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The Beers List: The "Must Know" List When Caring for Older Adults

Interview with Dr. Lisa Frank (Bonus!)

Episode #031

 

Dr Regina Koepp:    And so The Beers List has medications that are not necessarily psychiatric medications. They're just like over the counter medications that you can take.

Dr Lisa Frank:      Some are over the counter.

Dr Regina Koepp:    So not only physicians should be aware, should family members be aware of this list too, then?

Dr Lisa Frank:      I think it's a great idea. I always like for family members to have as much information.

Dr Regina Koepp:    That's why you're here!

Dr Regina Koepp:    Dr Regina Koepp: Hello there I am Dr Regina Koepp and this is The Caring for Aging Parents Show. I'm a Board Certified Clinical Psychologist and I specialize in older adults and families. I help you manage the most complicated situations with your aging parents so that you have peace of mind knowing that you are doing everything you can to help your parents live their best lives without giving up your own life in the process. So for the best tips on helping you to care for your aging parents, subscribe to my show and you'll get new tips every Wednesday. As we get started. I wanted to share with you an important guide that I made called Dementia 101: A Beginner's Guide to Dementia Disorders. In this guide I talk about what dementia is and what it isn't. I describe the phases of dementia and what to do if you're worried that your aging parent may have dementia. I'll link to it in my show notes, so take a minute and download it. It answers some of the most frequently asked questions I get about dementia.

Dr Regina Koepp:    In this bonus episode with Dr. Lisa Frank, Dr. Frank talks with us about one of the most important lists you need to know if you're caring for aging parents. It's called the Beers List. That's right, the Beers List. Let's get started.

Speaker 1:          So, this may be a good place for us to talk about then the medications on what's called The Beers List.

Dr Regina Koepp:    Which is spelled like.

Dr Lisa Frank:      "Beer", like you drink! But that's not what it means to me.

Dr Regina Koepp:    Should we?

Dr Lisa Frank:      So the Beers List Criteria is a list of medications that's put out by the American Geriatric Society and it's a list of medications that are inappropriate for use in older adults and it was just revised this year, 2019. Not all providers are aware of this list. And so it can be really helpful for family members to take a look at it. It's very commonly prescribed medications. One good example is medications like Benadryl that could be used...you know, most of us use Benadryl if we have pollen like we have right now.

Dr Regina Koepp:    Or, a lot of people use it for sleep.

Dr Lisa Frank:      Yes. And Benadryl because of some of the side effects of it. And because of the receptors that it interacts with can lead to cognitive symptoms in older adults. And so that medication is on the list.

Dr Regina Koepp:    And, can it worsen dementia? Like could it accelerate the disease course with a dementia?

Dr Lisa Frank:      I don't know if it actually accelerates the course, but it can certainly, um, it can lead to, it can contribute to a delirium. And a lot of people end up on multiple anti-histamine agents and for older adults that can be a precursor to a delirium.

Dr Regina Koepp:    And so The Beers List has medications that are not necessarily psychiatric medications. They're just like over the counter medications that you can take.

Dr Lisa Frank:      Some are over the counter.

Dr Regina Koepp:    So not only physicians should be aware, should family members be aware of this list too, then?

New Speaker:        I think it's a great idea - I always like for family members to have as much information.

Dr Regina Koepp:    That's why you're here!

Dr Regina Koepp:    So thank you. Right. Cause if there was some over the counter medications that people are taking like Benadryl.

Dr Lisa Frank:      Right? Or if a person goes into their very busy primary care provider who maybe they haven't seen for years and the provider doesn't think that day about, "Well this person is aging. They're coming in and saying they're having difficulty with sleep. Maybe he prescribes a benzodiazepine like Restoril or Valium or Ativan or Klonopin or Xanax. And those are on The Beers List. And those can also worsen cognitive symptoms and are not ideal medications for older adults.

Dr Regina Koepp:    So then is it possible that a person without a dementia disorder though, an older adult, who's on one of these medications and one of these medications worsens cognitive symptoms. Is it possible that they could be taking one of these medications or combination of these medications and appear to have a dementia-like condition and then stop taking them and recover some of the cognitive issues, like recover some of that?

Dr Lisa Frank:      Yes. So part of if someone is being evaluated for early onset dementia, one of the pieces that will be evaluated by the psychiatrist is a review of medications and medications that are inappropriate and that can contribute to cognitive decline should be discontinued if possible.

Dr Regina Koepp:    When you say early onset dementia, what are you referring to? New diagnosis.

Dr Regina Koepp:    Right. Not people under 65 with a diagnosis of dementia, right?

Dr Lisa Frank:      Yes.

Dr Regina Koepp:    Okay. So people who are newly, who are questioning if they have a diagnosis of dementia and are going in for testing, the physician should review the medications to make sure that those medications are not on The Beers List and contributing to the cognitive decline.

Dr Lisa Frank:      Right.

Dr Regina Koepp:    Wonderful.

Dr Regina Koepp:    In wrapping up our episode for today, I wanted to remind you to download that free guide that I created just for you called Dementia 101: A Beginner's Guide to Dementia Disorders. So if this video was helpful, be sure to subscribe and don't forget to share this video with your friends who are caring for their aging parents because nobody should have to do this caregiving-thing alone.

 


 

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