A patient with dementia comes to the pharmacy with a prescription. The pharmacist gives him the prescribed medicine and explains how he should take it: how long, how often, at what times of the day – and which foods he should avoid when taking the medicine. The problem: Can you be sure that someone with dementia will remember all of this? How do you make sure that he takes the remedy correctly?
This is where the “Dementia-Friendly Pharmacy” project of the Bavarian Chamber of Pharmacists (BLAK) comes in: pharmacists should be made aware of how to deal with dementia patients properly. According to the BLAK, there are currently around 250 pharmacies in 38 districts and urban districts in the Free State that have employees who are specially trained in dealing with dementia patients.
One of them is the Sonnen-Apotheke in Zapfendorf (district of Bamberg). Pharmacist Barbara Mysiak has completed appropriate training. “It’s mostly older people who come to our pharmacy,” she says. “They also include people with dementia. We are an important point of contact for them.” In the case of health problems, the pharmacy is often the first point of contact. Unlike with a doctor, you don’t need an appointment, you can just go and get advice. “We want to raise awareness of dementia among the population,” says Barbara Mysiak. “After all, we’re getting older. It’s about improving the quality of life of those affected in the long term and supporting their relatives.”
During her further training, Barbara Mysiak learned how complex the clinical picture is, what medication treatment is possible for dementia and which contacts, help and advice services are available in the region. The pharmacist now feels well prepared for working with dementia patients. “For example, I write them down exactly how they should take their medication,” she says. It is also particularly important for people with dementia that they always take the same medication.
In the event of supply bottlenecks or if the health insurance company changes a contract with the manufacturer, pharmacies sometimes switch to other medicines with the same active ingredient. However, it can be confusing for people with dementia if the package suddenly looks different or the tablets are a different color than before. “With dementia patients, I try to exhaust all possibilities so that they can stay with their usual medication,” says Barbara Mysiak. In general, the project is about sensitivity to the topic – also when dealing with people who have not yet been diagnosed with dementia, but have a suspicion. “Those affected often live alone and suffer when their memory fails,” says Barbara Mysiak. “Sometimes they are shocked, for example when the doctor calls because they forgot an appointment.”
Sometimes older patients come to the pharmacy and tell them that they have been very forgetful lately – and whether there is a remedy. Pharmacist Mysiak then asks more precisely: How is that expressed? What medications do you take? Do you suffer from stress? Are there any other health restrictions? “Sometimes I then advise them to go to the doctor and be examined,” says the pharmacist.
Because behind forgetfulness in old people is not necessarily dementia. The Scientific Institute for Prevention in Health Care at the Chamber of Pharmacists writes that dementia is “usually the result of a chronic, progressive disease of the brain with far-reaching disorders”. Brain functions such as memory, thinking, orientation and comprehension, learning ability, language and judgment are increasingly impaired as the disease progresses. But the institute also states: “Early diagnosis helps to give those affected and their families access to possible offers of help. If the disease is recognized in good time, the course of the disease can be positively influenced and those affected and their families can plan for the future together.”