Okay, listen up, how many of your residents are currently taking low dose (baby) aspirin daily to prevent cardiovascular events and/or strokes? Any idea? My guess is quite a few! Here’s the scoop as we know it today. The U.S. Preventive Services Task Force issued a bulletin that states “people 60 or older should not start taking aspirin”. The statement was very clear, left little to the imagination so think about what our current gold standard is, how many of our attending physicians are ordering low dose aspirin as a typical order?
So why the abrupt about-face? Well, if you read the statement it says “don’t START taking aspirin” after the age of 60, it says nothing about residents already on the aspirin regimen. Not sure about your center but the average age of nursing home residents in 2020 was 85 years old and relatively few residents are younger than 65 years of age. This is true of nursing homes but what about assisted living? Well similarly, the typical assisted living resident is between 75 and 84 years old. There are a few who move in close to the minimum age requirement (usually about 65), but again, not 60 years old.
A good rule of thumb is to remember that there is no pharmacological agent in the world that is without some side effects and risks. The risks, of course, bleeding in the stomach, intestines, and brain and these increase with age and can be life-threatening. Now what? First, talk to your attending physicians, have them evaluate anyone currently on a low-dose aspirin regimen, and determine if it is a safe choice. Second, educate the resident and their families on the risks and benefits and allow them to make an educated decision, stop or continue. It may also be helpful to have the QAPI committee review the statistics and determine if a further investigation would benefit your residents. Stay well, stay informed, and stay tuned!