Pharmacy cognitive services are a vital part of providing help for people with dementia and their carers, says Jon Kontopos, CEO of Dementia Caring.
Speaking during Dementia Awareness Month (September), Kontopos told the AJP that pharmacists have a significant role to play in caring for these patients and helping to educate them about their condition – a condition which is frequently not well understood.
“I think the public have a limited understanding of dementia,” he says.
“However, with over 340,000 people with dementia in Australia, that’s a lot of Australian families who are currently affected, so more and more people are becoming aware of what dementia is and recognising the signs of dementia in their loved ones.
“Medication and care go hand in hand – while it is important to have the correct medication for anyone living with dementia, tailored home care and providing a comfortable environment makes a huge difference to the life of people with dementia.”
People in the industry cannot ignore one over the other, he says.
“It’s not enough just to give the medicine without the care aspect. It is important to address the factors such as the person’s health, comfort, and home support first before jumping into medication – by minimising distress and agitation it is usually possible to reduce the use of medication, or cut down on medication which only targets the symptoms of dementia, e.g. antidepressants, sleeping medication.”
Home medicine reviews, therefore, are very relevant in dementia, he says, as they can help establish the right framework for correctly taking medication.
“I think behavioural and psychological symptoms of dementia can often result from unreported pain, other illnesses, drug interactions and environmental factors, which can all be helped with adequate, tailored home care,” says Kontopos.
“Pharmacists and those in the pharmacy industry can work together with dementia awareness groups and home care groups to achieve the best outcomes for people living with dementia and ensure they are getting the holistic care they need.”
Pharmacists may also be able to spot signs that a patient may need referral, he says.
“Pharmacists might notice their customers who are coming back too frequency for repeats which means they are forgetting that they already took their last tablet and taking too many.
“Alternatively they might notice their customers aren’t coming back for repeats when they are due, meaning that the customer might be forgetting to take their tablets.
“Other signs are that customers make repeated visits to the pharmacy for no reason, forgetting why they went there. This is often due to people with dementia going to places like the shops and pharmacies, just because it’s a familiar place.”
More warning signs could include:
- becoming frightened;
- becoming more withdrawn;
- darkness around the eyes;
- wandering around the shop looking dazed or disorientated;
- personality change; and
- weight loss.
He also suggests five tips a pharmacist can pass on to customers, which may help them when caring for a loved one with dementia:
- Planning, planning, planning
“Your loved one may lose track of simple routine tasks like showering, doing laundry, or feeding pets. The best way to keep track is to create a routine for these activities, and stick to it—don’t try to change familiar environments, and use checklists to act as reminders.”
- Safety is paramount
“Your loved one might find getting around the house more complicated than before, especially in cases of decreased mobility. Consider installing handrails in baths, showers and toilets, and using large fonts on time-orienting objects like clocks and calendars.”
- Simple communication is key
“Your loved one may find it difficult to speak fluently, understand simple sentences, or accurately express emotions. The best way to communicate with your loved one is to use short, simple sentences, keep calm while responding to them, and use positive body language.”
- Eat well, drink well
“People living with dementia often forget to eat and drink, so it is important to monitor their eating and drinking habits. Offer them easy-to-chew food and drinks regularly (five-six times a day), and set an alarm to remind yourself about their meal times.”
- Seek professional help and support
“The Aged Care Assessment Teams (ACATs) perform assessments for older people with dementia to determine their needs for home-based support or residential care. There is also a variety of dementia care groups such as Alzheimer’s Australia and National Dementia Helpline that can offer assistance.
“The pharmacist should also remind the family member of friend that the type of support a person needs is strongly dependent on their individual situation. There is no one-size-fits-all care routine, and as such, care needs to be tailored to cater to their personal needs.”
“Pharmacy professionals should also advise customers that it is important to seek professional help if at any point, caring for their loved one becomes challenging,” says Kontopos.