I had missed this article when it was first posted but absolutely agree that certain medications can increase the risk of falling and it is essential to be more vigilant the older you get. It is also helpful not to be too proud to use a cane or walker if you are feeling unsteady. Some days may be worse than others. so it important to remain aware of the way you are feeling on that particular day. Another important aspect is to limit the amount of alcohol consumed. If one is taking a huge number of medications it is important that they be reviewed with a Dr on a regular basis. Drugs recommended for younger people may no longer be appropriate for seniors or doses should be lowered. some drugs such as hormones for women may have been continued for many years but now are no longer recommended and discontinued if appropriate.

ProfeCheri.
I also missed your sad news about your husband's bladder. I hope by now you have both got over the shock and he is doing well. The good news if there is any is that the older one gets the slower growing malignancies are the more likely a patient ist o die from some other ailment so they don't have to suffer the pain associated with the late stages of cancer. hopefully when they did the sugery they found that ther had not been any further spread. Blessings to you both.

As far as the questions about coumedin are concerned. It is given to prevent blood clots or after having had one to lower the risk of heart attack or stroke when the patient suffers from certain conditions. It does take about seven days to completely leave the body which is the reason it is discontinued seven days before any invasive proceedure. In an emergency if surgery is necessary the use of Vit k can quickly reverse the effects so the patient is not in danger of bleeding. Coumadin is the only anticoagulant that can be reversed in this way although trials are in process for means to reverse some of the newer more convenient blood thiners. Anticoagulation can be quickly re-established with the use or IV heparin or the newer lovenox which is injected into belly fat and does leave bruises and may be uncomfortable to receive.

Staying active after a fall down a mountain has been a boon to me. At 65, hiking in the wilderness I slipped on moss, fell 75 ft. down a 45d. angle, got up and hiked in for one more hour!What saved me, altho I suffered from bruises, was my chropractor, who worked,( and still does today), with the subligations and the "wavy" spine injuries I got during that fall. I would have never thought spine damage could result in so many other complications after a fall like that. Keep active, do yoga and don't be afraid!

Jeannegibbs,You are correct, Jeanne. The benefits should outweigh the risks with all meds. I assume that you have already worked this out. I wouldn't worry about falling...just be aware that you CAN fall, and walk with caution.
As a side note, I find it interesting that you are taking an anti-depressent........you of all people...you seem so in-charge, so coherent, decisive....................If it were I, I might consider a little psychotherapy along with the anti-depressant, and then, if possilbe, drop the anti-depressant. You'll figure it out.

ProfeChari, I am so very sorry to her about the malignancy in your husband's bladder. I really am. You know that the bladder has to be removed. He will adjust.
They will teach you both about the various options to deal with once the operation has settled everyone down. Post-op procedures are rather standard. I don't know what they are, but DO ASK QUESTIONS. Good Luck, and may he have a celebratory birthday tomorrow!

Thank you to all who have given advice and concern about my husband's blood thinner being stopped before the cystoscopy. As usual this past year, we started out worrying about one thing and the problem turned out to be something else. As per your advice, N1K2R3, I made sure we got to know the anesthesiologist first and had a lot of information to share with him and some questions. He was wonderful and spent a long time with us. My husband's recent chemical stress test results were good, and he went through the other heart tests results, which we already knew, with us. His heart tests were all good. That part of his procedure went beautifully yesterday. The results of the cystoscopy didn't, though. I am saddened to have to tell you that the "mass in the bladder" is much larger than expected and is malignant cancer. The urologist said that it is so extensive that the entire bladder and some other parts of the urinary track would have to be removed even if (and I don't think he will...) my husband agrees to chemo or radiation. After the things my husband told me (ignoring the blood in his urine for some time before seeking treatment for incontinence! ), the reading I have done, and reading some other threads on this website, I had a gut feeling that it was going to be cancer...at least in the bladder. I am having the most bizarre reaction to what was discovered, though. I have shed a few tears, but I haven't really cried. The people in the waiting room expressed their sorrow, and I thanked them. I was called and told which room he was going to be in and that I could wait for him there. When he came in, I was jovial with him, hoping he would not ask the inevitable question. He did, though, and I wasn't able to tell him everything. I glossed over it and told him the mass turned out to be larger than expected and that the doctor would go into details with us this morning at 8:30. He said, "Well, s---! I thought I would wake up and know SOMETHING! " I busied myself with giving him crushed ice, etc. It was dark, and our little dog had been at home all day, plus I needed to come home anyway. I left him in good spirits, joking with the nurses and begging for his dinner. I thought I would be able to cry once I was alone. That's what happened when we were given the results of the cat scan and told of the necessity for the cystoscopy. ..I could almost read between the lines and feared that the doctor knew, or suspected, more than he was saying. I haven't answered inquires on the phone. I haven't emailed any of my friends. The only thing I have done is to take care of the dog, sleep for about two hours, and write this message. I dread going back when the doctor tells him and gives him his options. It even crossed my mind to go later and tell him I overslept. I know I can talk to all of you. You have dealt, or are dealing with, situations much worse than this and I know you understand how I am feeling. We both knew that this time would probably come in one form or another, given the 19 year difference in our ages. But I am not ready. Our years together have had their ups and downs, as all marriages do, but our years together have been the best.years of my life. After my mom passed away three years ago, we hit a rough spell. We have worked things out, though, and are even closer and more loving than when we first met. I apologize for whining about the realities of life. It is a compliment to those of you who are reading this...because I am now crying. Thank you for caring.

