Introduction

As hospice nurses, caregivers, and family members, we play a crucial role in ensuring the safety and comfort of our elderly loved ones. One of the most critical aspects of this care is medication management. As people age, their bodies process medications differently, which can lead to unexpected side effects and complications.

Why is medication monitoring so crucial for older adults?

  1. Increased sensitivity to medications.
  2. There is a higher risk of drug interactions due to multiple prescriptions.
  3. Changes in metabolism and kidney function.
  4. Greater susceptibility to side effects.
  5. Increased risk of falls, confusion, and other adverse events.

By closely monitoring medications, we can:

  • Prevent harmful drug interactions.
  • Reduce the risk of falls and injuries.
  • Improve overall quality of life.
  • Potentially extend life expectancy.

It’s essential to understand that not all medications affect older adults the same way they affect younger people. What might be a safe and effective dose for a middle-aged adult could be too much for an elderly person.

Here’s a simple table to illustrate some key differences:

AspectYounger AdultsOlder Adults
MetabolismFasterSlower
Kidney FunctionTypically normalOften decreased
Body FatLessMore (affects drug distribution)
Water ContentHigherLower
Sensitivity to MedicationsLowerHigher

As caregivers, it’s our responsibility to:

  • Keep an up-to-date list of all medications, including over-the-counter drugs and supplements.
  • Understand the purpose of each medication and its potential side effects.
  • Monitor for any changes in behavior or health that could indicate a medication issue.
  • Communicate regularly with healthcare providers about any concerns or observations.

Remember, your role in medication monitoring is invaluable. By staying vigilant and informed, you can help ensure that the medications intended to help your loved one don’t harm them. In the following sections, we’ll explore specific medication classes that require extra attention in senior care.

Cardiovascular Agents: Balancing Benefits and Risks

Antihypertensives and Orthostatic Hypotension

Antihypertensive medications control high blood pressure, which is crucial for preventing heart attacks and strokes. However, in older adults, these medications can sometimes cause a condition called orthostatic hypotension. This means that when a person stands up, their blood pressure drops suddenly, leading to dizziness, lightheadedness, or fainting. This can increase the risk of falls and injuries.

Key Points:

  • Orthostatic hypotension affects about 10% of people with high blood pressure.
  • It can lead to serious health issues like falls, fractures, and even death.

Tips for Managing Orthostatic Hypotension:

  1. Monitor Blood Pressure Regularly: Check blood pressure in different positions (lying down, sitting, and standing) to detect significant drops.
  2. Educate Patients and Caregivers: Teach them to rise slowly from sitting or lying positions.
  3. Adjust Medications: Sometimes, reducing the dose or changing the medication can help manage symptoms.
  4. Stay Hydrated: Encourage drinking fluids, as dehydration can worsen orthostatic hypotension.
AntihypertensiveEffect of AgingClinical Use Implications
Dihydropyridine CCB (e.g., amlodipine)Increased risk of postural hypotension, dehydration, and renal injury.Close follow-up and patient education about postural hypotension.
Non-dihydropyridine CCB (e.g., diltiazem)Bradycardia and severe constipation.Treat constipation aggressively and avoid other AV blockers.
DiureticsIncreased risk of postural hypotension, dehydration, and renal injury.Close monitoring of renal function and electrolytes, educate about postural hypotension.
ACE inhibitors/ARBsCNS side effects are more common in the elderly.Close monitoring of renal function and electrolytes, educate about postural hypotension.
Close monitoring for adverse effects is considered to be a lower initial dose.Close monitoring for adverse effects is considered to be a lower initial dose.Close monitoring for adverse effects considers a lower initial dose.

Anticoagulants and Bleeding Risk

Anticoagulants are medications that help prevent blood clots, which can reduce the risk of strokes, especially in people with conditions like atrial fibrillation. However, these drugs also increase the risk of bleeding, which can be particularly dangerous for older adults.

Key Points:

  • Bleeding Risk: Older adults are more prone to bleeding due to fragile blood vessels and other medical conditions.
  • Monitoring: Regular blood tests are necessary to ensure the medication levels are safe and effective.

