Health literacy and Medications
To my surprise, the health literacy of the individuals in my family vary greatly. I am going to use my father and my father-in-law as examples because their similarities and differences provide an interesting illustration. Both men are in their seventies, both are a healthy weight and have lived active lives, both received a Masters degree from Columbia University and had successful careers.
My father was diagnosed with type II diabetes mellitus when he was in his forties. His treatment plan includes oral antidiabetic medications along with exercise and diet modification. He is in good health and knows more about the physiology of his body than most members of the general public. In addition, he is married to a Nurse Practitioner who keeps him on informed about his medications, as well as aware of any signs and symptoms that indicate potential problems. He is knowledgeable about what medications to take, what they do, when to take them, and what is doses are.
My father-in-law has been healthy for most of his life. Three years ago he was diagnosed with prostate cancer. After consulting with his physician he decided that the best intervention was no intervention. He, like many elderly men with prostate cancer, is using the approach of “watchful waiting” and “active surveillance.” He lives alone in an apartment in midtown Manhattan. About a year ago he started to show signs of early memory loss and has since been diagnosed with the Alzheimer’s disease. Several factors now contribute to his low health literacy level and confusion about medications. One problem is that while he was gifted in mathematics, he had little interest and is not knowledgeable about how the body works. Having lived a very healthy life, he has little experience with medications or the medical system. In addition, one of the first signs of changing cognitive function is difficulty solving math problems (eg paying bills). While he can remember what medications he is taking and when to take them, he is not able to understand safe doses.
I think both of these men illustrate how two seemingly similar individuals can have two totally different health literacy levels and require different approaches to education about medications. Being able to recognize the needs of the individual is paramount and requires careful assessment.
