How do we figure out how much medicine my 99-year-old mom should be taking?

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She is looking her balance and has bowl issues. I am thing the drugs might be causing some problems.

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At 99 chances are she is taking too much medication and/or too high dosages.

First, I would go to her pharmacist and ask for a consult. Pharmacists understand the effects of drugs on a person given their age and weight.

Second, I would take what the pharmacist says about all of her meds to her current primary care physician and ask for a consult with the express purpose of weening her off medication and/or lowering doses.

Unfortunately, many doctors are not properly trained in dosing old people. Old people are like children insofar as needing dosages adjusted for their age and weight. You wouldn't take your child to a general internist; that's what pediatricians are for.

Finally, I would consider finding a geriatrics practice and having her seen by a doctor and/or geriatric nurse practitioner who specializes in health care of old people.
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Just wanted to add that your mom must have done a lot right over the years to be 99.
Do check out the geriatric primary if you can. It's been a positive thing for my aunt. Her prior primary didn't seem to be very aware of elder issues. Also my aunts pharmacist pointed out to me that one of her bp meds that she had been taking for years causes a lower pulse. I had been noticing her pulse was in the 50s so that was valuable information for her.
Also ask whichever dr for a home health evaluation and physical therapy evaluation. This can really help monitor her vitals and strengthen her through therapy.
Consider allergies for the dizziness.
Notice her food intake. Has she lost weight? Does she have a good appetite. Also extreme heat and dehydration need to be monitored. She may feel comfortable when she is a little warm but is the heat depleting her?
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My aunt takes probiotics every morning with breakfast. This with a daily dosage of miralax
Keeps her digestive system in good order.
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When my parents moved in with me they were going to multiple Drs each month. I got a geriatric PC dr, and had him go over everything! Less Drs, less meds and (dad passed due to alz) mom is doing as well as can be expected at her age! Find a geriatric Dr, it was great for us
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Thank you for sharing all your experiences. This is a tough one. I would have the doctor review her medications. I am very worried about the side effects of all the medications the elderly are taking. There is no one right answer for everyone, but its good to advocate as much as you can for your 99 year old mom. For myself, I would try to get by with a little meds as possible. Given her age, it might not be uncommon to have balance and bowel issues. But check with the doctor and get a second and third opinion if necessary.
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I do want to say that as caregivers we need to keep a handle on our parents medications. Here where I live if Primary does not have privledges at the hospital you are in a staff doctor takes over and...they don't consult the primary. An example: Mom was in the hospital for Graves desease. Her heart rate was too fast so she was given medication and oxygen. This continued when shecwent home. Her postox was checked everyday and had been normal for over 2 months but she was still using oxygen and taking the med for her heart rate which had also been normal because of her thyroid meds. I questioned it all at Mom's next Dr. Visit. If I hadn't Mom may still be on both. The oxygen was stopped and the med for heart rate she was weaned off of.  My husband has normal blood pressure.  He went into the hospital for AFib which they were able to get under control.  He was sent home with BP meds.  I questioned why, I was told his BP was high.  Yeah! because he was in AFib.  He took them and went to see his Primary 2wks later for a follow up.  His BP was so low she was surprised he could stand.  She took him off the med right then.  Next hospital visit, we will be seeing primary asap.  
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I am assuming that you are not worried about how much or how little medication Mom is taking but if what she is taking is causing her problems. I like the pharmacist idea. I feel they know more than the doctor's when it comes to interaction of meds. At 99 there maybe some she doesn't have to continue but this would be her Primary Drs call. Your Mom is 99, God bless her, things are going to start giving out. Does she use a walker, if not maybe she should. Does her diet include apple juice, prune juice, fresh fruits? The last thing I would give her is laxatives or stool softeners. My Mom did well on Phillips Milk of Magnesia. When u mean bowel problems, is it because she doesn't go everyday? Mom's Dr said if she didn't go by 3rd day, then Phillips first. But this is something that u should leave up to her Dr
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Does she live with you or independent? My dad is 95, lives independently and I "thought" he was taking his medicine correctly. He gets blood tests weekly for blood thinners and his numbers were always off. Come to find out that was the reason. He was taking all of them but some he was supposed to be taking at night some in the morning. That was throwing his tests off. Now I have a in home nurse coming once a week to do tests and make sure his meds are in the right daily/night container. I was doing it up until a couple of years ago and then made sure he was doing it right before handing the reins over to him. He is VERY unstable without his walker and is good about using it when he goes out but it in his apt due to furniture (and there's not that much). I would definetly check with the dr. At 99 there might not be anything that can be done due to declining age but along with that medication. Good luck and God Bless.
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Read the label on the bottle. That'll tell you when the prescription was filled and with how many tablets. Now count the pills to make sure the correct number are missing for the number of days since the refill. Make sure you take into account whether the refill was for one month or three.

You can try filling a pill box for her if she will allow it. You can also visit daily and give the morning or evening dose and leave the next dose with a clear label of the time to be taken. If you have the right question her pharmacist or Dr about what prescriptions have been written within the past year. Prescriptions are only good for one year.

Make a clear list of all prescriptions you find so it can be taken to all Dr appointments.
All medical records are now supposed to be in electronic form so one Dr can easily check her records from another Dr.

Finally dispose of any expired medications properly.
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Take the list of meds with dosages to her pharmacist and ask if s/he sees meds that might be causing those issues.

Next, is she seeing a geriatrics doctor? They often take a "less is more " approach to meds.

Third, how certain are you that she is taking only meds that have been prescribed and in the correct dosages?
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