Tips for Managing Bleeding Risk:

  1. Regular Monitoring: Frequent blood tests to check how well the blood is clotting.
  2. Educate About Signs of Bleeding: Teach patients and caregivers to recognize signs of bleeding, such as unusual bruising, blood in urine or stool, and prolonged bleeding from cuts.
  3. Medication Review: Regularly review all medications with a healthcare provider to avoid interactions that can increase bleeding risk.
AnticoagulantConsiderations for Older Adults
WarfarinRequires regular blood tests (INR) to monitor effectiveness and safety
Direct Oral Anticoagulants (DOACs)It is generally preferred due to fewer dietary restrictions and less frequent monitoring, but it still requires careful assessment.

Diuretics: Kidney Function and Fall Risk

Diuretics are medications that help the body eliminate excess fluid by increasing urine production. They are often used to treat conditions like high blood pressure and heart failure. However, in older adults, diuretics can lead to dehydration, kidney problems, and an increased risk of falls.

Key Points:

  • Kidney Function: Diuretics can cause dehydration and electrolyte imbalances, harming kidney function.
  • Fall Risk: Increased trips to the bathroom, especially at night, can lead to falls.

Tips for Managing Risks with Diuretics:

  1. Monitor Kidney Function: Regular blood tests to check kidney function and electrolyte levels.
  2. Educate About Hydration: Ensure patients drink enough fluids to stay hydrated.
  3. Fall Prevention: Encourage safe bathroom habits, such as using night lights and grab bars.
DiureticEffect of AgingClinical Use Implication
Loop Diuretics (e.g., furosemide)Increased risk of dehydration and kidney injury.Close monitoring of kidney function and electrolytes, educate about hydration.
Thiazide Diuretics (e.g., hydrochlorothiazide)Risk of electrolyte imbalance.Regular blood tests to monitor electrolytes and educate about signs of imbalance.

By understanding these risks and taking proactive steps, we can help ensure that our elderly loved ones receive the benefits of their medications while minimizing potential harm.

Remember, communication with healthcare providers is critical to managing these medications safely.

Central Nervous System (CNS) Medications: Navigating Cognitive Impacts

As hospice nurses, caregivers, and family members, it’s crucial to understand how Central Nervous System (CNS) medications can affect our elderly loved ones. While often necessary, these medications can significantly impact cognitive function and overall well-being.

Key Points to Remember:

  • CNS medications can cause cognitive decline in older adults.
  • Combined use of multiple CNS medications increases risks.
  • Effects can be reversed by adjusting or discontinuing medications.
  • Regular monitoring and communication with healthcare providers are essential.

Common CNS Medications:

  1. Antidepressants
  2. Antipsychotics
  3. Benzodiazepines
  4. Opioids
  5. Sedative-hypnotics

Let’s explore some of these medication types in more detail:

Antidepressants and Dizziness

Antidepressants, particularly SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors), are commonly prescribed for depression in older adults. However, they can cause side effects, including dizziness.

Common side effects of SSRIs and SNRIs:

  • Feeling agitated or anxious
  • Nausea and stomach issues
  • Dizziness
  • Sleep disturbances
  • Headaches
  • Reduced sex drive

Important note: These side effects often improve within a few weeks, but monitoring and reporting any persistent issues to the healthcare provider is crucial.

Antipsychotics: Weighing Necessity Against Side Effects

Antipsychotics are sometimes used to manage behavioral disturbances in dementia patients. However, their use requires careful consideration of benefits versus risks.

Key considerations for antipsychotic use in elderly patients:

  1. Efficacy: Atypical antipsychotics have shown efficacy over placebo in treating dementia-related behavioral issues
  2. Safety: They are generally safer than typical antipsychotics
  3. Dosing: Lower doses are often effective and safer for elderly patients
  4. Monitoring: Regular assessment of efficacy and side effects is crucial
Potential BenefitsPotential Risks
Reduced agitationDrowsiness
Improved behaviorFalls risk
Better sleepCognitive impairment

Sedative-Hypnotics: The Double-Edged Sword of Sleep Aids

Sedative hypnotics are often prescribed for insomnia in older adults. While they can improve sleep, they also come with significant risks.

