Focus on delivering person-centred care for older people
The attitudes and behaviours of pharmacy professionals can have an impact on patient outcomes, both positive and negative. Understanding the individual needs and concerns of older people is key in delivering person-centred care, a core element of the new standards.
In this article we have teamed up with Age UK to raise awareness of how pharmacy professionals can help older people with some of the challenges they can face within a pharmacy setting.
About Age UK
Age UK is the country's largest charity dedicated to helping everyone make the most of later life. The over-60s is the fastest-growing group in society and there are more of us than ever before. At Age UK we provide services and support at a national and local level to inspire, enable and support older people. We stand up and speak for all those who have reached later life, and also protect the long-term interests of future generations.
We are living longer
The number of people aged 85+ in England increased by almost a third over the last decade and will more than double over the next two decades. We are seeing similar patterns across the UK.
Many people in later life enjoy good health and do not need any additional support with daily living. Yet more than 60 per cent of people in their early 60s have been diagnosed with a long term condition. By the time a person reaches their early 80s, this rises to around 75 per cent, and by the early 90s it is over 93 per cent.
For a person aged 85, diagnosed with one long-term condition, there is an 80 per cent chance they are living with at least two others, and more than 40 per cent live with four or more. The consequence of this for many older people is having to take at least one and often many different medications as part of their treatment.
Providing person-centred care
Our new standards provide a framework that promotes shared decision-making and encourages pharmacy professionals to consider how they can provide person-centred care, whatever their area of practice. At the heart of the standards is the principle that every person is treated as an individual. This means recognising that the values and needs of people are different, even if they are managing the same long term conditions or health problem.
Pharmacy professionals can play a vital role in delivering care and involving, supporting and enabling people to make decisions about their health, safety and wellbeing. For an older person living with a long term condition, pharmacy professionals can often be central to helping them meet a whole range of their needs.
Through our recent consultation work around the standards we heard many older people talk about what person-centred care means to them and how the standards can have a positive impact on the care they receive.
One person told us that their pharmacist would always call before their delivery was due and would never deliver after dark. The pharmacist understood that they were living alone and that they may be worried about answering the door in the evenings.
Another person who suffered from hearing difficulties told us that their pharmacist would make additional written notes and instructions for them to ensure that they understood how to take their medication correctly.
Making every contact count
Polypharmacy is generally understood to be the concurrent use of multiple medication items by one individual. It is widespread but most common in older people.
Pharmacy professionals are well placed in the community and hospital to help older people to better manage their medications. They can do this by reviewing medication regimes, working with other professionals such as GPs to remove inappropriate prescriptions and helping to reduce harmful polypharmacy. They are also well placed to answer questions and encourage adherence.
Older people who have chosen to have their medication delivered may not have regular face to face contact with a pharmacy professional. In these circumstances, pharmacy professionals may choose to set up other means of ensuring they are supporting people and understanding their needs and what matters to them.
Pharmacies may have their own examples and experiences of providing person-centred care to older people. We wanted to highlight an example of what we had heard that a community pharmacy based in Lincolnshire was doing to proactively manage the pharmacy services they offer.
In order to help older people, the pharmacy set up monthly home visits for people receiving regular deliveries of their medication to allow them the opportunity to have a chat about their medication and to discuss any changes to their needs. The pharmacy makes records of their monthly discussions on a diary sheet and any changes are then flagged up. This has been well received, especially by older people who find it difficult to visit the pharmacy. They also contact the person ahead of a delivery to ensure they are available to receive their medication, and to expect them. This reduces the chances of people receiving their medication late or unexpectedly.
The pharmacy has placed a strong emphasis on building good relationships with older people using their pharmacy by adapting the care they provide to meet the person’s needs.
Pharmacies can use these types of arrangements to play a role in preventative strategies too by providing healthy living advice.
Later life and the digital world
As more services are moved online, the impact on older people can be significant. Internet use among older age groups has increased substantially over the past 5 years, but there are still non-users. 4.2 million people aged 65+ in the UK have never used the internet.
Age UK believes that older people should be supported and encouraged to get online, but those who cannot or do not want to do so should continue to be able to access services and support in a way that suits them.
Pharmacy professionals can take simple steps to ensure that the services they offer are accessible to older people by adapting their communication to meet the needs of the person they are communicating with. It is important to make sure no one is excluded from services and the help they need because they are offline.
Living with dementia
Over the past decade, we have seen a slow but steady increase in life expectancy. As a result, more of us are spending more time in later life with multiple long-term conditions, frailty, dementia and social care needs.
Pharmacy professionals must work in partnership with others, and for those living with dementia, engaging with family and carers is essential.
Within the community, pharmacy professionals can ensure their pharmacy is accessible to older people, especially those living with dementia, by providing a welcoming environment, a clear layout and by having dementia-friendly trained staff.
Simple things can also be done to make life easier for older people with dementia. For example, to minimise the confusion that someone with dementia might have, they may try to keep brands and appearance of medication as consistent as possible.
Find out more
- The standards for pharmacy professionals set out the key elements to consider in delivering patient centred care
- Age UK provide services and support at a national and local level to inspire, enable and support older people
- Alzheimer’s UK runs Dementia Friendly Communities - a programme which facilitates the creation of dementia-friendly communities across the UK.
- CPPE have an open learning resource for pharmacists and pharmacy technicians on managing medicines for older people and a learning programme on older people
- Pharmacy Magazine published a feature on older people's health
- A blog post in the Pharmaceutical Journal by a pre-registration pharmacist trainee shares their training experiences working with older people