Prescription drugs are important in the treatment and management of chronic diseases and pain in the senior population. The right medication can greatly contribute to improvement in quality of life, decreased pain and chronic symptomology, as well as increasing life span. Polypharmacy, including many over the counter remedies, is common with this population, often resulting in physical and cognitive deficits that impact recovery and achievement of positive therapy outcomes.

Seniors at highest risk include those with chronic disease processes, high level of fragility, existing cognitive deficits (dementia), and depression. Polypharmacy can result in increased hospitalizations (due to adverse drug events), increased falls with injury, decreased cognition and safety awareness. It is vitally important that the interdisciplinary team pay close attention to and monitor physical and psychological/cognitive changes for the resident that requires multiple medications. Even so, any single medication can produce subtle side effects that can impact optimal participation and positive outcomes while receiving PT, OT or ST.

On an initial therapy evaluation, the evaluating therapist should note the medications currently being prescribed, any over the counter remedies being used and document changes to the medication regime on an ongoing basis during the course of care. Therapists should be knowledgeable about specific medication, possible side effects and be able to recognize and report those side effects if interfere with the resident’s overall recovery and progress in therapy. Side effects that may affect therapy treatment include but are not limited to:

• Decreased balance, shuffling gait
• Decreased safety awareness
• Change in cognition
• Increased agitation
• Nausea/vomiting
• Weakness/decreased endurance
• Muscle tone changes/rigidity
• Increased sleepiness/lethargy

It is crucial that the long term care community’s interdisciplinary care team work together in recognizing and monitoring side effects to ensure the resident every opportunity to achieve the highest level of quality of life and functional independence possible.