Effects of sedative-hypnotics in older adults:

  • Improved sleep quality (small effect size)
  • Increased total sleep time (average 25.2 minutes)
  • Decreased night-time awakenings/

Risks associated with sedative use:

  1. Cognitive adverse events (4.78 times more common than placebo)
  2. Psychomotor adverse events (2.61 times more common)
  3. Daytime fatigue (3.82 times more common)

Important consideration: In people over 60, the benefits of these drugs may not justify the increased risks, especially for those at risk of falls or cognitive impairment.

Best Practices for CNS Medication Management

  1. Regular review: Frequently assess the need for and effectiveness of medications.
  2. Start low, go slow: Begin with lower doses and increase gradually if needed.
  3. Monitor closely: Watch for side effects and changes in cognitive function.
  4. Communicate: Keep an open dialogue with healthcare providers about any concerns.
  5. Consider alternatives: Explore non-pharmacological options when possible.

Remember, your role in observing and reporting changes in your loved one’s condition is invaluable. By staying informed and vigilant, you can help ensure that CNS medications are used safely and effectively in their care.

Pain Medications: Managing Discomfort Safely

As caregivers and family members of elderly patients, it’s crucial to understand how to manage pain effectively while minimizing risks. Pain medications can greatly improve the quality of life, but they must be used carefully in older adults.

NSAIDs: Gastrointestinal and Cardiovascular Concerns

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain relief, but they come with important considerations for older adults.

Key points about NSAIDs:

  • Effective for mild to moderate pain.
  • It can reduce inflammation.
  • Available over-the-counter and by prescription.
  • Include drugs like ibuprofen, naproxen, and aspirin.

However, NSAIDs pose significant risks, especially for long-term use in older adults:

  1. Gastrointestinal (GI) risks:
    • Increased risk of stomach ulcers and bleeding.
    • It can cause nausea, indigestion, and abdominal pain.
    • Risk is higher in those over 65 years old.
  2. Cardiovascular risks:
    • It may increase blood pressure.
    • It can worsen heart failure.
    • Slightly increased risk of heart attack and stroke.

Safety tips for NSAID use:

  • Use the lowest effective dose for the shortest time possible.
  • Take with food to reduce stomach irritation.
  • Consider using a stomach-protecting medication if long-term use is necessary.
  • Avoid in patients with a history of stomach ulcers or bleeding.
NSAID TypeExamplesBest Used For
Traditional NSAIDsIbuprofen, NaproxenShort-term pain relief, mild to moderate pain.
COX-2 InhibitorsCelecoxibPatients at high risk for GI complications.

Opioids: Balancing Pain Relief and Fall Risk

Opioids are powerful pain medications that can be very effective but come with significant risks, especially for older adults.

Key points about opioids:

  • Used for moderate to severe pain.
  • Include drugs like morphine, oxycodone, and hydrocodone.
  • It can be highly effective for both acute and chronic pain.

Risks and concerns with opioid use in older adults:

  1. Increased fall risk:
    • It can cause dizziness and drowsiness.
    • This may lead to confusion or disorientation.
    • Fall risk is highest in the first few weeks of use.
  2. Other side effects:
    • Constipation (often severe in older adults).
    • Nausea and vomiting.
    • Respiratory depression (slowed breathing).
  3. Risk of dependence and addiction:
    • Even when used as prescribed, physical dependence can occur.
    • Older adults may be more susceptible to developing opioid use disorder.

Safety tips for opioid use:

  • Start with the lowest effective dose and increase slowly if needed.
  • Monitor closely for side effects, especially in the first few weeks.
  • Use fall prevention strategies (e.g., removing tripping hazards and using assistive devices).
  • Regularly assess the need for continued opioid use.
  • Consider non-opioid and non-drug pain management strategies.
Opioid Safety MeasureDescription
Start Low, Go SlowBegin with the lowest effective dose and titrate up slowly if needed.
Regular MonitoringCheck for side effects, effectiveness, and continued need.
Fall PreventionImplement strategies to reduce fall risk in the home.
Constipation ManagementUse stool softeners and laxatives proactively.

