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Hard choices are definitely hard

The philosopher Ruth Chang of Rutgers University believes “hard choices” arise when “your options are not equally good, but none is better overall. They are good and bad in different ways.”

“What makes a hard choice hard is how alternatives relate,” she said.

Let’s stay with that observation for a minute. For some of us, a hard choice may involve the decision to get or abstain from getting the coronavirus vaccine — or that second booster. For older adults, that may not be a hard choice at all, but deciding which medications to take for pain — and when to take them — is definitely hard. A choice made many times daily in some cases.

The term “as needed” when it comes to pain medications — prescription or nonprescription — leaves choices up to us. When you’re in pain, you definitely want to make the best decision, so weighing the good and the bad is important. The goal is to alleviate or at least modify the pain while managing the side effects that inevitably come with those medications. They can range from severe constipation to debilitating fatigue.

My husband is on a new prescription medication with three pages of side effects. We could make the choice not to take it because of that, but I do not think we will.

Health providers and caring family members inevitably offer their perspective on the issue of pain management. Your helpmate and spouse may say, “Be sure you get in front of the pain.” Your clinician may offer, “Take Advil but not Tylenol — or is it Tylenol but not Advil?” Is acetaminophen the same as Tylenol? Is ibuprofen what is in Advil or Motrin? Aim for informed choice. Consider: www.healthinaging.org or www.fda.gov.

“The average number of prescription medications taken by people over 65 is five or six,” according to Dr. Michael H. Perskin, an assistant professor of medicine and an internist at the New York University Langone Medical Center. Maybe that’s not you, but maybe it’s your mother, or your step-dad, a good friend. Maybe it’s you in 10 years.

And when you consider how many prescribed medications you take, you also need to factor in your other over-the-counter medications — those that you buy in the local pharmacy, grocery store or online.

I used to say, “When a new medication is recommended, the first thing you absolutely must consider is, are there lifestyle changes I could make that would not require me to take this medication?” I am learning that when it comes to pain management, that’s too simplistic.

Yes, this is hard. The Centers for Disease Control and Prevention indicate that 85% of older adults have at least one chronic health condition, and 60% have two or more. The American Psychological Association found that 60%-75% of people older than 65 report at least some form of persistent pain.

I am an older adult. And I always think if we are well educated, if we have the best available information, we make better choices about medication use and lifestyle in general. I need to know more. Thought you might too.

Sharon Johnson is a retired health educator. Reach her at sharjohn99@gmail.com.