WEBVTT
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Welcome to the A JP podcast,
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A podcast for pharmacists by pharmacists where we discuss current events,
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relevant topics, and emerging issues. I'm your host, Carle Oo.
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And together with the A JP,
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I'm bringing you the opinions and expertise of different pharmacists to discuss
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their views and insights on topics relevant to pharmacists.
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Please like and rate each episode and subscribe to the podcast so you don't miss
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an episode.
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So my name is Jenny Kirschner, I'm a pharmacist and I've worked across retail,
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pharmacy and hospital pharmacy and as a national health programmes pharmacist as
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well. And I'm the founder of pals,
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which stands for Pharmacy Addressing Loneliness and Social Isolation,
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and also the founder of the World First Pharmacist training programme on
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loneliness. Thank you for having me.
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Thank you so much for your time. Jenny,
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wanted to find out about what prompted you want to undertake this
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research and producer course. Course.
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Yeah,
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so I experienced a lot of loneliness in my twenties and thirties
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and it really was a very painful experience.
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And like many people who experienced loneliness,
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there's a lot of shame and a lot of stigma. So I hid it very well.
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I even remember working at the hospital that I was working at as a clinical
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pharmacist,
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and to the outside I was really outgoing and so
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people wouldn't have known. But at home in my private life, I was living alone.
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I felt very lonely.
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So I really felt for a long time that people should
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talk about this more because as I learned more about loneliness,
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I learned that it didn't mean something was wrong with me,
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it was just really human,
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and it just actually was a warning sign to me to say, or an alert to say,
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Hey, the relationship quality that you want,
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you are not getting and therefore you're feeling lonely.
So once I realised and
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learned more about this and learned about the impacts that long-term
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loneliness can have on health,
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I thought actually I'd like to do something.
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I wish there was something available for me at the time that could have
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demystified a lot of things and helped give an explanation and context so I
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would've been supported to make my way through loneliness and then
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out of loneliness with the right support.
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So really that it came from my own experiences of loneliness
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and also realising that pharmacists see patients struggling with loneliness all
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of the time. And I think often we know that,
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but we don't necessarily do anything about it. We are not comfortable.
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We feel like it's outside of our scope.
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We feel like it might open Pandora's box and be too much,
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and we wouldn't know what to do with it. So I thought, well,
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actually there's a lot that we can do that doesn't take much time,
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doesn't cost much,
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but could be deeply transformational for our patients,
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shifting them away from, or again,
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helping them through their loneliness experience. So that was really the drive.
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Thank you. Can you tell us a little bit about the prevalence of it and yeah,
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social media, things like that.
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What has caused it to increase in the population and who are the people who are
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most affected?
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So the statistics are unbelievable actually.
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And I mean unbelievable in it's hard to actually believe that this is true.
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So one in three Australians feel lonely and one
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in six feel what's called chronic loneliness or persistent
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loneliness or intense loneliness, I should say. Sorry, intense loneliness.
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So that's a large number.
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So there are many risk factors and triggers which are different that can
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contribute to someone feeling lonely. But before I touch on some of them,
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I just want to remind us all that being lonely or experiencing loneliness is a
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human experience that at some point we will all have.
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So loneliness is not a mental illness.
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It's really important to distinguish here.
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Loneliness can increase your chances of experiencing depression or anxiety,
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and if you were depressed and anxious, perhaps you might feel more lonely,
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but it is not a mental illness, it is really human,
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right?
So when I give you these numbers, it might be surprising on the one hand,
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and on the other hand, well,
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we're humans who transition through lots of things in life,
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and there are times that we would be at increased risk of loneliness.
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So let me talk about a couple of those things. So things like triggers.
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So for example, if you've had someone bereaved,
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if you have moved out of home to go and study at university.
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So all these lifestyle or influencing factors can
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increases your chance of feeling lonely. But as pharmacists,
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we also see patients at high risk because of perhaps more demographics
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or other influencing factors such as socioeconomic status,
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or if you've come and you're a migrant or you don't speak English and you're in
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an area that's just English speaking,
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there's information showing patients on opioid replacement therapy programmes,
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they're at high risk of loneliness.
New moms,
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all the new moms that come into the pharmacy,
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there's a life transition there where suddenly they are having a different
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identity or an identity crisis and they're not necessarily surrounded by people.
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And a really interesting and important point here also is that
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loneliness doesn't just affect the elderly population.
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So contrary to what might feel like an obvious sum being
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elderly and therefore feeling lonely in Australia,
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in fact the population most at risk of loneliness currently are the 18 to 25
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year olds.
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So let's all just let that sink in for a moment because when you're in that
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peak time of feeling like you imagine, life is great,
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to imagine that there are so many people feeling lonely
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is profoundly disturbing. And I think you touched on it before,
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we've got a different landscape.
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The kids are engaging with technology all
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of the time.
Now, technology per se doesn't necessarily cause loneliness.
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It's how it's being used. So think of all the places where we used to hang out,
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go to the movies and you might see someone have popcorn,
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and now you sit at home and watch Netflix. You used to go to,
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as a mom, perhaps the library for library time to collect some books,
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and now you might listen to audio. There's meetings of the team and Zoom.
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So all of our interactions either being replaced with or
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being impacted by technology.