Remember, pain management in older adults is a balancing act. It’s essential to address pain effectively while minimizing risks. Always work closely with healthcare providers to find the safest and most effective pain management strategy for your loved one. Don’t hesitate to ask questions or express concerns about medication use – you are crucial in ensuring safe and effective care.

Anticholinergics: Recognizing Hidden Dangers

Anticholinergic medications are commonly prescribed to treat various conditions, but they come with significant risks, especially for older adults. These drugs block acetylcholine, a neurotransmitter involved in many bodily functions. While they can be effective, they also have a range of side effects that can be particularly harmful to elderly patients.

Common Anticholinergic Medications in Geriatric Care

Anticholinergic drugs fall into several categories and are used to treat different conditions. Here are some common examples:

  1. Antihistamines:
    • Diphenhydramine (Benadryl)
    • Chlorpheniramine (Chlor-Trimeton)
  2. Antidepressants:
    • Amitriptyline (Elavil)
    • Doxepin (Sinequan)
  3. Antipsychotics:
    • Olanzapine (Zyprexa)
    • Quetiapine (Seroquel)
  4. Bladder Control Medications:
    • Oxybutynin (Ditropan)
    • Tolterodine (Detrol)
  5. Muscle Relaxants:
    • Cyclobenzaprine (Flexeril)
    • Orphenadrine (Norflex)
  6. Parkinson’s Disease Medications:
    • Benztropine (Cogentin)
    • Trihexyphenidyl (Artane)

Cognitive Effects and Fall Risk

Anticholinergic medications can have profound effects on cognition and increase the risk of falls in older adults. These effects can range from mild confusion to severe delirium and cognitive decline.

Cognitive Effects:

  • Confusion and Delirium: These drugs can cause acute confusion and delirium, which can be mistaken for worsening dementia.
  • Memory Impairment: Long-term use of anticholinergics has been linked to an increased risk of developing dementia.
  • Sedation: Many anticholinergics cause drowsiness, impairing cognitive function and daily activities.

Fall Risk:

  • Dizziness and Balance Issues: Anticholinergics can cause dizziness and affect balance, leading to an increased risk of falls.
  • Muscle Weakness: These drugs can also cause muscle weakness, making it harder for older adults to move safely.
  • Frequent Urination: Some anticholinergics used for bladder control can lead to frequent bathroom trips, increasing the risk of falls, especially at night.

Important Note: The risk of falls and cognitive impairment increases with the cumulative use of multiple anticholinergic medications.

Tips for Managing Anticholinergic Risks:

  1. Medication Review:
    • Regularly review all medications with a healthcare provider to identify and minimize anticholinergic burden.
    • Use tools like the Anticholinergic Risk Scale (ARS) to assess the risk.
  2. Non-Pharmacological Alternatives:
    • Consider non-drug treatments for conditions like insomnia, depression, and bladder control.
    • Explore lifestyle changes, physical therapy, and other interventions.
  3. Monitor for Side Effects:
    • Watch for signs of confusion, memory problems, and balance issues.
    • Report any new or worsening symptoms to a healthcare provider immediately.
  4. Educate Patients and Caregivers:
    • Ensure that patients and caregivers know the potential risks of anticholinergic medications.
    • Provide information on how to recognize side effects and when to seek help.
Anticholinergic MedicationCommon UsePotential Risks in Older Adults
Diphenhydramine (Benadryl)Allergies, sleep aidConfusion, sedation, falls
Amitriptyline (Elavil)Depression, painMemory impairment, dizziness
Oxybutynin (Ditropan)Bladder controlFrequent urination, balance issues
Cyclobenzaprine (Flexeril)Muscle spasmsDrowsiness, muscle weakness
Benztropine (Cogentin)Parkinson’s diseaseCognitive decline, confusion

By understanding the hidden dangers of anticholinergic medications and taking proactive steps to manage their use, we can help ensure the safety and well-being of our elderly loved ones. Always work closely with healthcare providers to find the safest and most effective treatment options.