So my antidepressant might increase the risk of falling? Not taking it increases the certainty of mental distress. Isn't it always about weighing the benefits and risks?

ProfeChari, blood thinners are usually if not always about ten days before any operation. I agree with the others to check on this prior. I recently just had a colonoscopy, not big deal but even that procedure wouldn't be done if I had taken blood thinners for ten days and aspirin for three. Good luck and best wishes.

My mom takes around 20 meds a day. She has been on most of them for years with no issues but now with the dementia and not sleeping or sleeping all the time I have pulled her off two of her pain meds since she already take vicodin every six hours that are ten times stronger than the two I pulled. It seemed to help some. I recently had to fire our home health, not that they over all was not good but a new RN just didn't show that day to fill her med minder and I took off to meet with her about other issues. I used to be a med aid and my partner a pharmacy tech , us long with a daytime CNA is going it alone for now. I have started looking into her more pricey meds to see if she really needs to continue to take them or if the others have just been added along the way before we stepped in four years ago and from what I can tell so far, I think she could lose another five with increased doses on some she has been taking for thirty years that is doing nothing for her now. I'm looking into another doctor against her well. The one she goes to now "is so nice" but not the brightest bulb on the Christmas tree so trying to get her to see one I know is a good doctor and I think will work with me better. I also understand about the BP meds, mine makes me sleepy and they have my mom on blood pressure meds when she has never had high blood pressure. I worked in a hospital recovery room for a year and watch the doctors be smoozed by the pharmaceutical salesman push new meds and gadgets. If they prescribe enough they get trips etc. Not to say all doctors would do this but I know what I have seen with my own eyes and I'm starting to question the meds my mom is on more and more. All that said, everytime they add something mom becomes more unstable, add that to dementia, listening to me on safety measures just doesn't happen. At times I feel I'm drowning in paperwork, housework, cooking, doing laundry for her and then still holding down a fulltime job. I know many stories i have read are worse than mine and I commend you for caring for your parent and thank you for bits of advice.

It is so kind of you to share the information you have and to extend your wishes about my husband's procedure and birthday, NIK2R3. Thank you also for asking your urologist friend in Atlanta about our situation. After showing us the results of the cat scan on his computer screen and indicating the areas that are not identifiable from just the cat scan, the doctor said the cystoscopy was to be able to see inside the bladder and kidneys and to do a biopsy. If there are small polyps , they will be removed. So, our understanding is that nothing major will be done; the procedure is to explore and to identify what is going on. Please keep us in your thoughts. My husband is cool and calm about whatever life brings, but I have done more research than he has and have a bad feeling about the whole situation. Let's hope my fears are unfounded and whatever is wrong is fixable! I Thanks again for your interest and concern.

ProfeChari: Since both you and your husband have decided to go ahead with the operation on the bladder, I'd ask some questions such as : Will the mass be removed or just biopsied? I'm going to assume that the urologist knows what he's doing, and your husband will not be in danger. I'll check with my friend, Dr. Nabors ( Urologist) in Atlanta on September 3rd when he returns to the office.
He won't be able to comment on much since he hasn't seen the patient.
As for the coumadin, I've been told that no surgeon will operate if coumadin is present in the bloodstream. Fear of bleeding is the main concern......coumadin does cause bleeding, that's what keeps us clot-free....
I would keep in close contact with the anesthesiologist or nurse-anesthetist before the operation. I could comment further, but all I want to do is wish him good luck and a happy happy birthday on September 5th.

Yes, NIK2R3, it is the urologist who decided on the anesthesia and requiring that the Coumadin be stopped prior to the cystoscopy. The cat scan shows a "mass in the bladder" as well as various other irregularities. In pre-op they told us he would be "out" for an hour and 45 minutes. I thought perhaps the length of the procedure and my husband's age (87 on Sept 5) were the reasons for anesthesia, rather than the other possibilities I have read about. My husband and I are both concerned, to say the least, about the length of what we were told would be a non-invasive procedure. You sound much more informed about this situation than we are. I am glad you added some more information and concern to our limited experience. I think I will call the cardiologist and ask if he is aware of the length of time my husband will be under the anesthesia. Thank you so much.

ProfeChari: So the urologist is in charge now? Just wondering why a general (anesthetic) is being used to perform a cystoscopy. It's a procedure that does not require the pt to 'be under' with intubation...... I don't know.....
I'd be concerned... Good Luck.