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So for young adults who are using,
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not even going to university,
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I mean there's a lot of courses that are still online.
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So there's a limit in the amount of actual time that you can have
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for opportunities for social connection,
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but also social skill development is being impacted.
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Covid is a contributing factor also.
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So the next phase at the moment, people term,
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this era,
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the last 10 years or so have been a race for attention.
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So you've got all this social media and all the marketing,
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and we're really in a battlefield of trying to get your attention.
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What they're talking about with AI and AI bots and agencies is
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really a race
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to grab your intimacy and they call it the weaponization of loneliness.
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So if you've got someone who's feeling vulnerable due to feeling isolated
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and or lonely,
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then if you offer them some shiny new object that's there all the time and
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really feels like it's understanding you and knows you well,
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and they're not showing any of the nuances of what it is to be a human,
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they're not disappointing you. They're not letting you down.
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They're not confrontational. They're available 24 hours a day.
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Then there's something alluring about that if you're feeling vulnerable.
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And the challenge with that is
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you can't replace the nuances of what it is to have face-to-face human
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connection.
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We are wired as human beings for human
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connection in real life, human connection. Now technology,
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if you're in a remote area and you can't access in,
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it can be useful to connect people,
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elderly people into generational connections. It can facilitate.
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But if we get into the path of it replacing human interaction,
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then there's real concern about the future of humanity actually in that
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space, which I've gone a bit deep there. We've gone all into ai. But.
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No, I appreciate it because I dunno,
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you keep hearing about people talking about covid taking another way that you've
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just mentioned it, talking about covid and the impacts,
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and even on young children who couldn't go to school and couldn't go to
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childcare and lost a lot of the social skill development during that stage,
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and we probably won't see the impacts yet for the next few years,
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but there's that, and people are saying that even politically,
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everyone's just so polarised now,
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and it's just creating more and more division and separation.
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So there's so many social aspects as well causing it.
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So I guess I would say with all of this going on in the environment,
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I guess it makes sense that a lot more people are impacted by loneliness.
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What are your thoughts?
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Yeah, no, I absolutely agree.
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I think loneliness has been around for a long time
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because we are human,
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but there are factors that are influencing the amount of or the acute
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nature of loneliness. And the challenge also with loneliness,
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we've touched on it before, is if we are not talking about it,
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if we're health professionals, for example, not discussing it,
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then we are not empowering our patients and other people,
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other humans to realise, oh,
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this is just a sign to me that my social relationships are not where I want them
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to be, and I'm not nurturing that. So what can I do?
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We are leaving it in the space of shame and stigma where people
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internalise the experience of loneliness to feel like something's wrong with
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them,
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to feel like they're not worthy of love or connection to feel like they can't
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reach out long-term.
Loneliness has maladaptive
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cognition affects meaning that people start to feel like even though you need
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connection as the remedy,
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you start to withdraw more socially because you feel judged because you feel
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like people don't get you, you are not worthy.
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And so it's kind of counterintuitive.
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You actually step further and further away from people rather than being open to
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the connection that you need to start to shift you through that experience.
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So I think to answer your question,
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I think there's a lot of work to be done because we are not even talking about
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it.
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The US surgeon general in the US put out an
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advisory on how America should address this,
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and part of a statement that he talks about, which I really think gives context,
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is that we need to be approaching loneliness the same way we
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have been approaching other public health issues like obesity, smoking,
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and tobacco, and even over there they talk about the opioid crisis.
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That is the degree of impact that loneliness can have on help. They're on par.
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And if we can understand that as health professionals,
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which is why I created the evidence-based training programme,
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if you really comprehend the impact that this has,
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then I feel like it's a professional responsibility that we start to do
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something about that. So yes,
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I agree with your sentiment.
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Thank you. I guess thinking about introverts, extroverts,
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meaningful connections, how can this look different for different people?
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Great question.
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I'll start by saying no one is immune to loneliness,
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and I think that kind of actually answers your question,
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but it doesn't matter whether you're an introvert or an extrovert or you are
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young or you're old,
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or if you're in a room full of people or if you're in a room alone,
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you can still experience loneliness.
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I'll take this moment to answer your question,
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but just divert a tiny bit to share that loneliness is different to social
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isolation and this is really important.
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So loneliness is a subjective experience that if I feel lonely than
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I am lonely. Whereas social isolation is a number. So for example,
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if you see someone living alone,
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they're isolated or they don't have many interactions or no interactions,
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then they would be classified as isolated because that's objective,
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that's a number. Whereas you can be in a room full of people.
I mean,
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I'm sure we've all experienced this and still feel lonely.
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So coming back to your question,
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you can be introverted or extroverted and still feel lonely.
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It just depends on the person.
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So there's no prescriptive number of how many or how much contact you need
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to as a
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protective factor against isolation or loneliness or loneliness specifically.
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Sorry, there's no specific number.
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It's just what your individual needs are, your individual social needs.
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So an important part of working through loneliness is identifying or what do I
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need?
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Am I someone who likes to engage with a couple of people or do I like being
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crowded? What is nourishing for me?
