role of the pharmacist in geriatric patients

1. Hammad Elahi
PPCS20E013
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College of Pharmacy,University of Sargodha

2.  Communication barriers in elderly patients.
 Role of clinical pharmacist in geriatric health problems
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College of Pharmacy,University of Sargodha

3. The aspects or conditions that interfere with effective
exchange of ideas or thoughts.
Followings are communication barriers in effective
communication;
 Physical barrier
 Psychological barrier
 Physiological barrier
 Barriers The Professionals
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College of Pharmacy,University of Sargodha

4.  Environmental & natural conditions act as barrier.
 Noise
 environment/Climate change
 Information overflow
 Drive through window
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College of Pharmacy,University of Sargodha

5. Causes of Psychological Barriers
 Lack of Attention
 Poor Retention
 Distrust and Defensiveness
 Emotions
 Anxiety and stress that comes from addressing sensitive
topics can block effective communication and lead towards;
 Shyness
 Lack of confidence.
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College of Pharmacy,University of Sargodha

6. The self….
 Age related changes
 Hearing
 Vision
 Cognition
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College of Pharmacy,University of Sargodha

7.  This cause for communication problems is reversible.
 Taking medicines often produce adverse effects on the elders
such that they become easily fatigued or confused.
 Therefore, they find it difficult to understand communicative
patterns.
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College of Pharmacy,University of Sargodha

8.  Poor Listening Habits
 Inconsistent Signals
 Credibility Issues
 Time and Work Demands
 Psychological state
 Tone of Voice
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College of Pharmacy,University of Sargodha

9.  Structural or neurological damage from disease processes
 This condition is often caused by other diseases such as brain
lesions, Alzheimer's, Parkinson's, or strokes.
 Most of these conditions produce permanent results, there are
a few coping mechanisms and strategies provided for patient
so that they are able to communicate effectively.
 Can be caused by Delirium, Dementia or Depression
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College of Pharmacy,University of Sargodha

10.  Improving Communication With Older Patients
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College of Pharmacy,University of Sargodha

11.  The communication process in general is complex and can be
further complicated by age.
 One of the biggest problems (healthcare providers) face when
dealing with older patients is that they are actually more
heterogeneous than younger people.
 Their wide range of life experiences and cultural backgrounds
often influence their “perception of illness, willingness to
adhere to medical regimens and ability to communicate
effectively with health care providers.
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College of Pharmacy,University of Sargodha

12.  Studies have shown that older patients receive less
information from physicians than younger patients do, when,
in fact, they desire more information from their physicians.
 Because of their increased need for information and their
likelihood to communicate poorly, to be nervous and to lack
focus, older patients are going to require additional time.
 Plan for it, and do not appear rushed or uninterested. Your
patients will sense it and shut down, making effective
communication nearly impossible
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College of Pharmacy,University of Sargodha

13.  Eye contact is one of the most direct and powerful forms of
nonverbal communication.
 It tells patients that you are interested in them and they can
trust you.
 Maintaining eye contact creates a more positive, comfortable
atmosphere that may result in patients opening up and
providing additional information.
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College of Pharmacy,University of Sargodha

14.  Good communication depends on good listening, so be
conscious of whether you are really listening to what older
patients are telling you.
 Many of the problems associated with noncompliance can be
reduced or eliminated simply by taking time to listen to what
the patient has to say.
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College of Pharmacy,University of Sargodha

15.  The rate at which an older person learns is often much slower
than that of a younger person.
 Therefore, the rate at which you provide information can
greatly affect how much your older patients can take in, learn
and commit to memory.
 Don’t rush through your instructions to these patients.
 Speak clearly and loudly enough for them to hear you, but do
not shout.
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College of Pharmacy,University of Sargodha

16.  Simplifying information and speaking in a manner that can be
easily understood is one of the best to ensure that your
patients will follow your instructions.
 Do not use medical jargon or technical terms that are difficult
for the layperson to understand.
 In addition, do not assume that patients will understand even
basic medical terminology.
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College of Pharmacy,University of Sargodha

17.  Information overload can confuse patients.
 Avoid this, instead of providing a long, detailed explanation to
a patient, try the information in outline form.
 This allow you to explain important information in a series of
steps.
 For example, first talk about the heart; second, talk about
blood pressure; and third, talk about treating blood pressure.
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College of Pharmacy,University of Sargodha

