus, there are gaps in coverage, like the "donut hole," where seniors must pay full price for their medications after reaching a certain spending limit. This leaves many seniors paying high out-of-pocket costs for their prescriptions.Cost-Plus Pharmacies, such as Blueberry Pharmacy, aims to fix this problem. By offering lower prices on medications, these pharmacies can help seniors save money, making it easier to afford the medications they need without breaking the bank.How Can Cost-Plus Pharmacies Save Seniors Money?There are several ways that Cost-Plus Pharmacies help seniors save on their medications.1. Lower Prescription PricesThe biggest advantage of a Cost-Plus Pharmacy is that medications are sold at a lower price than what youd find at a traditional pharmacy. Rather than charging extra fees or high markups, these pharmacies focus on offering a fair price. For example, a medication that may cost $50 at a typical pharmacy could be priced at $35 or less at a Cost-Plus Pharmacy. Thats a savings of $15 on just one medication! If you need several medications, these savings can really add up over time.2. No Hidden FeesAt many regular pharmacies, you might find that your prescription comes with extra chargesdelivery fees, processing fees, or other hidden costs. These fees can make your final bill higher than you expected. Cost-Plus Pharmacies are often more transparent about their pricing. Theyll give you an exact breakdown of the cost, so you know what you're paying for. This way, you avoid any unpleasant surprises when its time to check out.3. Affordable Generic MedicationsGeneric medications are often much cheaper than brand-name drugs, but not all pharmacies carry affordable generics. Many Cost-Plus Pharmacies focus on offering a wide range of generic medications at lower prices. For seniors, choosing generic drugs is one of the easiest ways to save money without sacrificing quality. Cost-Plus Pharmacies make it easier to access these more affordable options.4. Special Programs for SeniorsSome Cost-Plus Pharmacies offer special programs to help seniors save even more money. For example, they may have senior discount programs or loyalty cards that give you even deeper discounts. Some pharmacies also offer free home delivery, which can be a huge help for seniors who may have trouble going to the pharmacy in person.5. Fewer Prescription ErrorsPrescription mistakes can be costlynot just in terms of money, but also in terms of health. If a pharmacy gives you the wrong medication or makes an error on your prescription, you may need to go back to correct it, which can add more time and money to the process. Because Cost-Plus Pharmacies tend to offer more personalized service and fewer customers, they often have fewer mistakes and are able to fill prescriptions more accurately. This can save you both time and money in the long run.As the cost of prescription medications continues to rise, finding ways to save money on those medications is more important than ever. For seniors, a Cost-Plus Pharmacy such as Blueberry Pharmacy can be a great option to lower prescription costs without sacrificing quality or service.By offering lower, more transparent pricing, Cost-Plus Pharmacies are helping seniors save money on the medications they need. Whether youre looking for a more affordable pharmacy in your area or you want to try an online option, these pharmacies can make a real difference in your healthcare expenses.If youre a senior or care for one, its worth looking into a Cost-Plus Pharmacy such as Blueberry Pharmacy. With a little research or by contacting us directly, you could be saving money on your prescriptions every month, making it easier to stay healthy without stressing about the cost. Reach out to us today!
