Medications

Risk

• The medications that a person takes may increase their risk of falling.

Reason

• Individuals who are taking four or more medications per day, are exposed to more side effects from, and more interactions between the medications, which puts them at an increased risk of falling.
• There are many medications that are known to adversely affect balance.
• The impact of the side effects from medication can increase as we get older and/or become more frail.
• The introduction of a new medication may cause an increased risk of falls.
• The impact of a medication may increase the longer the person is taking the medication.

Intervention

• Compare the medications and the side effects that the person may be having with the medications list here.
• If the individual experiences worsening balance check whether the onset coincides with the prescription of a new medication and also check the side effects of existing medications.
• Request a medication review from your GP from the person’s GP or the community mental health team (depending on who has prescribed the medication). It is possible that the dose may require adjusting or an alternative medication can be prescribed if necessary.

Considerations

• It is important that the individual’s capacity to make decisions around this specific area is considered and documented.
• Individuals who have capacity regarding these decisions can make choices about whether they take their medication or not. Remember to inform people who have capacity to make decisions about their medication, that they are allowed to ask what the Benefits, Risks, and Alternatives are, as well as what happens if they do Nothing. (B.R.A.N).
• You need to document their ability to make this decision, as well as what they chose to do every time is it relevant.
• You may need to inform them of the benefits and risks, if they are not aware, or you may need to remind them if they have difficulty remembering things.
• If the individual is assessed as not having capacity regarding these decisions, this needs to be documented appropriately and interventions need to be implemented and documented as part of a Best Interests Decision, using appropriate paperwork.
• Remember for people who cannot ask questions about the Benefits, risks, and alternatives, as well as what happens if they do nothing, you can be their voice where there are any concerns.