Caring for someone with dementia can be challenging, especially when it comes to managing their medications. One important tool that helps doctors and caregivers make safer choices is the Beers List. This article will explain what the Beers List is, why it matters for people with dementia, and how you can use this information to help your loved one stay healthy and safe.
What Is the Beers List?
The Beers List, also called the Beers Criteria, is a guide created by the American Geriatrics Society. It lists medications that may be risky for adults over 65, especially those with certain health problems like dementia. The main goal is to help doctors, nurses, and caregivers avoid medicines that could cause more harm than good in older adults.
The list was first made in 1991 by Dr. Mark Beers, a doctor who cared for older adults. It is updated every three years as new research becomes available. The Beers List is not a set of strict rules, but a helpful guide to support safer medication choices.
Why Are Some Medicines Riskier for Older Adults?
As people age, their bodies change. Medicines may not work the same way, and side effects can be stronger. Older adults are also more likely to be taking several medicines at once, which can increase the risk of harmful interactions.
For people with dementia, certain medicines can make confusion, memory loss, and behavior problems worse. Some drugs can even increase the risk of falls, sleepiness, or other serious side effects.
Medicines on the Beers List
The Beers List includes nearly 100 medicines or groups of medicines. Some of the most common types to watch out for in people with dementia include:
- Antipsychotics (like risperidone, quetiapine, olanzapine): These are sometimes used to manage behavior problems in dementia, but they can increase the risk of stroke, faster decline in thinking, and even death. They should only be used when other options have failed and the person is at risk of harming themselves or others.
- Anticholinergics (like diphenhydramine, amitriptyline): These can cause confusion, constipation, trouble urinating, and memory problems. They are especially risky for people with dementia.
- Benzodiazepines (like diazepam, lorazepam): These medicines are used for anxiety or sleep, but they can cause drowsiness, falls, and worsening confusion.
- Certain sleeping pills (like zolpidem): These can make people groggy, confused, or more likely to fall.
- Some pain medicines (like meperidine): These can cause confusion and are not recommended for older adults.
Not all medicines on the Beers List are completely forbidden. Sometimes, the benefits might outweigh the risks, but only under close supervision by a doctor.
How Is the Beers List Used?
Doctors use the Beers List as a tool to review medications for older adults. When your loved one is prescribed a new medicine, the doctor should check if it’s on the Beers List and consider if it’s the safest choice. Sometimes, there are better alternatives that work just as well but have fewer risks.
If a medicine from the Beers List is needed, the doctor will usually:
- Use the lowest effective dose
- Monitor for side effects closely
- Try non-drug treatments first, especially for behavior problems in dementia (like activities, routines, or changes in the environment)
What Can Caregivers Do?
As a caregiver, you play an important role in keeping your loved one safe. Here are some steps you can take:
- Keep a list of all medicines your loved one takes, including over-the-counter drugs and supplements.
- Ask the doctor or pharmacist if any medicines are on the Beers List and if there are safer options.
- Watch for side effects like confusion, sleepiness, falls, or changes in behavior, and report them to the doctor.
- Don’t stop or change medicines on your own. Always talk to the doctor first.
Questions to Ask the Doctor
- Is this medicine on the Beers List?
- Are there safer alternatives for someone with dementia?
- What side effects should I watch for?
- Can we try non-drug treatments first?
The Beers List is a valuable tool to help avoid medicines that could be harmful to older adults, especially those with dementia. By understanding the risks and working closely with your loved one’s healthcare team, you can help ensure they receive the safest and most effective care possible. If you have concerns about any medication, don’t hesitate to ask questions and seek advice. Attention can make a big difference in your loved one’s health and quality of life.