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And then make sure that you can craft that. And if you don't know, well,
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that's part of this beautiful journey that loneliness can offer is that ask
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you acknowledge this is feeling like I'm lonely,
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giving people the language to acknowledge it,
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and then really assessing what makes me feel good,
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what environments make me feel good, what kind of people,
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what kind of conversations,
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and then go forth and create that landscape for yourself.
So it's not a
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simple answer other than to say everybody's individual,
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their needs for social connection are very different.
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Everyone can experience loneliness.
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But if you go through the process of learning about yourself,
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knowing what makes you feel connected,
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and if partly this is about connection to yourself,
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am I being authentic as a person in the world? And if I'm being authentic,
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then what kind of people share those same values?
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And then when you engage with them,
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that's more likely to be meaningful connection.
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And then you determine whether you need a little dose of that or a lot of dose
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of that,
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a larger dose of that you get to determine based on when your cup feels
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full in its simplest terminology.
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Thank you. That makes a lot of sense.
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You've mentioned the stigma and the shame that comes with it.
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So can you tell us a little bit again about that from the perspective of the
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individual who is feeling lonely?
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Yeah, as I kind of touched on before,
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because it's a little bit, well, again, it's not mental health,
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but let's bring up mental health as a comparison for understanding stigma and
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shame. I think we've
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taken quite a few steps in Australia to shift some of the stigma.
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Are you okay? Dave, for example,
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do a great job at allowing people to share and realise that they're allowed to
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share that they're not okay. We haven't yet got there with loneliness.
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So internally, what happens when you're feeling lonely,
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really at the core you feel like there's something wrong with you?
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What is wrong with me that people that I'm not connecting in with other humans,
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and it's so visceral.
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So just at the core of what it is to be a human to connect,
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that if you are not connected, it feels like something is wrong with you,
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you're not looking at other people blaming them, you're feeling like,
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what am I deficit in?
What is not good enough about me?
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And then what happens is you start to, as I mentioned, kind of withdraw further.
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So I think the stigma and the shame stops people
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admitting that they're lonely and therefore stops 'em getting the help they need
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to move through it.
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So it's a real deterrent to addressing loneliness at a
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high level
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in the last six months in Australia and globally. But in Australia,
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there's been a shift. You'll see A, B, C doing
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reports or radio interviews on people who are lonely.
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So there's some help.
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There's some shift going on where people are starting to talk about it.
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And I have people tell me that they're lonely. When I experienced loneliness,
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I couldn't say the word.
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I remember I was telling a friend about this idea of a programme that I was
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going to create to help address this.
And when I mentioned the word loneliness
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and she's one of my best friends, I whispered the word. It wasn't on purpose.
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I just couldn't say I couldn't relate myself to that experience of
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loneliness because it's very painful.
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There are MRI studies that have been done that look at pathways in the brain and
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the pathways in the brain that are activated during physical pain are similarly
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activated when you experience loneliness.
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So it's physically a painful experience.
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So the shame and the stigma,
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it's very alive in the experience. I found it, as I said,
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hard to say the word when I was going through it, and I feel like that,
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and we can perhaps get to this in a moment,
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part of the role of the pharmacist is to help de-stigmatize loneliness,
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help to normalise it so we can just talk about it. Because again,
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reiterating what I've said a few times, it's really human.
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It's really human for us to desire and crave meaningful
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connection and to feel seen and be heard and valued as a human being.
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Thank you. We've mentioned social skills as well,
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and I guess in the times that people may not have the same opportunities to
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develop their social skills as they might've had in the past,
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what changes have you seen in your research as well with social skill
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development and where we're at now?
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I dunno if I've got a full complete answer to that other than to say I've seen
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more and more social skill development programmes coming up,
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especially I've got two young children at school and I have paid
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for, I mean,
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there was an offering at the school where they at lunchtime had social skill
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development. They didn't call it that. They called it funtime lunchtime,
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where people who were having more challenging experiences connecting in the
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school ground, which can be such a confronting place,
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they scaffold and help children learn the skills to manage
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negotiation and conflict and joining play.
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And if they're not interested in the programme,
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how to leave that kind of play and enter another group.
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So I think ideally this starts at an early age. I mean,
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I think it scores something that's very much alive in my mind now is
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neurodiversity and difference in ways of learning and difference in ways of
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being.
And I'll talk about the school playground, the school environment.
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It is really challenging heartbreakingly challenging for kids who learn
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differently to be in a school system who only kind of see a particular way.
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And I think what's hard is unless we have support for the children to
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learn all children,
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those who are neurotypical and those who are neurodivergent to help each other
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bridge the gap of how to connect,
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then that's setting up kids for a really a lifetime of challenge in their social
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space. And everybody craves connection.
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We might need different amounts and it also might look different.
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There are children perhaps or adults who don't enjoy eye contact as much as
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their form of communication,
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but they may play side by side that is just as valid,
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but we all need to understand that so we can respect different ways
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of play and different ways that connection looks.
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Again, coming back to your question,
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which is now kind of past my mind, can you just rejig my mind?
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Yeah. It was about social skills.
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Yes, yes, thank you.
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So I think I'm seeing lots of programmes crop up and pop up for young
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people and more people with disabilities, for example,
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or other people because there's a recognition that there's a skill in this.
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We learn as humans how to have respectful conversations,
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how to have attentive listening,
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how to engage and ask questions with the other person. Reciprocally.
