RECOGNISING THE SIGNS


How One Pharmacy Is Supporting Patients with Dementia


Staff at Belfast based Balmoral Pharmacy are helping to identify patients with early signs of dementia so they can get treatment sooner to help manage their symptoms.


Pharmacy technician and dispensary manager, Bethany Hall, has taken advantage of a new dementia eLearning programme, available to all health and care staff in Northern Ireland, and is putting her skills to use in the pharmacy. She has also been able to share her learnings with other members of the team, improving the experience of patients who come into the branch with dementia.


Pharmacist, Gerry Watters, said it all started with a local patient who had dementia and had recently moved back to Belfast from England. “We knew we had more patients coming in who were struggling with dementia and we had spoken to families and realised that as a team we needed to do some training. But there was one dementia patient in particular that stuck with me. He wasn’t aware of what he needed and kept coming into the pharmacy at the same time every day. It all really started from that patient,” explained Gerry.


“We spoke to him to reassure him we were here to be able to help him. We communicated with his GP surgery and his family here and in England. We then arranged for a family member to come in with him to collect his prescription at the same time and day each week so he recognised our faces and felt it was a safe space,” he said.


The importance of routine


Bethany explained that the online course went through all the different types of dementia and different symptoms. “It explains the importance of routine and how you go about putting a routine in place for patients. I also learned that not every patient with dementia is going to have the same symptoms,” she said.


“It is a simple course to do, most of it is read out to you so there isn’t loads of reading to do and you need to answer a couple of questions at the end of each module. I am now planning to do an additional course from the Alzheimer’s Society. I have been able to share my learnings with all the other pharmacy staff so they understand how important routine is for dementia patients,” said Bethany.


Gerry said staff at the branch were now able to recognise possible early symptoms of dementia in other patients. “We chat with them and their families to see if they have noticed any changes but do it in a way that doesn’t make them panic. We then check with the doctors at the surgery to see if there are any issues we need to address.


“Because we now recognise the early symptoms in patients, we have been able to flag this with the GP and it has allowed those patients to get access to treatment earlier, helping them to maintain independence for longer and delaying advancement of the condition,” he said.


Awareness led to improvements


Bethany said that she had been surprised to discover on the course that one in three people live with dementia. “These patients don’t necessarily have a diagnosis. As people get older they simply put it down to their age. If they knew and were diagnosed earlier they could be started on medication to delay progression of the disease.”


Gerry explained that they have also been able to implement a range of improvements in the pharmacy for dementia patients since becoming more aware of the condition. “Once someone has been diagnosed we will put that patient straight onto blister packs to support the patient with taking their medication. We also encourage them to come into the pharmacy with a family member on the same day and time each week,” he said.


“When we speak to the patient we always use their name and fully engage them in the conversation. We ask them how they are doing and make sure we are not leaving them out of the conversation and only speaking to their family.”


They use the same approach even if the patient is not able to communicate back with them. “You still know they are okay and listening as they nod and smile. It is lovely when you get that little smile off them as you know you are making a difference.” said Gerry.


“These patients know the pharmacy is a safe place. We are creating an environment where they recognise a familiar face and know it is a safe place to be. We provide reassurance. We always try and make a bit of a fuss of them,” he said.


Working with others to improve outcomes


The pharmacy keeps any changes in the shop to a minimum and no longer moves products around. “We used to move stock around all the time but we have realised that people with dementia don’t like that so we try not to move things about too much so it remains the same familiar environment for them,” said Gerry.


Both Bethany and Gerry are now part of a local dementia steering group made up of other healthcare professionals, representatives from the Alzheimer’s Society and Queen’s University. They meet every month and have an action plan in place to improve life for dementia patients in Belfast. For Alzheimer’s Awareness Week the pharmacy team had a stand in local community halls where they spoke to patients, families and other organisations to raise awareness of how their pharmacy can support them.


Bethany is encouraging other pharmacy staff in Northern Ireland to take advantage of the dementia eLearning programme as she believes pharmacy staff are ideally placed to make a difference to patients living with dementia.


“We know patients don’t see the same GP each time they visit, so the GP does not have an understanding of what that patient is like normally. In the pharmacy we see the same patients all the time, we are a constant so we are ideally placed to spot those early symptoms and do something about it. We have now referred a number of patients to the surgery because we were concerned,” she said.


First regional dementia programme


The dementia eLearning programme is the first regional dementia training of its kind and its aim is to increase awareness and deepen understanding of the experiences of those with the condition.


Former Health Minister Mike Nesbitt said Northern Ireland has the highest prevalence of dementia rate compared to its UK counterparts with at least 25,000 people living with dementia and the number projected to rise to 43,000 people by 2040.


“Ensuring that staff are equipped with the correct training to care appropriately for those with dementia is therefore of paramount importance. The awareness module offers guidance on how to effectively support individuals living with dementia and helps staff enhance the quality of care provided to them and their carers, whether in hospital, at home, or within care facilities.”


The programme was created by the HSC Clinical Education Centre (CEC) in collaboration with the Regional Dementia Project Board for Northern Ireland, Health and Social Care staff, people with dementia, the community and voluntary sector, Queen’s University and Ulster University.


You can access the Dementia Awareness Training here


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