18.  When giving patients instructions, avoid making them overly
complicated or confusing.
 Instead, write down your instructions in a basic, easy-to-
follow format.
 Writing is a more permanent form of communication than
speaking and provides the opportunity for the patient to later
review what you have said in a less stressful environment.
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College of Pharmacy,University of Sargodha

19.  Visual aids will help patients better understand their condition
and treatment.
 Pictures can be particularly helpful since patients can take
home a copy for future reference.
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College of Pharmacy,University of Sargodha

20.  As you discuss the most important points with your patients,
ask them to repeat your instructions.
 If after hearing what the patient has to say you conclude that
he or she did not understand your instructions, simply
repeating them may work, since repetition leads to greater
recall.
 You may also want elderly patients to bring a family member
or friend in during the conversation to ensure information is
understood.
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College of Pharmacy,University of Sargodha

21.  The National Council on Patient Information and Education
recommends having a nurse or pharmacist repeat instructions
for taking medications, and it advises always combining
written and oral instructions.
 However, be aware that if patients require a second or third
repeat, they may become frustrated and disregard the
information altogether.
 An effective technique to try at that point is to rephrase the
message, making it shorter and simpler.
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College of Pharmacy,University of Sargodha

22.  Once you have explained the treatment and provided all the
necessary information, give your patients ample opportunity
to ask questions.
 This will allow them to express any apprehensions they might
have, and through their questions you will be able to
determine whether they completely understand the
information and instructions you have given.
 If you have doubts, you may want to contact the patient in 24
hours to review educational points.
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College of Pharmacy,University of Sargodha

23. Role of clinical pharmacist
in geriatric health problems
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College of Pharmacy,University of Sargodha

24. It is evident that if patients do not use the medications
prescribed to them, the benefits of those medications are
negated completely. With intimate knowledge of
medications and impact of medication nonadherence,
pharmacists can simplify complex regimens and to assist
older adults adhere to their appropriate poly pharmacy.
Such interventions can produce improvements in
medication adherence that can extend to improved clinical
outcomes for older patients on poly pharmacy.
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College of Pharmacy,University of Sargodha

25.  Older patients most often suffer from chronic diseases,
including asymptomatic conditions, such as hypertension and
dyslipidemia. Pharmacists having extensive knowledge of
medications to treat chronic conditions and an up-to-date
stance on clinical guidelines can provide impactful care to
older populations.
 Pharmacist care consisted of patient education, adherence
interventions, cardiovascular risk assessment, medication
management with communication to providers, or provider
education
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College of Pharmacy,University of Sargodha

26.  Preventable medication errors are highly prevalent during
transition points in older patients’ care, whether they are
moving from home to hospital, or hospital to home,
rehabilitation facility, or nursing home.
 Medicine management & medication reconciliation
performed via phone by pharmacists within patient-centered
medical homes and impact on patient readmission and cost
savings.
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College of Pharmacy,University of Sargodha

27.  Inter professional team-based care has often been posed as
a solution to growing older populations with heavy chronic
disease and medication burden. The roles of pharmacists
have evolved from being a chemist to drug dispenser and
basic educator to now direct patient care provider serving
as medication expert within inter professional teams in
diverse settings
 The recommendations made most often by pharmacists
included dose adjustment, administration time and
frequency, and medication discontinuation.
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College of Pharmacy,University of Sargodha

28. 1. Sunil Kripalani, MD, MSc Kara L. Jacobson, MPH, CHES . Strategies to Improve
Communication Between Pharmacy Staff and Patients: A Training Program for
Pharmacy Staff. AHRQ Publication No. 07(08)-0051-1-EF October 2007
2. Lee JK, Alshehri S, Kutbi HI, Martin JR. Optimizing pharmacotherapy in elderly
patients: the role of pharmacists. Integrated pharmacy research & practice.
2015;4:101.
3. Thomas E. Robinson II, PhD, George L. White Jr., PhD, MSPH, and John C.
Houchins, MDFam Pract Manag.2006Sep;13(8):73-78.
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College of Pharmacy,University of Sargodha