How a Geriatric Pharmacist Can Reduce Risk, Without Forcing a Move
Certain pharmacists are trained help seniors stay safely in their homes for as long as possible.
Board Certified Geriatric Pharmacists (Geriatric Pharmacist) usually work in retirement homes, long-term care facilities, and community health centres.
That’s why I’m one of the few in the Kitchener-Waterloo area who works out of a community pharmacy.
If you’re a senior living at home, or your elderly parent could use an extra pair of eyes, my training may help prevent a crisis — like a fall — before it happens.
Why Elderly Parents Refuse Help
When talking to patients who feel reluctant to get help at home, the most common thing I hear is, “I’m not ready.”
It’s common for anyone to fear losing autonomy & independence, and to avoid admitting they’re not as sharp as they used to be. That plus an emotional connection to their home makes it a tough decision.
Even wanting to keep a familiar routine can make change hard. Something usually has to go wrong before people will consider working with a different new health professional.
But it doesn’t mean nothing can be done.
We’ve had adult children who switched their parents over to our pharmacy because they want them to get better care.
What can help is explaining WHY you’re concerned, and reassuring them that keeping their independence as long as possible is the goal.
Geriatric Pharmacists can help because we know how aging affects the way your medications actually work.
What’s Actually Driving the Decline
As we age, our bodies change.
We all know our eyes and ears may start to go.
But other changes – like having a higher percentage of body fat and less lean muscle mass – are just as important when it comes to how well your medication works.
Muscle mass affects how your body metabolizes medications. So something that’s been fine for 30 years may become a problem.
An example of this is an increasing anticholinergic load.
It’s a technical term, but easy enough to understand.
Let’s say you’re on a single medication that contributes to constipation, dry mouth, and dizziness. But you’ve never experienced any side effects from it.
After a visit to the doctor, another drug with similar side effects is added, and suddenly you’re feeling dizzy. That’s because the impact of taking more drugs can add up.
Even something as common as Benadryl, which you can buy without a prescription, is notorious for increasing the load.
And Diazepam is a big one for me. I’ve helped multiple people get off it.
While they may be reluctant to stop — they’ve been taking it for years and can’t understand why it would suddenly be a problem — it’s a very high risk factor for falls.
But removing or reducing these kind of drugs have to be done carefully.
You can actually die from Diazepam withdrawal, never stop any of your medications on your own — it needs medical supervision.
What a Geriatric Pharmacist Does for Patients
One way I help patients stay in the home of their choice for as long as possible is by identifying problem medications, and doing what I can to reduce the risks.
Getting certified in geriatric care gave me few additional lenses for thinking about medications in a different context.
For example, I look at how a drug relates to kidney function, whether it’s increasing falls risk, and whether it’s helping or interfering with sleep.
My services include two types of specialized reviews — all with the goal of putting more eyes on a patient who could use a little more monitoring in the community.
What is a Geriatric Review?
The first is a Geriatric Review.
It happens right in the home, so I get eyes on how someone is actually living — is it cluttered, are there tripping hazards, who shovels the walkway? Not every age-related problem is medication-related.
You can pay for this service out of pocket if you need a comprehensive look at how safe the living environment is in the home.
What is a Medication Review?
The second service is a Medication Review.
This one is covered by OHIP. I can conduct this after you’ve switched all prescriptions to my pharmacy to ensure I’ve got the full picture.
The first step is building a complete list of everything someone is taking — what we call the best possible medication history — so if they land in the emergency room, that record already exists, saving time and reducing the chance of errors.
The geriatric assessment is what happens next: identifying the problems on that list and working to solve them, not just documenting them.
Right now, “deprescribing” is one of the big buzzwords in this field, and for good reason. It means looking at every medication someone is on and asking whether the medication or the dosage should be reduced or removed altogether.
The next step is handing your doctor the top three issues that need to be addressed.
We find family doctors who don’t have enough time to see their elderly patients appreciate having another expert eye on their team.
That’s because lurking in the background of any aging-in-place plan is the risk of a fall.
That means if you’ve already had a fall at home, the risk of another goes up significantly. You should explore ways to reduce the risks however you can.
As a part of your health care team, I don’t just do that from behind the counter. I like to deliver medications to folks who never come into the store, so I can lay eyes on them and make sure things are okay.
The One Change That Doesn’t Start a Fight
The good news is if you’re concerned about your parents, another loved one, or a neighbour’s safety at home, you may not need to convince them to move — not yet.
But how do you broach the topic?
Consider a few key facts, like:
- How often do you need to check in — once a week or once a day?
- How often are you getting calls — not at all, a few times a week, or 12 times per day?
Using numbers as a tool can kick off a conversation without raising emotions too high.
To help with this process, we’re happy to hop on a quick call — on the phone or on video — to introduce ourselves and explain why switching to our pharmacy can help prevent a crisis before it starts, and might even buy your family members a few more years at home.
Transferring your prescriptions is easy to do. You can fill out this form including name, date of birth and the name of your current pharmacy. We’ll handle the rest.
Our patients who made the switch are universally happier and glad they did.
It’s why we call ourselves a small-town pharmacy that just happens to be in the city.
If you’re ready to see whether a medication review could make a difference for your parent, reach out to The Medicine Shoppe in Kitchener and let’s talk.
FAQ
Can a pharmacist help with fall prevention — how?
Yes. Mainly through a geriatric medication review. I look for drugs that raise falls risk, adjust or remove them where I can, and work with the doctor on changes. I can also do a home visit to check for other hazards, like clutter or poor lighting.
How dangerous is a fall for an older adult, in your experience?
Very. Once you’ve had one fall, your risk of another goes up substantially. You have to assume more are coming and manage the risk factors you can control.
What is a Geriatric Pharmacist, in one or two sentences?
It’s my focus to help someone live in the home of their choice for as long as possible. I do that by identifying problem medications and doing what I can to reduce the risks.
Is aging in place realistic for someone with complex medical needs — what has to be true for that to work?
Everybody reaches a tipping point eventually. My focus is on extending that window of safety and confidence for as long as possible — not promising it lasts forever, but making sure it lasts as long as it safely can.