Strategies to Meet Specific Needs

Older Adults

• 2/3 of older adults suffer from a chronic condition
• Those 60 and over account for 1/2 of the medications going out

Learning

• Old age may affect the process but not always the ability
• It takes them longer to process information and sometimes the amount of data at one time
• This is an excellent reason to ask for feedback.
  • Get them to summarize what was said.
• Also may have to be talked to a little louder or slow; make sure you don’t assume that to be the case

Difference in Perspectives

• It usually boils down to what they were brought up in
• It was a completely different generation where during possibly the war, sharing was caring
• The reverent respect they have for doctors
• Some may feel that they are entitled to every bit of information possible, even if it is not necessary

Sense of Loss

• They are at a point of a lot of change and loss
  • New location
  • Loss of job
  • Loss of friends
• They may be feeling stressed, and you are the one they see
• They may have a lot of fear and anxiety about the future so they may actively try to control it their way

Visual Impairments

• Make sure everything is well lite
• Try to give them bigger fonts or different coloured paper
• Accommodate them the best you can

Hearing Loss

• Their hearing loss may be described as physically hearing the words and not being able to put them together
• Three general types of hearing loss
  • Central: when the nerve sensors in the brain are affected
  • Conductive: when something blocks the conduction of sound into the ear’s sensory nerve
  • Censorial: the problem is the sensory section of the central ear
• In men, especially higher, frequency sounds are the first to go, so speaking them in a low tone may help them to hear and understand you
• Many people with hearing impairment rely on reading lips and body movement
• So try not to stand a little distance from them and do not speak directly into their ear

Aphasia

• Stroke patients
• A reduced ability to understand people
• Their hearing is found it is the understanding they have problems with
• It takes them longer to process and longer for them to say what they want to say
  • Giving them a multiple-choice question is sometimes helpful
• A lot of their communicative abilities lie in repetition and memory
  • They know all seven days of the week but can’t tell you Tuesday comes before Friday
  • They know what to say cause they say it a lot
• Most times, it is easier to convey with a friend or family remember not to leave them out of the conversation

Patients with…

Disabilities

• Patients who are wheelchair bound
  • More often than not pharmacies are not set up for wheelchairs
  • Assuming they can get in the door the isles are often narrow making it hard to maneuver
  • Counters are too high
  • Try not to talk down to them when making eye contact
• Patients with learning disabilities
  • It is important to repeat key information
  • Try not to get frustrated
  • If the caregiver is present try to explain the medications/machine to them as well as the patient
• Patients who are homebound
  • Work with the caregivers
  • Take advantage of pamphlets and any written information
  • Communication over the phone is also a good option
  • Also recommending good websites that explain everything they need to know
  • Some insurance companies pay for in-home visits

Terminal Illnesses

• Meet the patient where they are
• Ask open-ended questions like “how are you doing” or “How are things going” to see how open they are
• Being open is the best way to ensure there are no mixed signals
• Sometimes the family members of the patients have just as hard of a time dealing with it and will commonly go through the stages
• Make sure the patients know they can talk if they want to and will not be judged for what they say

STDs

• In conjunction with the actual disease, they also have to deal with the psychological and sociological aspects
• They may become prey to the stigma and lose their support system
• They may need financial help as well

Mental Health Problems

• These customers might be socially different but should not be treated hugely different
• Asking open-ended questions helps you get to know them and how they function
• Sometimes less is more
  • Lot of psychotropic medications are used in non-mental health disorders and may freak out some patients

Low Health Literacy: is a problem when it comes to understanding their medications and drug directions

• The hardest problem is that is it almost impossible to diagnose until it is too late
• Studies have shown that adding pictures alongside the text helps them grasp the concept
• Having them summarize their instructions to you will show you what they do not understand so you can work it out with them

Patients

Who are Suicidal

• Myths about potentially suicidal patients

  1. They want attention

     1. Most people who have committed suicide have been giving warnings
     2. Typically they do want attention but it is because they have a problem

  2. Those who attempt suicide want to die

     1. Most suicide victims want an escape regardless of how they get it
     2. They typically think all hope is lost and there is only one way out

  3. Risk is highest when they are severely depressed

     1. Typically they almost get happier knowing “it will be over soon”

  4. Asking depressed people if they are suicidal puts that idea in their mind

     1. If they were not already thinking it wasn’t there
     2. Asking if they are suicidal shows you care about them and given them someone to vent to

  5. You can’t talk them out of killing themselves

     1. The feeling of needing to kill themselves is short-lived
     2. Therapy later is more to make sure they do not relapse

• Do not be uncomfortable if you think someone is suicide

• Stay with them until they get the right kind of help if your suspicions are true

Cultural Competence

• Communication may become an issue with the wide variety of ethnic backgrounds on a day-to-day basic
• Being sensitive to them and their situation to their differences and try working with community leaders to grasp some of the diversity
• Work to maybe find a translator
• Ask open-ended questions the more they say the best in a chance to understand one another

Are Caregivers

• Over the last few years having a caregiver is more and more common
• Making it harder and harder for the pharmacy team
• Written information is crucial
  • We have just discussed that the average reading grade is an 8 but more pharmacy handouts are written at a grade 12 reading level
  • Trying to explain something to one person to tell another person is hard
  • The best way to ensure good communication with the patient is to call them
• Be aware of the nonverbals
• Sometimes it is the caregivers who need reaching out to