When Barb Rusland fell at home and had to be hospitalized for two weeks in the spring of 2020, her family feared the worst. Though she didn’t break anything, tests revealed she was experiencing disorientation and poor overall physical health. It was clear she could not return home to live on her own once released. Instead, she would stay with her daughter, Sandy, in London, Ont. while she underwent rehabilitation and physiotherapy to build her strength and stamina. She also needed time to adapt to her medication changes.
The alternative to that arrangement was moving Barb into a long-term care facility, something neither she nor her family wanted, especially during COVID. Remaining at home was the preferred option.
That desire is echoed in research conducted in July 2020 by the National Institute on Ageing at Toronto’s Ryerson University. COVID has further reinforced the conviction of many Canadians to stay in their homes rather than moving into a nursing home or long-term care facility. Sixty per cent of study participants said the pandemic had changed their opinion on whether they’d arrange for themselves or an older loved one to live in a nursing or retirement home. Meanwhile, 91 per cent of respondents said they aimed “to live safely and independently in their own home as long as possible.”
Independence and empowerment with aging in place
While remaining at home as long as possible is the goal for many, it takes planning to enable aging at home. For the Rusland family, it was a group effort to ensure Barb could maintain her independence. Two months after her hospital stay, she was able to return home. Sandy and her two brothers visit their mother frequently to manage her care so she could feel empowered, live where she was the happiest and avoid going to long-term care.
“It was important to our family to facilitate that, especially during COVID,” says Sandy. “Our goal is to make sure she can remain at home so long as it’s safe and she remains healthy. We have created a safe environment while bolstering her independence, ongoing recovery and health management by taking the necessary steps.”
It has been a great success for Barb. She feels like she’s achieved a level of independent health she could not have achieved without the support of her family. Thanks tocollective efforts, she has dramatically transformed her life and her outlook over the last year.
Dynamic aging means careful medication management
One of the ways Barb has been ableto age at home isthrough strict adherence to her medication regime. As Sandy notes: “Medications are non-negotiable when it comes to maintaining health for chronic conditions. It’s of the utmost importance to take the right dose at the right time, while balancing sleep, exercise and nutrition. Disorientation along with chronic condition flare-ups mean long-term care for my mother.”
Barb takes six different prescription medications. To make sure they are taken as directed, the family has turned to easy-to-use blister packs. Sandy tears off one week’s worth of medications from Barb’s blister pack at a time and places it in her mother’s bathroom drawer. It’s easy for Barb to embrace routines around med times and she can see which doses she has already had and which ones are next – all at a glance. Often, multiple medications in vials are impractical to manage, especially for an older person with declining cognition, manual dexterity or hand-strength issues.
Pharmacies’ central role in supporting independent aging
Your local community pharmacy is an invaluable resource for helping patients to manage their medication needs. James Morrison is a pharmacist with more than a decade of experience and director of pharmacy excellence with Whole Health Pharmacy Partners. The company has earned a reputation for going above and beyond for its clients. “Our focus is on optimizing the patient experience with expanded offerings and services,” he says. “Our pharmacists are passionate about what they do every day and learning to do it even better. That includes working with patients to help understand their medications, how to best take them and how to avoid any potential side effects.”
Whole Health pharmacists use software to help with day-to-day dispensing. The software monitors whether a patient is filling their prescriptions on time and whether there are delays. “When you identify those patients who are falling behind, we can ask some open-ended questions to help understand how they are taking their medication in the home,” says Morrison. “If someone is having difficulty with organizing their medications, we can present them with solutions. You can see the tension ease on their faces when they realize there are ways their pharmacy can assist, like preparing blister packs, for example.”
“Medications are non-negotiable when it comes to maintaining health for chronic conditions”— Sandy Rusland
Tapping into pharmacy resources
Morrison also emphasizes that pharmacists can do more than just dispense medications. They can spot potential problems. He talks about a situation where a patient was taking two similar medications for hypertension from two different pharmacies. When the man reported low blood pressure, his Whole Health pharmacist investigated and discovered the duplication – something that can happen when drugs are prescribed by a specialist or through a hospital visit, without the primary care physician being aware. In some provinces, like Ontario, there is not a central system where there is a record of all medications a patient takes. A pharmacist can help fill the gap.
A recent trend in pharmacies, especially important for older adults, is deprescribing, the process of reducing or stopping medications no longer needed or ones that may cause harm. “Medications that may have been appropriate at one stage in a person’s life could actually be contributing to more serious side effects as they age,” says Morrison. “Whole Health’s pharmacists’ deep knowledge of prescribing can be incredibly important to assist a more senior population.” That would include their familiarity with the BEERS List, which outlines drugs that may be inappropriate for older adults.
It all connects back to medical adherence, a critical piece of the puzzle for aging Canadians to be able to stay at home. Issues with dosage, timing and frequency of medications are responsible for 25 per cent of hospitalizations among older adults. Stay well, stay at home longer and stay in touch with your pharmacist as part of your healthcare team.
3 Critical Pillars or Aging at Home
Safety. To prevent falls and injuries, living spaces for older adults may need to be modified. The Rusland family took a number of steps to prepare Barb’s home for return post-hospitalization, including restricting the living space to one floor, installing gates across stairs, bed rails, toilet and shower supports, and removing doors and obstacles to accommodate her new walker.
Support. It takes a team of caregivers to help spread the workload. Barb’s daughter, Sandy, is the primary caregiver for her mother, assisted by her brothers. Tasks are divided among them so everyone understands their responsibilities, from laundry to arranging the delivery of home-cooked meals. Bring in others to the healthcare team including personal support workers, nurses, pharmacist and physiotherapists, in addition to a primary care physician and/or specialist.
Medication management. Staying healthy and addressing any chronic conditions requires medication adherence. Calendarized blister packs are a practical, easy-to-use tool for both caregivers and patients. Consult your pharmacist for more information and for solutions available to assist with successful aging at home.
Sponsored by Jones Healthcare Group.