Hypoglycemics: Preventing Dangerous Blood Sugar Fluctuations

As hospice nurses, caregivers, and family members, understanding how to manage hypoglycemic medications in older adults is crucial for their safety and well-being. Hypoglycemia helps control blood sugar levels but can also lead to dangerous lows if not appropriately managed.

Key Points to Remember:

  • Older adults are more susceptible to hypoglycemia (low blood sugar).
  • Symptoms of hypoglycemia may be less noticeable in the elderly.
  • Preventing hypoglycemia is crucial to avoid falls, confusion, and other complications.

Tips for Preventing Hypoglycemia:

  1. Regular blood sugar monitoring
  2. Consistent meal times and snacks
  3. Proper medication management
  4. Education for patients and caregivers
  5. Regular communication with healthcare providers

Insulin Management in Older Adults

Insulin is a critical medication for many older adults with diabetes, but it requires careful management to avoid complications.

Important Considerations:

  • Start low and go slow: Begin with lower doses and increase gradually.
  • Simplify regimens: Use once-daily long-acting insulin when possible.
  • Monitor closely: Check blood sugar levels regularly, especially when starting or changing doses.
  • Know kidney function: Insulin doses may need adjustment as kidney function declines.
Insulin TypeOnsetPeakDuration
Rapid-acting15 minutes1-2 hours3-5 hours
Short-acting30 minutes2-3 hours5-8 hours
Intermediate-acting2-4 hours4-12 hours12-18 hours
Long-acting1-2 hoursNo peak24 hours or more

Tips for Safe Insulin Use:

  1. Use pre-filled pens or simplified delivery systems when possible
  2. Teach proper injection techniques to patients and caregivers
  3. Rotate injection sites to prevent tissue damage
  4. Store insulin properly to maintain its effectiveness
  5. Have a hypoglycemia action plan in place

Sulfonylureas and Hypoglycemia Risk

Sulfonylureas are oral medications that stimulate insulin production. While effective, they carry a higher risk of hypoglycemia, especially in older adults.

Common Sulfonylureas:

  • Glipizide (Glucotrol)
  • Glyburide (Diabeta)
  • Glimepiride (Amaryl)

Hypoglycemia Risk Factors:

  • Age: Older adults are more susceptible.
  • Kidney function: Decreased function increases risk.
  • Missed meals: Skipping or delaying meals can lead to low blood sugar.
  • Multiple medications: Interactions can increase hypoglycemia risk.

Managing Sulfonylurea Use in Older Adults:

  1. Consider alternatives: Newer medications may have lower hypoglycemia risk.
  2. Use the lowest effective dose.
  3. Monitor kidney function regularly.
  4. Educate about hypoglycemia symptoms and treatment.
  5. Encourage regular meals and snacks.

Remember, the goal of diabetes management in older adults is to maintain quality of life while preventing complications. It’s essential to balance blood sugar control with the risk of hypoglycemia. Always consult healthcare providers to develop an individualized care plan considering the patient’s health, preferences, and life expectancy.

By staying informed and vigilant, you can help ensure the safety and well-being of older adults managing diabetes with hypoglycemic medications.

Best Practices for Medication Management in Geriatric Patients

As hospice nurses, caregivers, and family members, managing medications for older adults is critical. By following these best practices, we can help ensure the safety and well-being of our elderly loved ones.

Regular Medication Reviews

Regular medication reviews are essential for maintaining optimal health and preventing complications in older adults. Here’s why they’re so important:

  • Prevent adverse drug reactions: As we age, our bodies process medications differently, increasing the risk of side effects.
  • Reduce polypharmacy: Many older adults take multiple medications, which can lead to dangerous interactions.
  • Ensure medications are still necessary: Some medicines may no longer be needed as health conditions change.

How to conduct a medication review:

  1. Make a comprehensive list of all medications, including over-the-counter drugs, vitamins, and supplements.
  2. Review each medication with the healthcare provider, discussing its purpose, dosage, and potential side effects.
  3. Check for potential interactions between medications.
  4. Assess the need for each medication based on current health status and goals of care.