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These are things that don't necessarily naturally come and also depends on what
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you've been exposed to in your household and how you've learned to engage.
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So social skill development is one core component.
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There are a couple of other components.
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It's also opportunities for social engagement.
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So if children aren't invited to parties, for example,
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if you're not being included, you don't have those opportunities.
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And also needing to take into account what makes someone comfortable to engage
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in a social opportunity. So if someone doesn't like large crowds,
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and I'm going on this particular stream, it's riping my mind at the moment,
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but if it's very noisy or too loud when we're not giving the right opportunities
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for individuals
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to engage or to find the like-minded individuals where they feel
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comfortable to connect.
So there's social skill development,
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there's opportunities again where pharmacy can play a role.
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Many pharmacies have health events or health
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initiatives in the pharmacy. Sometimes they have educational events.
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These are opportunities where people can come along in an environment where they
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trust and they feel safe that they can come and be themselves and perhaps
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mingle with other people.
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And then there's also other things like we talked about skills and
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opportunities, and then some of the cognition. So as I mentioned,
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the brain changes over time.
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If you've been chronically lonely and you might need things like CBT or some
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other interventions or positive reframing of your mindset to
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realise you're not being judged the way you think you are or you are worthy
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of being in certain environments. So there's a spectrum of things.
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At the moment, they do not have the best evidence-based approach.
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That's how new this space is.
In terms of research,
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they definitely think cognitive behavioural therapy or some of that
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cognitive behavioural therapy is most evidence-based,
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but that's for people who are chronically lonely.
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And then all the other initiatives are kind of being evaluated at present,
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not only at an Australian level,
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but at a world health organisation level where they have what they call,
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I think it's got heat maps or their maps, evidence maps, evidence gap maps.
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So there's maps of a whole range of interventions,
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everything from companion robot pets through to social skill
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programmes individually or in groups.
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And they've kind of ranked how much evidence is currently available for the
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different interventions. But this is new space.
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And if I was to say one thing, I'd say as pharmacists,
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we should do something rather than nothing.
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And what we're doing is got little to no risk at all.
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Just acknowledging that your patients are lonely goes a long
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way to letting someone kind of drop and feel seen.
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So even though I'm sharing that we don't exactly know the best evidence approach
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at the moment, that's not to say we shouldn't do anything.
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We absolutely have a role to play in helping to raise awareness and
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de-stigmatize and normalise and provide
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opportunities or encourage opportunities for social connection.
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Thank you. And the term social prescribing,
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I've been hearing that a lot more lately,
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and I thought I'd find out from you what does that actually entail?
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So I'm going to read you the consensus definition if that's okay,
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because I feel, and then I'll explain it. So this says,
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social prescribing is a means for trusted individuals in
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clinical and community settings to identify that a person has
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non-medical health related social needs,
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and to subsequently connect them to nonclinical supports and services within
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the community by co-producing a social prescription,
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which is a non-medical prescription to improve health and wellbeing and to
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strengthen community connections. So at a very simple level,
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rather than prescribing a medication for someone,
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if you find somebody has non-medical health related social needs that we are
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prescribing something that is non-medical by connecting them to
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something in a social activity or a social service in your
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local area. So for example, it might be volunteering,
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it might be going to play bowls,
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it might be what's the new one?
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Pickle club or Pickle Pickle, pickle Ball. Pickle Ball.
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But the important thing here, and I'll highlight the word, is co-producing.
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So this isn't a pharmacist or a GP or a trusted individual saying, Hey,
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let me prescribe for you to go to tennis.
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It's actually sitting down with a person to hear them,
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to actively listen to them,
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to understand what is meaningful to them and what would make their life
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great.
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And then helping to co-design and bridge the gap between that desire that they
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have and what's available in the local community.
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So my next question was going to be practical skills pharmacists can use to
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support patients on a daily basis, which kind of ties into that,
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I guess you're saying that pharmacists are adequately placed,
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they know a lot more about what's going on in the local community and having the
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opportunity to talk to the patients and help identify what's important to them
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to bridge that gap.
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So I wanted to find out practical skills that pharmacists can use on a daily
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basis to bring those together.
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So I guess the most important thing,
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and I'll just kind of flag here if it's okay, the training,
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the World First Pharmacist training on loneliness.
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So it's a training programme that's created that it's worth actually looking,
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if you're interested in the subject, it's worth taking a deep dive. Five hours.
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It's comprehensive, and it's got interviews with global experts,
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including the World Health Organisation and other people,
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including pharmacists who are on the ground already doing this kind of work.
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So I'm going to give you a top level view of what's covered in there in terms of
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what the pharmacist can do.
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But in terms of taking a deep dive into the practicals and the health impacts,
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it might be worth having a look at. You can find it for PSA members, it's free.
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And for other people there's a cost. But so at a high level,
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what pharmacists can do at a patient level is talk about loneliness,
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as we've mentioned, is when you identify someone, if you see someone,
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don't avoid the subject.
What you learn in the training programme is how to talk
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about loneliness.
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Some people might not use the word loneliness because of the stigma and shame,
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but you could still through conversation if speaking to someone,
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you could pick up if someone's not connecting with anyone and they're
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feeling like they have to deal with all the challenges themselves.
