--94eb2c054824722b61054661f74b Content-Type: multipart/alternative; boundary=94eb2c054824722b5e054661f74a --94eb2c054824722b5e054661f74a Content-Type: text/plain; charset=UTF-8 Content-Transfer-Encoding: quoted-printable Hi Jeff, I wanted to thank you again for stopping by the office with Hamsa. There's no denying the need for this service. The questions lies in execution... We're going to review the program as a team once my father returns late next week. We'll be touch afterwards with next steps. Best regards, Tim. On Tue, Jan 17, 2017 at 1:12 PM, jeffrey Brock wrote: > Maria > > > > While it was unfortunate that you could not attend our meeting yesterday, > your obvious understanding of how the issue of polypharmacy impacts senio= rs > was rather impressive. As you are undoubtedly aware this condition, > affecting anywhere from 40 to 70% of community based seniors is the numbe= r > one modifiable risk factor for loss of autonomy, and most of the time > passing under the radar of family physicians and pharmacists who often la= ck > the knowledge, understanding of this issue and the clinical information o= n > their clients to address it. > > > > I am currently running two polypharmacy pilot projects (one in a CHSLD an= d > one in an autonomous seniors residence) which consist of three parts, whi= ch > has been very successful in stabilizing and in some cases reversing > declining autonomy; > > > > 1. Risk Assessment =E2=80=93 Done on patient/client metrics, check lis= ted > symptoms & the pharmacy profile > 2. Remediation =E2=80=93 Done internally with our medical staff, with = a > geriatric pharmacist as required and with the treating physician makin= g the > required changes > 3. Follow up =E2=80=93 Ongoing, but for a finite period of time as med= ications > are slowly and gradually adjusted > > > > So often timing is a funny thing, as today I received your excellent brie= f > on Alzheimer Disease and noticed one crucial missing tidbit of informatio= n. > The changes outlined in Stage 2 and 3, so often attributed to =E2=80=98ju= st aging=E2=80=99 > or early dementia may in fact be due to polypharmacy, as are so many of t= he > other signs and symptoms afflicting seniors, reducing their autonomy and > causing adverse drug reactions, hospitalization and other co-morbidities; > > > - Confusion > - Incontinence > - Agitation > - Insomnia > - Falls > - Sleepiness > - Decrease in appetite or thirst > - Increase in appetite or thirst > - Depression > - Walking difficulties > > > > I would imagine that close to 85% of your clients with declining autonom= y > have these issues which can be reduced and/or stabilized with appropriate > polypharmacy remediation and follow up. For homecare providers focused on > providing their billable hour services without even a cursory glance to > understand causation, this brings to mind one of the best commercials, fr= om > my perspective as a physician, that I have recently seen. Its one of thos= e > MasterCard com