GERIATRIC PHARMACY PRACTICE PATHWAY

This pathway is designed to prepare graduates to work with older individuals in a variety of practice settings or pursue advanced degrees (PhD, MPH) or training (fellowships, residencies) in the area of geriatrics or gerontology. By completing this pathway, graduates will learn essential principals to manage medication related issues as well as understand the complexities in caring for the elderly.

Outcomes of this pathway are to develop a database of current students as well as graduated students focusing in the area of geriatrics. In order to finish this pathway students must complete: the core didactic electives (5 credits), 4 credits worth of other geriatric focused electives or special projects and 3 credits worth of geriatric focused geriatric rotations. (Total = 12 credits)

CORE DIDACTIC ELECTIVES

PHMY 552 PHARMACOLOGY AND AGING 1 CREDIT

This course presents advances in our understanding of variations in drug responsiveness in the aging population. The course is designed to give the student an appreciation for the basic physiological and biochemical changes which normally occur with aging, and how these changes relate to altered pharmacodynamic and pharmacokinetic responses following drug administration. Basic and clinical pharmacologic studies are used to support the conclusions presented. A lecture/discussion format is used with students participating in the discussion of reprints or reviews of original research articles, which are previously distributed. Evaluation is based on a final exam, paper, and participation in class discussions.

PHMY 516 GERIATRIC IMPERATIVE-2 CREDITS

The Geriatric Imperative Minimester is a five-day interdisciplinary course open to all students on campus during the first week in January. The course presents a wide range of information regarding the health and well-being of older adults through clinical research and policy presentations. Course content will be conveyed through the use of lectures, panel discussion, team and case presentations, role play, video tapes and site visits. Students will be required to write an in depth paper on a subject pertaining to geriatrics/gerontology within two months of completing the didactic portion of the course.

The following presentations will be part of the 2001 course: The Comprehensive Geriatric Assessment, Levels of Independence (Housing Options), Social Aspects of Caring for the Older Adult, Oral Health Care, Nutrition and the Older Adult, Exercise and the Elderly, Mental Health Issues, Gero-Pharmacology, Family Caregiving, Health Care Decision Making, Elder Abuse, Minority Elderly and Health Care Utilization, The Senior Center Experience, and Serving the Older Adult Through Managed Care.

Site visits will include: Levindale, Hopkins Geriatrics Center, Charlestown Retirement Community, Magic Me, Elder Health, Keswick, Jenkins Community, Roland Park Place, and Basilica Place.

Objectives will be to identify and describe basic biological, psychological and social stresses which impact on individuals as they age, discuss the need and rationale for a multi disciplinary approach to the care of the older patient and describe the continuum of healthcare, social service and environmental supports for older adults.

PHMY 529 GERIATRIC PHARMACOTHERAPY 2 Credits

This elective course is designed for students who are interested in working with chronically ill older adults in the community or long-term care settings. The course will focus on disease states and syndromes commonly seen in older patients as well as emphasize pharmacological and non-pharmacological management of these problems. The format of this class will be a case based approach.

OTHER GERIATRIC PATHWAY DIDACTIC ELECTIVES:

PHMY 553-CONSUMER EDUCATION PROGRAM FOR OLDER ADULTS 2 Credits

Course Description:

The urgent need for pharmacists to become more involved in the health care of older patients is well documented. This course prepares pharmacy students to educate groups of elderly about drugs and drug taking. Students will benefit from the didactic and applied aspects of this course. Students will learn about special needs of the elderly and then actually interact with elderly both in large groups and on a one-to-one basis. Students will observe three talks and present five to eight talks to community groups at any time following the training session and by the time they graduate. Grades will be added as a "No Mark" (NM) until the time that the talks are completed. [IMPORTANT: All courses must be dropped by deadline, otherwise it will remain on your record as a NM]

Objectives:

The student will be able to describe demographic, psychosocial, and medical issues which influence the drug-taking behavior of older adults, demonstrate communication skills and educational strategies which motivate older adults to become more proactive and assertive with regard to positive drug-taking behavior, present at least five consumer talks to older audiences and perform a "brown bag" medication review.

Grades will be based on the number of talks (i.e. experience) given in the community. Students are required to do three observations and give eight talks.

PHMY 529 SPECIAL PROJECT: GERIATRIC ASSESSMENT INTERDISCIPLINARY TEAM PRACTICE (GAIT) 1-2 Credits

This is an interdisciplinary program that is offered at various times throughout the year. It is offered on both the Eastern Shore and Western Maryland to address the need to reach out to the rural areas. Housing is provided. If interested, please see the handout that relates to each program.

PHMY 593 CARE OF THE TERMINALLY ILL 2 Credits

The purpose of this course is to prepare pharmacy students to interact with terminally ill patients through increased understanding of the social and psychological aspects of death and dying as well as the palliative pharmacotherapeutic management of these patients.

Course Objectives:

At the conclusion of this course, the student will be able to:

• Recognize attitudes and conflicts in the care of the dying and state his/her own attitudes toward death and his/her own mortality.
• Identify the meaning of death for different cultures, societies, and religious and age groups; and how they affect client behavior
• Discuss current social and ethical issues of death and dying
• Describe the clinical presentation and systems of common terminal illnesses, and actual cause of death.
• Describe effective pharmaceutical care approaches in the palliation of common symptoms associated with terminal illness.

PHMY 597 BEREAVEMENT THEORY 1 Credit

Unresolved grief has been found to be the underlying etiology of 10-15% of all the clients in mental health clinics. Similar statistics are available documenting the grief response as the underlying cause of all morbidity and mortality.

Every day the pharmacist will interact with someone who is dying, the family of a dying person, and/or an ill person who has a physical manifestation of disease as the result of unresolved grief. To best serve these patients, health care professionals must understand the theory of attachment, loss, and grief, as well as how to effectively interact with the bereaved.

GERIATRIC PATHWAY CORE AND EXPERIENTIAL ELECTIVES:

PHPC 532 LONGITUDINAL CARE I 1 Credit

This is the first of two courses, which constitute Phase II of the experiential learning curriculum. In this course, students have the opportunity to interact with older individuals, collect a pharmaceutical care database, develop a problem list and make appropriate recommendations. Students will develop a pharmacist-patient relationship as the first step in the delivery of pharmaceutical care. In addition to appreciating the humanistic aspects involved in providing care to older individuals, students will acquire skills necessary to deliver pharmaceutical care to the elderly.

Over the course of a year, students are given the opportunity to observe health care transitions in a variety of patient care settings (nursing facility, assisted living facility, senior housing and independent living). Students will learn to describe problems or needs related to social, cultural, environmental, health and pharmaceutical care issues.

This is a one-credit course, which is conducted over the course of two semesters in the second year of the entry-level doctor of pharmacy program. This course provides opportunity for students to integrate and apply knowledge previously acquired in PHAR 516 Pharmacy Practice and Education, PHAR 522 Context of Health Care, and PHAR 523 Ethics in Pharmacy Practice.

PHEX 572 GERIATRIC PHARMACOTHERAPY ROTATIONS (2, 3 credits)

Clerkships may be available in ambulatory care, assisted living, continuing care retirement communities, nursing homes and/or institutional settings. A description will be available on each site as well as information to contact the preceptor.