Thank you for your concern, NIK2R3. My BP meds are Lasix, Diovan, and Cardura. My husband is preparing for a cystoscopy, and his cardiologist released him from taking it for that. The urologist wouldn't permit the use of anesthesia during the procedure unless he stopped the Coumadin for a week prior to it. Should I call his cardiologist about it, even though he gave my husband permission to temporarily stop it? I certainly don't want him to be in danger! Thank you for pointing out what to look for. You are very helpful.

Janet: B12 (sublingual) and Folic Acid should have no effect on the possibility of falling whatsoever. Can't find any literature to support this.

ProfeChari: First you: Your doctor is looking at the whole picture, I'm sure, since he/she has made no changes to your BP meds.......mind telling us what they are exactly?....Just curious.
Now for your husband: Here is a more serious issue. Coumadin or a prescribed vasodilator should not be taken off the table. If he suddenly discontinues the Coumadin, without the blood check, weekly or bi-monthly, he is in serious danger of an ischemic stroke. Atrial fibrillation produces an abnormal EKG. Sure he may seem fine, even more mobile, but the danger is lurking. I'd strongly advise keeping him on the Coumadin with regular check-ups. Give him the pill, same time every day and be on the look-out for subtle changes, such a speech slurs or talking jibberish, putting the fork up to his mouth and missing the mark, walking to one side if he tries to walk straight, and of course, falling. Good Luck!

The only medications my husband is on is Coumadin for A FIB and two different eye drops for Glaucoma. He was released from taking the Coumadin for five days before a procedure that will require anesthesia. Today is the first day after no Coumadin. He is more stable and not holding to furniture for balance. He feels so much better that he decided to make Belgian waffles for brunch, and they were delicious. As the mother of a previous poster said, it's six of one and half a dozen of the other. It makes me wonder if he should make some lifestyle changes and take his chances with the A FIB or take the medicine, feel badly, and struggle with his balance? I am on three blood pressure meds. I have lost over 40 lbs., but the doctor wants me to continue with no changes to BP meds.. When I first get up inn the mornings, I feel fine. After breakfast and beginning with only one BP med, I begin to feel lethargic and it is downhill for the rest of the day. Who knows which is better?

Cindy55, you hit on the issue of patients taking too many pills. When my Dad had a bad fall on his driveway and got a bump the size of a goose egg, the Cardiologist at the ER looked at all the meds he was taking and decided that Dad was taking too many different heart/blood pressure pills... she took him off of one... now after a couple of weeks, Dad is thinking a lot clearer because I know for myself my own blood pressure pills can zone me out.

My mother used to be on 10 different medications for years before coming to live with me. No one tried to take her off or test to see if she required all of them still. Slowly but surely I researched each drug to know about it's effects and side effects. I started out with the least harmful to her and did a slow reduction of a particular med. After having success in her showing no adverse side effects of not taking that drug I would report to her doctor and tell him she has displayed no need for it in two months.At first he didn't like it but now that he sees her kidney function improving and her edema under control (as opposed to never before ) he is pleased to see she is on only three meds with a fourth on used on rare occasions.

I wonder if it is really the medicine or the fillers being used the medicine. I know my Mom and I both have issues with fillers and with a lot of trial & error we have narrowed it down to one pharmaceutical manufacturer where we can use the pills made by them without all the crazy side effects. Some people can use pills made by all the manufacturers and have zero side effects.

Fillers are used to make the pill large enough to handle and there is the binder which holds the pill together. Then there is the coating on the pill.

Some common fillers are lactose (milk sugar), microcrystalline cellulose, corn starch, sugars, whey and yeast. Common binders are povidone, xanthan gum and Carbopol (an acrylic resin).

Coatings help to prevent the tablet from dissolving too soon. They are also used to keep you from tasting or smelling the active ingredients. A common coating is shellac - yes the same stuff used on wood floors.

Well another interesting one to be added in the future, marijuana.(dronabinol} https://www.alzheimersreadingroom.com/2014/08/marijuana-may-be-treatment-for.html

I wonder how B12 and Folic Acid increases the risk of falling? Also, how do NSAIDs increase fall of females only?

Thank you for the helpful article. I suspected that medications might be a factor in falls among the elderly and it's great to have the full story.

My dad is on several of these medications, with good reason, and sustained a fall last night. He split his lip and lost a tooth. D*mn this "new normal"!

Mother used to say, "It's six of one, and a half-dozen of another". Drugs should be prescribed with caution and only when necessary, however, when necessary, it is important that the patient rely on their own good common sense to prevent falling. All of us fall, or will fall at some time. My suggestion is simple: Think about falling when you walk. That's right.....think about it. Help may include the Hurry Cane, the four-pronged cane, the upright wlker, and another person to walk along with you.

On this list should be blood pressure medications as well.