The rise of Artificial Intelligence (AI) has brought incredible innovation to our lives, from facial recognition unlocking phones to smart assistants handling our schedules. However, AI also poses significant risks, such as phishing emails, deepfake videos, and voice simulations impersonating individuals. Seniors must be informed of AI fraud to prevent them from falling victim to such schemes.Scams to Be Aware of in 2024As AI technology advances, scammers are finding new ways to develop more intricate and believable schemes. Its important to stay updated on these emerging tactics to protect yourself and your loved ones. These are some of the most prevalent AI scams to watch out for in 2024:AI-Generated Email PhishingAI-generated phishing emails are designed to look incredibly convincing, often mimicking legitimate communications from trusted organizations. The sophistication of AI means that these emails can include personalized details, making them even harder to detect. For example, a phishing email might use an email address like boss@cornpany.com instead of boss@company.coma subtle but critical difference in spelling.To stay safe, always verify the senders email address, look for any inconsistencies in the message, and avoid clicking on suspicious links. If you get an invoice for something you are confident you did not purchase, dont click on the link or attachment; instead, go directly to your credit card account to ensure there are no fraudulent purchases. The same applies to money requests from apps like Venmo and PayPal; go directly to the source without clicking any links.Chatbot FraudChatbots have revolutionized customer service, but they can also be used maliciously. Fraudsters use AI-powered chatbots to engage with victims, extract personal or financial information, or direct them to phishing websites.Red flags for scams include urgent requests, offers that seem too good to be true, or unusual language or grammar. A good rule of thumb is to not share sensitive information like passwords or credit card details through chat interfaces.Deepfake ScamsDeepfakes are AI-generated audio and video clips that make it appear like someone is saying or doing something they never actually did. These can be used to create convincing scams. For example, a common scam involves someone calling and claiming to be a loved one in an emergency and needing money, often mimicking their voice. Instead of panicking and sending the money, you should verify the persons identity, usually by calling them directly.If you receive such a call, look for inconsistencies in video or audio quality, unusual behavior, or other red flags.Investment ScamsFraudsters may use AI to generate convincing investment opportunities, complete with fabricated data and endorsements from seemingly reputable sources. Be cautious of high-pressure sales tactics urging you to make a quick decision, and thoroughly investigate any investment opportunity and the company behind it. Be wary of offers that promise unusually high returns with little risk.If you suspect an investment scam, immediately report it to regulatory authorities and financial institutions like the SEC or FINRA.Social Media ManipulationAI can generate and spread misinformation on social media platforms, influencing public opinion and manipulating users. This can include fake news stories, fraudulent advertisements, and the impersonation of trusted figures.Limit your privacy settings on social media and only accept requests from known individuals. Always verify the credibility of the sources and accounts you follow as well.At The Oberon House in Arvada, CO, we always prioritize your safety and well-being. Your security is our top priority. Contact us today to learn more 303-420-7258.
Scammers are increasingly adopting new methods to deceive unsuspecting victims, especially older adults. One of the latest threats is AI-generated voice fraud, also known as vishing (voice phishing). These scams use sophisticated AI technology to create highly realistic voices that mimic trusted individuals or organizations.Lets talk about what you should do if you receive such a call and how to protect your sensitive information.Understanding AI-Generated Voice FraudAs mentioned, scammers perform AI-generated voice fraud using synthetic voices that sound convincingly like a family member, friend, or legitimate entity such as a bank or government agency. These calls can be exceptionally persuasive and dangerous since the synthetic voices replicate the speech patterns and tone of the impersonated individuals. Additionally, fraudsters can manipulate caller ID to make it look like the call is coming from a trusted source when it is not.Common Tactics Used in AI-Generated Fraud CallsBe on alert for the following AI-generated fraud calls:Impersonation of Family Members: Scammers may claim to be a relative in urgent need of money due to an emergency. The voice will sound distressingly familiar, making it easy to fall for the ploy.Bank Representative Scams: Fraudsters impersonate bank representatives, asking for account details or prompting money transfers to secure accounts.Tech Support Scams: Callers pose as tech support from reputable companies, convincing victims to grant remote access to their computers or pay for unnecessary services.Government Agency Impersonation: They may mimic officials from agencies like the IRS or Social Security Administration, threatening legal action or demanding immediate payment of fines or taxes.Utility and Phone Company Scams: Fraudsters imitate representatives from utilities or phone companies, claiming issues with the account and requesting payment or personal details to resolve them.Steps to Take If You Receive a Suspicious CallSo, what should you do if you receive such calls that are highly convincing? Here are some essential steps to take:Stay Calm and Dont Panic: Scammers often create a sense of urgency to pressure you into making quick decisions.Verify the Callers Identity: If the caller claims to be a family member, ask specific questions only that person would know. If the caller claims to be from a legitimate organization, hang up and call the organizations official number to verify.Never Share Personal Information: Legitimate entities like the bank or the government will never ask for sensitive information over the phone. Do not provide personal, financial, or account details to the caller.Report the Call: Report the incident to your bank, local authorities, or the Federal Trade Commission (FTC). This helps to alert others and potentially track down the scammers.Educate Yourself and Others: Stay informed about the latest scam tactics and share this information with friends and family. Awareness is a key defense against fraud.If you need assistance or have concerns about potential scams, dont hesitate to seek help. At The Oberon House in Arvada, CO, we prioritize the safety and security of our residents. Contact us today to ensure your loved ones are in a safe space 303-420-7258!