Deprescribing Strategies

Deprescribing is the process of reducing or stopping medications that may no longer be beneficial or may be causing harm. It’s an integral part of medication management for older adults.

Key principles of deprescribing:

  • Start with medications that have the highest risk and lowest benefit.
  • Reduce doses gradually to minimize withdrawal effects.
  • Monitor closely for any changes in symptoms or health status.

Steps in the deprescribing process:

  1. Review current medications and health status.
  2. Identify potentially inappropriate medications.
  3. Discuss the benefits and risks of stopping medicines with the patient and family.
  4. Create a plan for tapering or stopping medications.
  5. Monitor and support the patient through the process.

Patient and Caregiver Education

Educating patients and caregivers about medication management is crucial for ensuring safe and effective use of medications.

Important topics to cover:

  • Proper medication administration: How and when to take each medication.
  • Potential side effects: What to watch for and when to seek help.
  • Storage and organization: How to keep medications safe and easily accessible.
  • Importance of adherence: Why taking medicines as prescribed is crucial.

Educational strategies:

  • Use simple, clear language.
  • Provide written materials for reference.
  • Demonstrate proper techniques (e.g., using inhalers or measuring liquid medications).
  • Encourage questions and open communication.
Best PracticeWhy It’s ImportantHow to Implement
Regular Medication ReviewsIt prevents adverse reactions and reduces polypharmacy.Schedule reviews at least annually or after health changes.
Deprescribing StrategiesReduces medication burden and potential harm.Work with healthcare providers to identify and safely stop unnecessary medications.
Patient/Caregiver EducationImproves medication adherence and safety.Provide clear instructions, written materials, and ongoing support.

Remember, medication management is a team effort. By working with healthcare providers, patients, and caregivers, we can help ensure that our elderly loved ones receive the safest and most effective medication regimens possible.

Conclusion: Empowering Safe Medication Use in Older Adults

As we conclude our discussion on medication management for older adults, it’s crucial to remember that safe medication use is a collaborative effort. Hospice nurses, caregivers, and family members all play vital roles in ensuring the well-being of our elderly loved ones. Let’s recap the key points and final thoughts on empowering safe medication use.

Key Takeaways:

  1. Awareness of medication risks: Understanding the potential dangers associated with various medication classes is crucial for prevention and early intervention.
  2. Regular monitoring: Consistent observation and reporting of changes in condition or side effects can prevent serious complications.
  3. Open communication: Maintaining an open dialogue with healthcare providers, patients, and caregivers is essential for effective medication management.
  4. Education: Ongoing learning about medications, their effects, and proper administration techniques empowers everyone involved in the care process.
  5. Personalized approach: Tailoring care plans requires acknowledging that each older adult has unique medication needs and responses.

Empowering Strategies for Safe Medication Use:

StrategyDescriptionBenefits
Medication organizersUse pill boxes or electronic reminders.It helps identify medication-related issues quickly.
Medication listsKeep an up-to-date list of all medications.Facilitates communication with healthcare providers, prevents drug interactions.
Regular reviewsSchedule periodic medication reviews.Ensures medications remain appropriate and effective.
Symptom trackingKeep a log of any new symptoms or side effects.It improves adherence and reduces errors.
Emergency planHave a plan for medication-related emergencies.Improves adherence and reduces errors.

Final Thoughts:

As we care for our elderly loved ones, it’s essential to approach medication management with both diligence and compassion.

Remember:

  • Every medication decision impacts the quality of life: Balancing the benefits and risks of medications is crucial for maintaining comfort and dignity.
  • Empowerment through knowledge: The more we understand medications and their effects, the better we can advocate for our loved ones.
  • Flexibility is key: As health conditions change, be prepared to adjust medication regimens accordingly.
  • Self-care matters: Caregivers should prioritize their health and well-being to provide the best care possible.

By implementing these strategies and maintaining a proactive approach to medication management, we can help ensure that our older adults receive the safest and most effective care possible. Remember, you are not alone in this journey. Contact healthcare providers, support groups, and community resources for needed assistance.

