I
Page 2 Portland Observer, N ovem ber 10, 1982
Medicine and the elderly
¿HnUgfoaob <3Flnri»t
Program to help elderly stay home
Three Oregon State U niversity
pharmacy professors are launching
a unique project aimed at "keeping
people out o f nursing homes” and
saving hundreds o f thousands o f
dollars—fo r families and the state
o f Oregon—in the process.
Thousands o f elderly people
could be kept out o f nursing homes
if they were able to properly manage
their medications at home, the three
pharmacy profs point out. Their
project would make that possible.
The researchers are Lee R. Strand-
berg, William Simonson and Doug
las Reid.
“ Twenty-four percent o f the pa
tients in Oregon nursing homes now
are there simply because they cannot
manage their medication consump
tion,” says Strandberg.
The OSU proposal, fo r which
federal funding is now being sought,
would take the proven good prac
tices o f nursing home medication
procedures and apply them to at-
home elderly patients so they hope
fu lly w on’ t have to enter nursing
homes in the future.
Local pharmacists would play a
key role in the improved home phar
macy service. They would package
required medications on a coded 31-
day punch out card so that the el
derly at home could have their daily
medicines available on a handy, unit
dose basis. A t breakfast or on aris
ing, they would simply push open
the plastic bubble on the card cover
ing the tablets, capsules, etc., that
they are to take at that time on the
particular day o f the month.
Other punch out cards would con
tain medicines to be taken at noon
and at night. Cards would have code
holes in an upper corner so the pa
tients could id e n tify them. The
cards would also serve as records of
which medicines had been taken.
Being able to stay at home
"w here they want to be” rather
than going in to nursing homes
would provide a great lift for many
older persons and would mean tre
mendous savings in money as well as
reduced trauma and troubles for the
individuals and their families, says
Strandberg, who is spearheading the
project.
"The public ought to know what
we’ re trying to do; to increase the
quality o f care and life and to de
crease the costs. We hope to get
funding next year and if it is success
ful we believe that it will be adopted
as standard practice in Oregon, per
haps even before the end o f the pro
posed three-year research project.
"W e ’ re not the first to come up
with the concept but we’ ll be the
first to try it on a large, statewide
scale if funding comes throught,”
Strandberg explained. " I became
aware of this innovative way to ap
proach drug therapy from a com
pany in Silver Springs, Md. There’s
also a community pharmacy in Fort
Smith, A rk., that makes up 31-day
dispensing cards fo r some o f their
elderly patients living by themselves
or wishing to m aintain their in
dependence while living with famil)
members.
Under the broadened OSU propo
sal that could be adopted in any
Oregon com m unity, pharmacists
would have more involvement in pa
tient counseling and screening o f pa
tient medication records to see indi
vidual drugs are not working against
one another or producing adverse
reactions.
The costs for the expanded phar
macist service would increase, o f
course, but the savings in suffering,
Ellsberg, Berrigan
speak on peace
Anti-war activists Daniel Ellsberg
and Daniel Berrigan will talk about
ending the nuclear arms race on
Sunday, November 21st, at the First
Congregational Church, 1126 S.W.
Park at 12:30 p.m. Adm ission is
free.
Daniel Ellsberg and Fr. Daniel
Berrigan, S.J., have practiced ivil
disobedience as a means o f resisting
the Vietnam War and the nuclear
arms race. In 1971 Ellsberg released
top secret documents about the
Vietnam War, the Pentagon Papers.
Daniel Berrigan, along with his
brother, P h ilip , was one o f the
Catonsville Nine who, in 1970-1971,
served 18 months in prison fo r
burning draft files with homemade
lapalm.
Berrigan was convicted o f
burglary, crim inal mischief and
crim inal conspiracy fo r breaking
into a GE plant in Pennsylvania and
trying to beat two nuclear nose
cones into plowshares with
hammers.
w orry and avoided nursing home
and hospital costs would far over
shadow the other considerations,
says Strandberg.
"Savings conceivably could reach
a million dollars a year for the state,
and its Department o f Human Re
sources, that picks up the b ill for
much o f the medication and nursing
home charges,” Strandberg be
lieves.
"W e know that a lot o f old
people who are livin g at home or
w ith fam ily members or friends
have trouble managing their medi
cations. As a result, they end up in
nursing homes, or end up in hospi
tals because o f too much or too little
medicine or problems that grow out
o f the medications themselves, such
as over medication or drug reactions
that occur when different medicines
are taken in combination. ”
Pharmacists are perhaps more
m indful o f such potential reaction
problems than even physicians,
Strandberg suggested. "H a v in g
pharmacists participate in the re
view o f medication regimens has
proven o f tremendous w orth in
nursing homes and hospitals. And
much has been learned o f value
from nursing home experiences with
medications,” he added.
"O u r plan is to transport the
good pharmacy procedures and
drug distribution systems found in
Oregon and U.S. nursing homes to
an outpatient home setting.”
W illiam Simonson, the second
pharmacy professor invovled in the
new proposal is one o f the nation’s
top authorities on drugs (medicines)
and the elderly. A book of his on the
subject is scheduled for publication
in early 1983, and he is a member of
IJfloinrrs JFrnnt ¿nnllufa OOJ
(he national advisory panel on geria
trics, U.S. Pharmacopeial Conven
tion.
"A b o u t one third o f (he elderly
fa il to take their medicines p ro p
e rly ,” Simonson reported. "A n d
medication consumption increases
dram atically w ith age. Men and
women 65 and over receive 11.2 and
14.3 new or re fill precriptions, re
spectively, each year now on the av
erage. Adverse drug reactions are
common,” Simonson pointed out.
“ Proper nursing care, and sup
port services such as the one we pro
pose, can help manage, reduce or
overcome many medicine problems
in the elderly,” he stressed.
A lthough the elderly represent
only 11 percent o f the population,
they consume more than one-fourth
o f all prescription drugs, it was
noted.
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