By Tom Smiley, BScPhm, PharmD
After receiving her Certified Geriatric Pharmacist designation in May 2015, Natalie Galea PharmD started offering “wellness days” programs at retirement homes in Southern Ontario where she practises as a clinical consultant pharmacist with Medical Pharmacies Group. She had no idea how popular they would be.
Natalie remembers one ‘Heart Health Wellness Day’ that drew a particularly large attendance of residents. “One of the residents had recently experienced a stroke, and that resulted in many of the other residents discussing their risks for stroke as well as signs and symptoms to be looking for.” It is safe to say that residents find the education gained from wellness day programs very practical and relevant to their life circumstances. Natalie offers four quarterly wellness days, each two hours in length, at the retirement homes she serves: heart health; lung health/COPD; diabetes; and osteoporosis/bone health.
The wellness day programs start with a presentation aimed at increasing residents’ understanding of the medical condition of the day. For example, the heart health wellness day includes education about blood pressure and cholesterol relating to screening, prevention and management. Natalie educates residents about issues such as the meaning of blood pressure and cholesterol readings and the targets that residents should be trying to achieve. She also dispels myths related to heart health during her presentation. For example, some seniors believe that obesity is a prerequisite for heart disease, or that feeling well means that prescribed cholesterol medications do not need to be taken at the time.
Natalie, who is an Ontario-based practitioner, meets with residents in the clinic portion of the wellness day program, and often conducts these sessions via a MedsCheck. She has found that while many residents do have blood pressure monitors, many do not know how to use them correctly. Moreover, a number do not understand how to interpret readings and therefore lose interest in using the monitor. She finds that focused education and follow-up are key to appropriate use of medical devices such as the blood pressure monitor, and to checking for medication adherence. Follow-up often takes place in the resident’s apartment where Natalie takes the opportunity to help clean out expired and unused medications.
The pharmacist credits her background as a CGP with her ability to implement the unique assessment skills required for the care of seniors. Issues such as increased risk for falls associated with hypotension and hypoglycemia, individualization of blood pressure targets, and medication management challenges are but a few of the assessments Natalie undertakes when meeting with residents. She finds that many clinicians tend to overlook ‘frailty’ as an important consideration in prescribing medications. As a result, many residents are over-treated. Natalie’s expertise in geriatrics has helped her to recognize these circumstances and manage them appropriately in concert with the resident and other healthcare team members.
Wellness Days programs such as the Heart Health Wellness Day have been professionally satisfying for Natalie. Knowing that she has made a difference in the lives of so many through education, screening and assessment more than makes up for the effort required to conduct the wellness days.