Nursing Care of the Postmenopausal Woman, 3rd Edition
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but the use of restraints or drugs (CDC, 2021a; WHO, 2022). Healthcare fraud and abuse happen when a professional healthcare provider acts unethically. This might include charging for services the woman did not receive, overcharging or double-billing, over or under medicating the patient, recommending unnecessary procedures or medications, or getting kickbacks from suppliers (CDC, 2021a). As a woman ages, she may become more physically frail. She may not hear or see as well, and she may not function at the same cognitive level as when she was younger. Predatory strangers may try to sell her goods and services she neither needs nor can afford. Others may promise to take care of her in exchange for some of her assets. According to the Federal Bureau of Investigation, perpetrators of fraud target older adults for several rea- sons, including their likelihood of having some savings, their confusion over how to report fraud, their shame at having been defrauded, their declining cognition, and their vulnerability to fraud related to health issues (U.S. Department of Justice, 2021). The Federal Trade Commission found that 80% of telemarketing scams targeted people older than age 60 (U.S Department of Justice, 2021). Polypharmacy As women age, they frequently are pre- scribed more medications to deal with increasing chronic health issues. Wom- en are more likely to take multiple med- ications than men, and as women age, they may become more vulnerable to the side effects of the medications they are taking (CDC, 2022). A woman may take multiple medications multiple times during the day. Polypharmacy is the con- current use of multiple (>5) medications (Van Wilder et al., 2022). Remembering
which medications to take, and when, can be confusing, especially considering that some medications should be taken with food and others on an empty stom- ach. The Centers for Disease Control and Prevention has estimated that more than 177,000 older citizens visit the emer- gency department each year because of medication problems. Polypharmacy can be complicated when different providers prescribe more than one medication for the same problem or when two medica- tions are prescribed that have adverse drug reactions (Van Wilder et al., 2022). The situation becomes even more com- plicated when over-the-counter medica- tions are added to the mix. Metabolism and excretion of medica - tions can be altered as people age. Older adults are also at increased risk for drug toxicity, adverse reactions to medications, and drug interactions. Pharmacokinet- ics can cause one drug to interact with another and alter the absorption, distri- bution, metabolism, or excretion of the medication. Also, drug–drug, drug–food, and drug–disease interactions can lead to what is known as a “prescription cas- cade,” which is when the side effects of one or more drugs can lead to the misdi- agnosis of another syndrome rather than realizing that a drug interaction has oc- curred. If the result is a symptom such as drowsiness, the older woman may be at greater risk for injuries, to say nothing of the impact on her quality of life (Van Wild- er et al., 2022). Polypharmacy and its complications can be expensive for the older woman and for society in general. Visits to mul- tiple specialists and emergency depart- ments, as well as hospital admissions re- sulting from drug reactions cost billions of dollars each year in the U.S. Seniors may
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