March/April 2020 Print - Debra Levy Eldercare Associates

Are generic drugs inferior?

If your relative is taking brand-name prescription drugs, a switch to generic could provide significant savings.

Why are brand-name drugs so expensive? It takes a lot of money and time to develop a new drug. In particular, it must be tested to show it works and is safe for humans. Patent laws give an innovator company 10 to 20 years to sell the drug with no competition. When the patent expires, any company can develop the generic equivalent. It is less expensive because they don’t have to repeat the testing.

The Food and Drug Administration approves both brand-name and generic drugs. The two medicines are identical in

active ingredient(s), strength, quality, safety, and how they work
required lab testing to prove they are absorbed 80%–120% as well as the original (the average tends to be 96%–104%)
manufacturing standards that ensure consistency and purity

Brand-name and generic drugs are different in

inactive ingredients. Think fillers, binders, colors, and flavorings
appearance, such as shape, size, and color
clinical testing on humans. This is not required for generics
name. The generic’s name is scientific as it was not created for advertising

The biggest difference is cost. Generic drugs cost about 66%–85% less than their brand-name equivalents.

Is there a downside to generics? Not generally. Some consumers in online forums write that the generic has not worked as well. But there is no scientific evidence or study to explain or support these personal reports. Others mention more or different side effects. There may be some validity to this. Pharmaceutical companies are always looking to reduce side effects. Perhaps the latest version has a new twist that is enough to make it easier for your loved one to take. With no generic version available, this brand-name update might be worth the extra cost.

Consult with the doctor or pharmacist if you are considering a switch.

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When Dad "saws logs" all night

If your loved one snores, this may be a sign of “sleep apnea.”

All snoring jokes aside, sleep apnea is a serious condition that deprives the brain of oxygen. A person with sleep apnea goes without oxygen for at least 10 seconds, five to 30 (or more) times an hour. It happens because the soft tissues of his or her airways collapse and stick together, blocking air.

What should be restful sleep time is instead mini-suffocations and a nightlong struggle to breathe.

Sleep apnea is more common in men than in women. Aging is a big risk factor. So is nighttime alcohol consumption. Both cause the soft tissue of the airways to lose tone and collapse. Obesity, smoking, and allergies are also contributors (all three narrow the airways).

Sleep apnea has multiple potential consequences.

Type 2 diabetes. The chronic nightly jolts to the nervous system affect the body’s blood sugar control.
High blood pressure. Sleep apnea is estimated to be a factor in 38,000 deaths from heart-related problems each year. The risk of heart disease increases by 30% and risk of stroke by 60%.
Earlier onset of dementia. Those with sleep apnea appear to develop dementia as many as 10 years earlier than their full-breathing peers.
Depression, foggy thinking, and irritability. Quality of life definitely goes down when you don’t get a good night’s sleep.
Car accidents. Daytime fatigue seems to result in a 2.5 greater risk of falling asleep at the wheel.

Just because sleep apnea is more common in men does not mean that Mom is immune.

If either parent snores, wakes up with headaches or a dry mouth, complains of daytime fatigue, or has trouble with fuzzy thinking or irritability, talk to the doctor about a sleep apnea test. There are more than a few logs at stake.

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Are you pushing against reality?

We all quarrel with reality from time to time and wish things were different than they are. Especially when life seems unfair. For instance, your mom, who has disabling arthritis, develops memory loss and now can do even less for herself. Or your brother’s wife gets a promotion out of state, so he has to move and can no longer help with Dad.

While anger and resentment are completely natural responses, harboring such feelings does nothing to improve the situation. In fact, it perpetuates emotional suffering for you.

Although you can’t change these events, dialectical behavioral therapy (DBT) posits that your self-talk—your internal “story” about them—is where you have options to ease the strain in your life.

Don’t fight reality. By “radically” and unconditionally accepting life as it is—on its own terms, with no blame, anger, or resentment—you can shed a layer of tumult. It’s natural to think, “This shouldn’t be happening!” Without acceptance of what is, however, you’re in an endless and exhausting battle with reality, pushing the rock uphill when gravity clearly prefers it stay in the valley. Instead, try dropping any “shoulda, woulda coulda” thinking. Refocus your self-talk on the present, what is now and real.

Practice accepting self-talk.
“I don’t like this but it is the truth of my situation.” “I am (sad/mad/frustrated) about this … but it is not something I can change.” “I accept that my life (or situation X) is what it is.”

It’s not as hard as you might think.
We daily practice acceptance of little things, such as yielding to the fact of a traffic jam. And likely you have done it—eventually—for big things, too, like a breakup you may not have wanted.

When acceptance is not healthy.
If you are in an abusive or unsafe situation, work toward change—not acceptance. Seek guidance from a counselor if you are uncertain.

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