Pharmacists well-positioned to support individuals living with dementia
Tuesday, November 27, 2018
Each year 7.7 million new cases of dementia are diagnosed worldwide. In the United States alone, age-related dementia affects at least 5 million people — a number expected to rise in upcoming years as life expectancy increases and more baby boomers age.
The high percentage of the population affected — around 1 in every 6 people aged 80 years and older — makes dementia something that medical professionals across all sectors will undoubtedly encounter.
Healthcare professionals and pharmacists who are person-centered in their approach will be able to provide much more effective care for this growing population.
Patient-centered care ideal for wide range of dementia symptoms
Dementia, an umbrella term for brain conditions affecting a person’s perception, memory and reasoning, manifests itself differently for each individual. Commonly characterized by challenges with language, thinking and problem-solving as well as changes in mood and behavior, the illness is progressive. The speed at which it progresses also depends on several factors.
Given the variety of symptoms and issues associated with the condition, pharmacists who offer personalized, patient-centered care are a real asset for those living with dementia, their families and caretakers.
:Each person’s experience of mild cognitive impairment and dementia will be quite different," writes Julie Blagburn, author of a learning article published by the Royal Pharmaceutical Society in Great Britain. "Pharmacists and pharmacy teams are well placed to assist in both the early identification of dementia, as well as to help patients manage their medicines."
"Whether the support takes the form of providing extra help with prescription ordering, collection and delivery, helping find solutions to help with medicines adherence or signposting patients to additional services or organizations who may be able to provide more specialist help, it is important that the approach is individualized to each patient," explains Blagburn.
Tips for assisting people with dementia in early stages
For the community pharmacist, having a private area available for discussions with patients, caregivers or family members will help facilitate increased trust and open communication. When speaking to people living with dementia, it’s far more supportive to concentrate on what they can do and how they can maintain their independence instead of their limitations.
Supporting patients in remembering their medicines is one of the ways pharmacists can help those with mild cognitive impairment. To begin with, the pharmacist needs to get to the crux of the problem to see whether the patient is forgetting to reorder or take medicines, or not recalling which medicines he or she has taken.
Then, the pharmacist can work with the individual to identify potential options to improve the situation then subsequently select the best fit for his or her lifestyle. One example is pairing medicine taking with another daily activity such as making a cup of coffee or watching a particular television program.
If patients regularly forget to take medication in spite of actions taken to remedy the situation, they may be avoiding it by choice. Pharmacists can make sure that patients clearly understand the benefits they’re receiving from each prescribed medication.
Issues faced in managing later stages of dementia
As dementia progresses, confusion and memory loss often increase, sleep patterns are disrupted and most activities of daily living become risky or impossible to manage independently, according to a report by the Alzheimer’s Society.
Pharmacists may face patients in later stages of dementia who become suspicious, easily agitated or even aggressive. Demonstrating to the individual that you pose no threat by keeping an open posture, moving slowly and deliberately, along with maintaining eye contact are recommendations found in a guide for care takers published by the National Health Service of the U.K.
It is more likely that patients living with more advanced dementia will be prescribed medicines to slow cognitive decline and/or manage behavioral and psychosocial problems. Such medications, which can include memory drugs or antipsychotics, often add complicating factors to prescription and pharmacy practice.
According to a report on the use of antipsychotic medication for people with dementia, around 90 percent of patients with dementia will experience challenging behavior such as restlessness or shouting or behavioral and psychological symptoms of dementia (BPSD). However, antipsychotics are thought to be effective in around 20 percent of BPSD cases.
Pharmacists are advised to verify whether medicines such as memory drugs or antipsychotics are being prescribed by a qualified specialist with the patient’s family or caregiver. Communication among everyone involved in the person’s care including pharmacists is important so all healthcare professionals are aware of and understand the patient’s treatment plan.
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