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So number one is that we can talk about loneliness.
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We can also increase awareness of the impacts of loneliness on health.
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So as pharmacists,
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we give advice on healthy eating and exercise as part of holistic care. I mean,
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you wouldn't dispense a medication for a patient who's a diabetic and not think
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about the food if you know that they're coming in and eating McDonald's.
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I just feel like you'd make a point because as a pharmacist, you're trusted,
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you know them well, you have a relationship, and you would feel an obligation,
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a sense of professional responsibility to just let them know in the appropriate
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manner to think about their food or their food choices because of the impacts it
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has.
And in the same way, there's a new kind of fancy term coming out,
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social health,
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same thing when you're speaking to someone, when you're advising them,
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when you're seeing someone in pain perhaps because of loneliness,
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and you need to find out through conversation.
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You I think have a professional responsibility to educate them,
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to let them know that they deserve connection and it's important for their
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health because loneliness can impact physical, mental, and cognitive health.
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And if they know that social connection is protective,
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they know that, then they can go forward and do something about it.
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So I think we can talk about loneliness at a patient level,
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increase awareness of the health impacts of loneliness,
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but also the protective factor involved in connection.
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And then you could also, what you've mentioned, talk about social prescribing.
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So if you know of a patient and they always talk to you about, actually,
480
00:29:28.680 --> 00:29:33.120
I'm going to share a story to give the perfect example I just saw on LinkedIn,
481
00:29:33.120 --> 00:29:37.230
a pharmacist shared a story saying that she had a particular customer who was
482
00:29:37.230 --> 00:29:40.380
always resistant to chatting, very closed off,
483
00:29:40.870 --> 00:29:45.340
and each time she tried a little bit more just to get him to open up.
And one
484
00:29:45.340 --> 00:29:47.500
day she started to talk about fishing,
485
00:29:48.130 --> 00:29:53.050
and she said he totally softened and he opened and they started
486
00:29:53.050 --> 00:29:57.580
to over the subsequent interactions, talk about stories,
487
00:29:57.580 --> 00:29:58.600
fishing stories,
488
00:29:59.140 --> 00:30:03.970
and she said all it needed was her hearing and understanding
489
00:30:03.970 --> 00:30:08.260
about him and then being patient and slowly increasing
490
00:30:09.850 --> 00:30:12.190
the focus on that part of the conversation.
491
00:30:12.520 --> 00:30:16.510
And so that was a relationship now that shifted that experience.
492
00:30:16.990 --> 00:30:18.910
The patient was no longer grumpy when he came in.
493
00:30:18.910 --> 00:30:21.790
Every time he'd softened and he would come in for that connection.
494
00:30:22.060 --> 00:30:25.060
So if for example, that patient loves fishing,
495
00:30:26.830 --> 00:30:29.980
or as part of your job, you could look what's in your area,
496
00:30:30.040 --> 00:30:32.560
you could do a quick Google search if you're more savvy at that than your
497
00:30:32.560 --> 00:30:36.850
patient, if you know there's a fishing club for that age group and it's safe and
498
00:30:36.850 --> 00:30:38.170
appropriate for that gentleman,
499
00:30:38.650 --> 00:30:43.120
then you could suggest or you could share with him a flyer or call the
500
00:30:43.120 --> 00:30:48.070
organisation on his behalf or just give him the steps to take to join
501
00:30:48.070 --> 00:30:52.840
that club if there's such a thing that exists.
So when we talk about
502
00:30:53.080 --> 00:30:56.710
referring people or connecting people in a social prescribing framework,
503
00:30:57.040 --> 00:31:01.990
part of it could be that connecting them to something local or there are lots of
504
00:31:01.990 --> 00:31:06.430
social prescribing programmes that are being run out of primary health networks
505
00:31:06.430 --> 00:31:10.690
around Australia, and you need to go looking for them. And if you find them,
506
00:31:11.470 --> 00:31:16.420
then you can refer patients into this programme because these programmes have
507
00:31:16.420 --> 00:31:19.780
what's called link workers. Now. Link worker is a new term,
508
00:31:19.780 --> 00:31:24.670
and it's kind of a new stream of occupation where the
509
00:31:24.670 --> 00:31:29.140
sole job of a link worker is to facilitate the connection for someone between
510
00:31:29.140 --> 00:31:31.870
what is meaningful to them and what is available.
511
00:31:31.870 --> 00:31:36.580
So that patient might need someone to hand hold their hand for their
512
00:31:36.580 --> 00:31:40.480
first encounter or the second, and that's what they're willing to do.
513
00:31:40.690 --> 00:31:45.370
Or the link worker might just call up and make the appointment for them or enrol
514
00:31:45.370 --> 00:31:49.270
them in a programme, and that might be sufficient.
So again,
515
00:31:49.270 --> 00:31:52.510
tying it back to what the pharmacist can do, talk about loneliness,
516
00:31:52.600 --> 00:31:55.630
increase awareness, know what social prescribing is,
517
00:31:55.900 --> 00:31:58.330
look for programmes that are available in your area,
518
00:31:58.330 --> 00:32:02.260
specific social prescribing programmes. Reach out, introduce yourself,
519
00:32:03.640 --> 00:32:08.050
look at what's available in your community and have those things available that
520
00:32:08.050 --> 00:32:09.280
if you meet somebody,
521
00:32:09.490 --> 00:32:14.050
you can share what's available as a bridge between the healthcare sector
522
00:32:14.410 --> 00:32:16.150
and the community care sector.
