How many pills do you take in the course of a week? Include the popular vitamins and supplements that many people take and

you might be surprised. For the elderly, they may be taking dozens of pills every day, some from their doctors and some taken randomly. Vitamins and supplements are heavily marketed products, with all sorts of promises being made on the radio, TV, and internet, often by doctors hired for that purpose. This marketing is effective.

What can happen?

I see lots of elderly people in the course of a day in my law practice. A few weeks ago, one of my clients (let's call him Tom) ended up in the emergency room in serious condition. I'm Tom's agent under his POA, so Tom told the hospital to call me and I went there to find out what was happening. This was one of the times that having an advocate -- a family member, private social worker, or an attorney -- was important. It took some discussion and searching, but I finally figured out that Tom had been taking five different prescription medications from three different doctors, plus 14 vitamins and supplements. I got a list of these and the doctor was able to pinpoint what caused the problem. Tom was released and is doing fine now. I contacted his doctors and everybody is on the same page. Tom agreed to get permission from his primary care doctor before he takes any kind of pill.

What's in this stuff?

Tom was taking one supplement with a name like "Power ABC", while at the same time taking "Energy XZY" and "Good Life 123". All three of these pills contained similar ingredients, so Tom was getting triple and even quadruple dosages of the same things. Some pills were counteracting the effects of other pills. The result was to land Tom in the emergency room with something close to kidney failure.

Tom didn't mean to do this: he thought he was taking care of himself, but instead, he ended up accidentally poisoning himself. His doctors didn't know he was taking the vitamins and supplements because Tom never thought to bring it up to them.

What can you do?

If you are acting as an agent for a relative or friend, or simply taking care of somebody and looking out for them, it is a good idea to find out what kind of medications, vitamins, and over-the-counter supplements and meds the person is taking. An agent under POA is usually paying bills for the principal person, so look closely, especially at credit card statements.

Companies are constantly marketing new medications and vitamins. It is easy to buy on the internet or by calling an 800 number, which was exactly what Tom was doing. My suspicions were aroused by Tom's credit card bill, which had hundreds of dollars of charges for vitamins and supplements.

Be proactive. Coordinate between the person's doctors. Elderly people often see three or four different specialists, so make sure that each one knows what the other is prescribing. Don't assume that the doctors are checking this. Few doctors have time to make telephone calls to each other. 

Being an agent under POA often means being an advocate for your principal when that person cannot advocate for themselves.