DEMENTIA
A CRUCIAL ROLE TO PLAY
WITH AROUND 90,000 PEOPLE NOW DIAGNOSED WITH DEMENTIA IN SCOTLAND EACH PHARMACY WILL NOW FACE THE CHALLENGE IN CARING FOR AN AVERAGE OF 80 PEOPLE IN THIS VULNERABLE PATIENT GROUP....
T
he 2012 'Improving Pharmaceutical Care in Care Homes' report not only
considered how the work being done by pharmacists with regards to pharmaceutical care and medicines management could be recognised more widely, but also explored ways in which pharmacists could be engaged in all aspects of dementia care.
As an Independent Prescriber, Audrey McAnaw from
Audrey McAnaw
McPherson Pharmacy in Broughty Ferry had been looking for
different ways to use her prescribing skills, so when she was approached by Diane Robertson and Kate Wood from NHS Tayside about becoming
more clinically involved in the care of her local dementia patients she was delighted.
'As a pharmacy team we had all noticed an increasing number of patients coming into the pharmacy who were being diagnosed with dementia,' said Audrey, 'and so we felt there was a local need to put steps in place to help both patients and their families cope not only with diagnosis but to help signpost them to local services. This pilot offered me the perfect opportunity to utilise my clinical skills for the benefit of dementia patients and to help improve our pharmacy’s standards of pharmaceutical care.'
'The model currently is that the patient’s GP refers the patient to the
psychiatrist-led team at Kingsway Care Centre, Dundee, to which all patients are referred for dementia services. At this time a diagnosis is made and a patient-centred care plan is formalised with their anticholinesterase medication being initiated by their consultant psychiatrist.
'The patient is subsequently referred to my clinic where I meet with the patient and their family and conduct a full medication review through CMS. My role is then to monitor their medication tolerance, compliance and effectiveness. I will meet with the patient at various intervals during the next six months depending on their individual needs, liaising closely with their consultant psychiatrist and altering the dosage or if necessary changing the drug. This is where my medicines and prescribing expertise comes into play. After six months the patient's GP will then take over the prescribing role for the patient under the shared-care agreement for Tayside.
Stress levels, if not managed, can spiral out of control.
WE CAN HELP Wardley wellbeing service
Workshops, e-therapy programmes, webinars and factsheets
Listening Friends helpline Support for those who may benefit from talking things through with a pharmacist trained to listen and reflect
Pharmacist Support – the profession’s independent charity Call Listening Friends: 0808 168 5133 Call general enquiries: 0808 168 2233 Visit:
www.pharmacistsupport.org Email:
info@pharmacistsupport.org
Pharmacist Support is a charitable company limited by guarantee registered in England & Wales, company no 9237609 & charity no 1158974
'I have also had training from the Kingsway Care Team to conduct tests for changes in memory which will also help review patients at the six and twelve month stages after their diagnosis. This has seen my role develop within the wider team in Tayside caring for our dementia patients which is a huge step forward for us.'
Audrey has already noticed benefits for the dementia patients in her care, particularly those of a practical nature.
'My clinic in Broughty Ferry gives patients who live on the east of the Dundee the option of being seen closer to their home for their reviews. This has already helped to make things easier for patients and their carers. 'This pilot has allowed me to take my pharmacist's role in the care of dementia patients to a different level and I’m looking forward to learning from it to further improve our patients care in the future.’
36 - SCOTTISH PHARMACIST
Meanwhile, just over 60 miles away in Edinburgh, Sally Arnison from Barnton Pharmacy, is heavily involved in ensuring that she and her staff are not only providing a care plan for their dementia patients, but also in developing a community-wide dementia-friendly initiative involving all local businesses.
Sally Arnison
'It was really towards the end of 2012 that I and my staff had become increasingly aware that dementia was becoming a major issue at the pharmacy, so I subsequently contacted Alzheimer's Scotland and they provided basic training for myself and the rest of the team in dealing with their dementia patients. Since that time, I've become increasingly involved in dementia care - including developing a dementia-friendly community forum in our part of Edinburgh.
'As all pharmacists will know,' Sally told SP, 'recognition of dementia symptoms is vitally important in signposting a patient to the relevant healthcare professional. With the increasing numbers of people being diagnosed with dementia, we have to reshape care for our patients through media such as telecare. As such, I now work as part of a multi-disciplinary team, which is looking at a very broad spectrum of ways in which we can assist our dementia patients.
'All of our staff are aware of how to recognise deterioration in a patient and we have a resource kit in the pharmacy which facilitates - and helps to guide - conversations between staff and patients on matters such as respite care. As pharmacists, we have a vital role to play in dementia care, particularly since we fall between health and social care - so we're ideally positioned to do the signposting for people at a very difficult time.' •
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