523
00:32:17.800 --> 00:32:22.120
And I'll give two more concepts of what I think people could think about is
524
00:32:22.990 --> 00:32:27.850
sharing resources with patients. Flies like a CMI, but a social version,
525
00:32:28.210 --> 00:32:31.720
what is loneliness? There is a self-care card available.
526
00:32:32.020 --> 00:32:34.630
And then also into the future,
527
00:32:34.630 --> 00:32:37.090
there are validated screening tools for loneliness.
528
00:32:37.450 --> 00:32:40.820
So in medication reviews or home medication reviews,
529
00:32:41.030 --> 00:32:43.730
in addition to asking about the lifestyle components,
530
00:32:44.090 --> 00:32:49.010
you could ask either a single item measure question or a four item measure
531
00:32:49.010 --> 00:32:53.900
question around someone's experience of loneliness.
Some of the measures use the
532
00:32:53.900 --> 00:32:56.600
word loneliness, and some of them don't indirect.
533
00:32:57.050 --> 00:33:01.820
But there are ways that we into the future could start to capture this data as
534
00:33:01.820 --> 00:33:05.750
part of holistic profile of that patient and holistic care.
535
00:33:06.920 --> 00:33:11.420
So yeah, these are some of a sprinkle of ideas of practically. Again,
536
00:33:11.420 --> 00:33:13.190
I don't want people to be intimidated.
537
00:33:13.820 --> 00:33:17.090
I want people just to start by acknowledging that yes,
538
00:33:17.090 --> 00:33:21.530
I see loneliness in many of my patients that it's really human.
539
00:33:21.530 --> 00:33:22.363
It's okay,
540
00:33:23.060 --> 00:33:27.800
learn how to talk about it so patients feel safe to open up and you as a
541
00:33:27.800 --> 00:33:28.910
pharmacist feel safe. I mean,
542
00:33:28.910 --> 00:33:32.660
pharmacists feel lonely within the health profession.
543
00:33:33.440 --> 00:33:36.980
There's lots of loneliness as there are with gps also.
544
00:33:37.280 --> 00:33:42.170
So it's important to be able to be vulnerable yourself and
545
00:33:42.170 --> 00:33:43.970
share your stories with patients. So yeah,
546
00:33:43.970 --> 00:33:47.120
I had a bit of an average day and I felt quite lonely on the weekend.
547
00:33:47.120 --> 00:33:49.190
And if you are comfortable doing that,
548
00:33:49.190 --> 00:33:53.480
it's unbelievable what can come as a result of that honesty and the
549
00:33:53.480 --> 00:33:56.450
vulnerability and the connections that result there.
550
00:33:57.950 --> 00:34:00.770
Brilliant, thank you. I'll ask you one more question,
551
00:34:00.770 --> 00:34:04.700
but I guess beyond the scope of the training, I guess,
552
00:34:05.780 --> 00:34:09.410
what did you want to share with pharmacists that have completed the training or
553
00:34:09.470 --> 00:34:10.550
what they can do after?
554
00:34:11.960 --> 00:34:16.310
What I would love to see and where I think this is going is that
555
00:34:17.870 --> 00:34:21.800
I'm on the leadership team of what's called the International Social Prescribing
556
00:34:21.800 --> 00:34:23.090
Pharmacy Association.
557
00:34:23.420 --> 00:34:27.350
So there's some pharmacists globally who have come together to define or
558
00:34:28.220 --> 00:34:31.520
propose the role that pharmacy can play in this space.
559
00:34:32.120 --> 00:34:37.100
And we need some pilots to really evaluate and
560
00:34:37.100 --> 00:34:38.810
understand what's feasible,
561
00:34:39.950 --> 00:34:43.610
where are the remuneration funding models, where are they going to come from?
562
00:34:43.970 --> 00:34:44.810
All of these things.
563
00:34:44.810 --> 00:34:48.170
I'm not at all proposing in terms of social prescribing that we should be doing
564
00:34:48.170 --> 00:34:50.780
this stuff for free. A lot of us do it anyway as pharmacists.
565
00:34:51.350 --> 00:34:56.210
So I think the bigger picture is we will see some larger scale pilots involving
566
00:34:56.210 --> 00:35:00.650
pharmacy, so we can collect the data and then determine a roadmap and a pathway.
567
00:35:01.160 --> 00:35:02.570
But right now,
568
00:35:02.720 --> 00:35:07.490
I feel like if you've done the training and you feel like you're not sure where
569
00:35:07.490 --> 00:35:08.323
to start,
570
00:35:09.020 --> 00:35:13.820
just start small.
There are stories in the training programme of pharmacists who
571
00:35:13.820 --> 00:35:18.800
even have, for example, a couch instead of chairs in their pharmacy.
572
00:35:19.280 --> 00:35:21.080
And she said to me the other day,
573
00:35:22.100 --> 00:35:25.670
she did it because it feels more inviting rather than clinical,
574
00:35:25.760 --> 00:35:27.890
and it invites people to sit and to chat.
