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I approach my home visits as an educational possibility as well as an
opportunity to gather information from the patient.
A well planned HMR visit with
appropriate supporting resources can
turn your time with a patient from a
mediocre question and answer exchange
into a positive and productive experience
for both patient and practitioner.
My husband often bemoans the
'excessive' contents of my handbag, but
is pleasantly surprised when he needs a
piece of gum, a portable phone charger
or a bottle of water. Should I ever get
stranded on a desert island, it is also fair
to say, I could open a small pharmacy
based on my handbag contents.
I approach my home visits in a similar
manner, hoping to pleasantly surprise
my patient with a relevant phone
number, pamphlet or instructional
video. My HMR 'handbag' generally
consists of a smart phone with GPS
and internet access (where possible),
the AMH Aged Care Handbook,
a notebook, pen, my business card,
warfarin booklets, patient referral,
relevant demonstration devices and a
folder full of those glossy device and
medication handouts that usually collect
dust on community pharmacy shelves.
Over time your collection of resources
will grow. Add things such as samples
of various dose administration aids,
some Heart Foundation information on
healthy eating and some pamphlets on
prescription reminder services such as
MedAdvisor. You may end up with a box
of devices and handouts in your car.
It only takes a few minutes before the
HMR to collect the material that will be
relevant for your patient.
My favourite inclusion by far is a local
directory of other health professionals,
programs and community groups.
A referral to the local Men's Shed
organisation could be an essential
lifeline for an isolated male.
Information about a Medicare funded
exercise physiologist running a diabetes
program could give someone the
tools to make positive changes to their
lifestyle and health. This is something
ACCREDITED PHARMACIST SPECIAL INTEREST GROUP
How do you prepare for your
BY ELISE RYAN
Brisbane-based pharmacist Elise Ryan was a 2014 PSA
ignite program participant.
built up over time and carefully
considered -- a recommendation reflects
on the person giving the referral and you
need to be confident in those you are
recommending. Connecting people to
local community groups, whether they
be health based or social groups, can all
have a positive impact in a patient's
overall health and well-being.
Emerging research suggests that an
elderly brain can display the same
plasticity (mental flexibility) for learning
as a younger brain but, it has trouble
filtering out the most important or
relevant pieces of information.1 With this
in mind, I often leave a patient with a
simple list of important points from our
discussions -- things to do, how to take
each medicine, phone calls to be made,
websites to visit etc. For motivated
patients this can be quite empowering
and gives them back a feeling of
involvement and control around their
health. And it is always satisfying as
a practitioner to get feedback from a
patient who has taken renewed interest
in their health!
While my kitchen sink approach
is definitely not for everyone, it is
always worth considering how we
approach a task like a home visit and
how we can improve our practice
for the betterment of our patients.
Importantly, consideration of the
differences in how our patients may learn
and retain information is paramount to
HMR preparation as well as being able to
manipulate information for those who
suffer vision impairment, dexterity issues
or cognitive impairment. Providing the
patient with written information will
reinforce education provided at the
HMR. By focussing on the patient's
individual needs the HMR will be more
productive and your report to the GP will
be patient-centred. A little time planning
your HMR visit is time well spent.
1. Watanabe, T. Elderly brains learn, but maybe too much.
News from Brown Nov 2014. At https://news.brown.edu/
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