Together, we can create a safer medication environment for our elderly loved ones, promoting their comfort, dignity, and quality of life.

Resources

The Benefits of Deprescribing Medications in Hospice: A Guide for Patients, Families, and Hospice Nurses

Importance of Medication Reconciliation in Hospice Care

How to Use the Beers Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

How to Use the START/STOPP Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies

Cardiac drug therapy—considerations in the elderly

New loop diuretic prescriptions may be an acute risk factor for falls in the nursing home

Impact of Central Nervous System (CNS) Medication Use on Cognition Decline in Community-Dwelling Older Adults: Findings from the Health, Aging and Body Composition Study

Cardiovascular Risk of Nonsteroidal Anti-Inflammatory Drugs: An Under-Recognized Public Health Issue

Anticholinergic burden: the unintended consequences for older people

Anticholinergic Drugs in Geriatric Psychopharmacology

Use of insulin among older adults with type 2 diabetes not aligned with national guidelines

Glucose Control, Sulfonylureas, and Insulin Treatment in Elderly People With Type 2 Diabetes and Risk of Severe Hypoglycemia and Death: An Observational Study 

Older Adults: Standards of Care in Diabetes

Medication Management of the Community-Dwelling Older Adult

Resources for the Comprehensive Geriatric Assessment Based Proactive and Personalised Primary Care of the Elderly

Medication Management Tips for Seniors

Medication Review in Preventing Older Adults’ Fall-Related Injury: a Systematic Review & Meta-Analysis

Deprescribing

Eldercare Locator: a nationwide service that connects older Americans and their caregivers with trustworthy local support resources

CaringInfo – Caregiver support and much more!

Surviving Caregiving with Dignity, Love, and Kindness

Caregivers.com | Simplifying the Search for In-Home Care

📚 This site uses Amazon Associate links, which means I earn a small commission when you purchase books or products through these links—at no extra cost to you. These earnings help me keep this website running and free from advertisements, so I can continue providing helpful articles and resources at no charge.

💝 If you don’t see anything you need today but still want to support this work, you can buy me a cup of coffee or tea. Every bit of support helps me continue writing and sharing resources for families during difficult times. 💙

Caregiver Support Book Series

My Aging Parent Needs Help!: 7-Step Guide to Caregiving with No Regrets, More Compassion, and Going from Overwhelmed to Organized [Includes Tips for Caregiver Burnout]

Take Back Your Life: A Caregiver’s Guide to Finding Freedom in the Midst of Overwhelm

The Conscious Caregiver: A Mindful Approach to Caring for Your Loved One Without Losing Yourself

Dear Caregiver, It’s Your Life Too: 71 Self-Care Tips To Manage Stress, Avoid Burnout, And Find Joy Again While Caring For A Loved One

Everything Happens for a Reason: And Other Lies I’ve Loved

The Art of Dying

Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying

Top 30 FAQs About Hospice: Everything You Need to Know

Understanding Hospice Care: Is it Too Early to Start Hospice?

What’s the process of getting your loved one on hospice service?

Picking a hospice agency to provide hospice services

National Hospice Locator and Medicare Hospice Compare

Holistic Nurse: Skills for Excellence book series

Empowering Excellence in Hospice: A Nurse’s Toolkit for Best Practices book series

Bridges to Eternity: The Compassionate Death Doula Path book series:

Find an End-of-Life Doula

Currently, there is no universal director of end-of-life doulas (EOLD). It’s essential to note that some EOLDs listed in directories may no longer be practicing. The author recommends starting with IDLM, as their training program is always current and thorough, followed by NEDA, which is the only independent organization not affiliated with any school.

End-of-Life-Doula Articles

Oh hi there 👋 It’s nice to meet you.

Sign up to receive updates on new articles to your inbox.

The emails we will send you only deal with educational articles, not requests to buy a single thing! Read our privacy policy for more information.

This field is required.
Share your love

Newsletter Updates

Enter your email address below and subscribe to our newsletter