ElderWeb

Registration has begun for SILVERxCARD, South Carolina's new $20 million prescription drug plan for the state's poorest elderly. The SilverCard initiative will cut medication costs for the poor who are at least 65, have lived in the state for at least six months, and have no other prescription drug insurance.

Applications will be accepted until December 1. Seniors can call toll- free at (877) 239-5277 to have an enrollment form sent to their home. Local pharmacies, Councils on Aging, doctor's offices, libraries and legislative offices also will distribute applications. Those who qualify will be able to start using their SilverCard at participating pharmacies Jan. 1. Co-payments and deductibles will be determined in December but are expected to be modest.

Priority will be given to single seniors making $12,525 or less, and to married couples earning a combined $16,875 or less. But single seniors who earn $14,612 or less, and married couples earning $19,678 or less, also are encouraged to apply. Persons whose income is below SILVERxCARD limits but who have been rejected Medicaid coverage by the DSS due to assets may apply for SILVERxCARD and include with their application a copy of their rejection letter from DSS -AS LONG AS that rejection letter is dated within the past SIX MONTHS.

Some of the most common prescription and over-the-counter medicines can produce side-effects with symptoms similar to those of dementia, glaucoma, and other diseases of old age, according to Dr. Jacobo Mintzer of the Medical University of South Carolina in the September Journal of the Royal Society of Medicine. Some of the side-effects he noted were dementia-like symptoms of confusion, memory loss, and disorientation, and glaucoma-like blurred vision, dry mouth, constipation, urinary problems, dizziness, likelihood of falling, anxiety, rapid shallow breathing, and irregular or rapid heartbeat.

He said that illnesses like angina, diabetes, glaucoma, and dementia appear to be worsened by drugs with "anticholinergic activity". This includes many of the prescription drugs used in the treatment of Parkinson's disease, depression, allergies, migraine, and irritable bowel syndrome, as well as some pain relieving drugs. Non-prescription drugs of this type are also becoming increasingly available, including cold and flu medicines, indigestion tablets, sleeping pills and anti-diarrhoea treatments. The risk of side-effects from a dose of one of these might be very small, but many elderly patients take several kinds of medications at once, increasing the likelihood of "anticholinergic load".

Dr. Mintzer warns that elderly patients in nursing homes are most at risk, since some reports suggest that 60% of nursing home residents will have received drugs from the anticholinergic group in the past year, compared with only 23% of elderly people in the community. Doctors may assume that any side-effects are an inevitable part of the ageing process rather than something which could be avoided by altering existing medication regimes. The elderly are also more likely to be at risk from anticholinergic load because their metabolism is often less efficient, allowing drugs to stay longer in their system.