575
00:35:27.980 --> 00:35:32.960
And she had a customer who went home and sewed pillows for pillow for the
576
00:35:32.960 --> 00:35:34.550
couch that she has in the pharmacy.
577
00:35:35.210 --> 00:35:38.190
There are other stories of pharmacists who write little scribble notes when
578
00:35:38.190 --> 00:35:41.970
there's medication deliveries to people.
579
00:35:42.330 --> 00:35:45.210
So when someone's not actually coming into the pharmacy,
580
00:35:45.480 --> 00:35:48.840
there's a lost opportunity, therefore connection of seeing someone,
581
00:35:49.110 --> 00:35:53.010
her little notes that kind of just say, have a nice day, a smiley face,
582
00:35:53.280 --> 00:35:56.790
and you send that. Now this pharmacist visited this patient.
583
00:35:56.790 --> 00:36:00.120
It was during Covid at the time, she was sharing the story,
584
00:36:00.540 --> 00:36:05.250
and this lady had collected in an envelope all of the little
585
00:36:05.250 --> 00:36:10.050
scribble notes that the pharmacist had written.
That's how meaningful they were,
586
00:36:10.050 --> 00:36:15.000
because sometimes the pharmacist is the only person that patient will
587
00:36:15.000 --> 00:36:19.140
see all week. So my call to action here is,
588
00:36:19.980 --> 00:36:21.570
let's think about the bigger picture.
589
00:36:21.870 --> 00:36:26.850
Let's increase workforce capacity by knowing about the issue and then start
590
00:36:26.850 --> 00:36:30.720
to do little things that don't take too much time, but the morale.
591
00:36:30.720 --> 00:36:35.070
It will impact the morale in the pharmacy holistically. Other staff,
592
00:36:35.070 --> 00:36:36.300
it's a bit contagious,
593
00:36:36.900 --> 00:36:40.380
and there's a job satisfaction that is so deep within that.
594
00:36:41.070 --> 00:36:43.200
I'm going to share one more story because it's profound.
595
00:36:43.200 --> 00:36:47.760
There was a story about a patient who was in the hospital, and sorry,
596
00:36:47.760 --> 00:36:48.930
in an aged care facility,
597
00:36:49.230 --> 00:36:51.600
and they were trying to do de-prescribing for that patient.
598
00:36:52.860 --> 00:36:56.370
That patient didn't want the medications taken off
599
00:36:56.970 --> 00:37:01.590
because at the nighttime, the nurse came around to hand the medications,
600
00:37:01.590 --> 00:37:04.980
and during that exchange, there was a physical touch.
601
00:37:11.280 --> 00:37:13.650
You can feel that.
602
00:37:13.680 --> 00:37:17.460
You can hear that we are lucky as pharmacists,
603
00:37:17.460 --> 00:37:22.230
we see people all of the time. They trust us, we know them.
604
00:37:22.800 --> 00:37:25.110
We have the opportunity to sprinkle magic,
605
00:37:25.680 --> 00:37:30.240
a little bit of magic to change the trajectory of their day. So pharmacists,
606
00:37:30.240 --> 00:37:31.320
to walk away here realising,
607
00:37:31.320 --> 00:37:33.420
I'm not asking you to take on a whole nother programme.
608
00:37:33.870 --> 00:37:36.090
I'm not asking you to change everything.
609
00:37:36.480 --> 00:37:41.220
I'm just asking you to no longer ignore seeing patients who are lonely
610
00:37:41.250 --> 00:37:46.110
to recognise that just by giving them a couple of more minutes of attention
611
00:37:46.410 --> 00:37:50.700
that that could really change the day for that person Overseas,
612
00:37:50.700 --> 00:37:55.260
they have supermarkets now with queues that are intentional
613
00:37:55.650 --> 00:37:58.830
for people who want to chat longer. So rather than just rush them out,
614
00:37:58.830 --> 00:38:00.870
people sit there and talk to people for longer.
615
00:38:01.020 --> 00:38:04.290
If you've got capacity in your pharmacy to give someone two extra minutes,
616
00:38:04.290 --> 00:38:07.890
you or pharmacy assistance, everybody.
If you've got capacity,
617
00:38:08.160 --> 00:38:09.480
it goes a long way.
618
00:38:10.080 --> 00:38:14.580
So I guess that's my call to action is do something, not nothing.
619
00:38:14.670 --> 00:38:19.110
It doesn't have to take much time. It just takes, what does it take?
620
00:38:20.820 --> 00:38:24.540
It just takes a decision. It just takes, yeah,
621
00:38:24.540 --> 00:38:28.800
it just takes a moment of recognising that it's not always about
622
00:38:28.800 --> 00:38:32.130
medication as a solution, that it's actually,
623
00:38:32.130 --> 00:38:36.760
we are providing connection.
624
00:38:36.790 --> 00:38:41.080
And I always go back to the whole term community pharmacy.
625
00:38:41.650 --> 00:38:45.430
Community pharmacy is a community within itself. It is.
626
00:38:45.430 --> 00:38:48.430
So I'm just saying let's lean into that a little bit more.
627
00:38:48.520 --> 00:38:53.350
Let's enhance our visibility about being the community aspect of the
628
00:38:53.350 --> 00:38:54.370
community pharmacy.
629
00:38:56.890 --> 00:38:58.030
Thank you so much.
630
00:38:58.030 --> 00:39:00.460
Is there anything that you'd like to share that I haven't asked you?
631
00:39:02.050 --> 00:39:06.910
No, I just want to thank you in particular and personally for being interested
632
00:39:06.910 --> 00:39:09.040
enough in this subject. Again,
633
00:39:09.040 --> 00:39:13.900
it's not about medicines and it's not about revenue or business.
634
00:39:14.380 --> 00:39:19.300
It's actually about being better humans. And really,
635
00:39:19.300 --> 00:39:20.500
I mean, it sounds aspirational,
636
00:39:20.500 --> 00:39:25.060
but creating a better world for ourselves and also for the little ones,
637
00:39:25.060 --> 00:39:28.000
like if we can value in a workplace,
638
00:39:28.000 --> 00:39:30.730
if we can value social connection,
639
00:39:31.390 --> 00:39:36.220
then that has an energetic shift that changes things for everybody.
640
00:39:36.610 --> 00:39:41.110
We as staff, as employees will turn up more,
641
00:39:41.440 --> 00:39:45.100
we'll show up more as ourselves. We'll bring more innovation,
642
00:39:45.130 --> 00:39:47.650
we'll bring more creativity, we'll bring more passion.
643
00:39:47.980 --> 00:39:51.280
We just need permission to do that.
644
00:39:51.280 --> 00:39:53.260
It's going to take leadership for someone to say,
645
00:39:53.320 --> 00:39:58.270
I value connection in this workplace and with the patients that we
646
00:39:58.270 --> 00:40:01.750
serve. So let's introduce that as a cultural shift.
647
00:40:02.050 --> 00:40:04.360
And I can hand on heart.
648
00:40:04.360 --> 00:40:08.320
I feel pretty confident to say that that will have its own beautiful flow on
649
00:40:08.320 --> 00:40:12.760
effects to create a nicer workplace as well as profound
650
00:40:13.240 --> 00:40:17.170
transformation to humanity. Sounds very big, but I do believe that.
651
00:40:18.670 --> 00:40:21.070
Thank you. And from my perspective,
652
00:40:21.070 --> 00:40:23.650
I wanted to know more about it because I still think,
653
00:40:23.650 --> 00:40:27.940
when you think about it for the 18 to 24 year olds and you think about what
654
00:40:27.940 --> 00:40:32.440
impact you can make on this group of individuals who are going to be out there
655
00:40:32.470 --> 00:40:35.350
in the workforce, forming families, relationships,
656
00:40:35.680 --> 00:40:39.970
what can we do to help support them with better social skills and
657
00:40:40.900 --> 00:40:44.470
coping mechanisms and conflict resolution?
658
00:40:44.470 --> 00:40:48.820
I think we can all continue to learn so much in just how we can develop
659
00:40:48.820 --> 00:40:52.630
ourselves to be better and better communicators,
660
00:40:52.990 --> 00:40:56.530
better at understanding ourselves and understanding others and better at
661
00:40:56.530 --> 00:41:00.720
supporting ourselves and others in the process as well. So I.
662
00:41:00.880 --> 00:41:04.960
Just want to say to that, you've just, that's profound to think about.
663
00:41:04.990 --> 00:41:09.940
All the pharmacy interns who come into a workplace who
664
00:41:09.940 --> 00:41:11.230
are about that age,
665
00:41:11.590 --> 00:41:16.480
many international pharmacy students and interns who are living alone,
666
00:41:16.990 --> 00:41:19.090
working very hard, studying very hard,
667
00:41:19.090 --> 00:41:22.960
don't have the finances or time necessarily to socialise, and again,
668
00:41:22.960 --> 00:41:26.380
a different language, perhaps you as a preceptor,
669
00:41:26.440 --> 00:41:30.820
as a workplace could absolutely provide an environment that could
670
00:41:31.510 --> 00:41:35.720
nurture that individual's development within the workplace and without,
671
00:41:35.960 --> 00:41:39.980
and I've even heard stories of pharmacy internships said their preceptors have
672
00:41:39.980 --> 00:41:43.820
gone out of the way to invite them to football clubs with them and explained
673
00:41:43.820 --> 00:41:44.720
what it was about,
674
00:41:44.900 --> 00:41:49.700
and that was totally transformative for that person individually and as a
675
00:41:49.700 --> 00:41:53.690
professional. So yes, we, you're right, the 18 to 25 year olds,
676
00:41:54.470 --> 00:41:59.450
actually, the pharmacy profession could do a lot to do to
677
00:41:59.450 --> 00:42:03.680
support that cohort who currently are showing that they're at the highest risk
678
00:42:03.680 --> 00:42:05.510
of loneliness. So thank you for that point.
679
00:42:07.220 --> 00:42:09.080
Thank you so much. Thank you.
680
00:42:10.730 --> 00:42:13.670
We hope you've enjoyed this episode of the A JP podcast.
681
00:42:13.910 --> 00:42:17.240
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682
00:42:17.450 --> 00:42:22.340
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683
00:42:22.340 --> 00:42:23.173
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684
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