A VISIT TO

GROUP MEMBERS
• LIM LAY SIN - A116631 (LEADER)

• TEH SUET YIN - A116613

• CAROLYN TEO AI LI - A116832

• TE CHIN YEW - A116834

• NUR FARIHA BINTI NORMAN - A117019

• NURUL FAUZANA JAMALUDDIN - A117388

• NOOR ARIDZA BT AMRAN - A117252

• EBSON ANAK NGUMBANG - A116392

• KOH HOCK PENG - A116823

• WALTER BIN EYANG - A117248

• AHMAD SHAFIEE B. MD AJIS - A117350

• MUHAMAD FAREED BIN MOHAMAD SARONI - A117176

• ZAINUDDIN BIN MAAMOR – A114705

 BACKGROUND
• Established on 9th March 2002
• Ceremonies by; Y.B Dato’ Dr Hajah Siti Zaharah binti Hj Sulaiman.
• Manager: Datuk Haji Nordin bin Ibrahim
• Workers: 5 people (2 clerks, 1 caretaker, 1 guard, manager)
• Daily elderly care center
- Elderly stay at their home
- Attendance- Walk in
- Operating time- based on suitability of the local
environment
• Old folks consist of Malay, Chinese, Indian
 BACKGROUND
• Target group:
a) elderly (56 years old and above)
b) able to manage themselves
- Old folks are free from any payment
- For special case, eg: those with stroke, need to pay
RM250 for the extra attention and care services provided.
• Financial source:
a) government (RM 30,000 per year)
b) NGO
 BACKGROUND
• Facilities
- Hall
- Mini gym
- Spacious garden
- Karaoke set
- Television
- Surau
- Resting room
- Reflexology path

• Activities
-aerobic
-gardening
-sewing
-travelling
-invitation from
other welfare
organizations
PHARMACEUTICAL CARE
ISSUES
Centre Patient
Caretakers Polypharmacy

Self medication
Medication record

Financial Compliance

Inadequate health-
Transportation related knowlegde
 LACK OF CARETAKERS
 There are only 1 caretaker in the centre.

 The caretaker do not have enough health-related

knowledge (untrained)

Difficulty in communicating with old folks who are mostly

Chinese.

Visit from healthcare providers (doctor, dentist, nurse) is

only once a month

No involvement of pharmacists, physiotherapists etc.

 NO MEDICATION RECORD
The centre does not keep any records on the
diseases and medication taken by the old folks

Could cause problems especially during

emergency cases as the center do not have any
reference on how to handle the situation.
 FINANCIAL
Money from Jabatan Kebajikan Masyarakat
(JKM) per year is not enough to support the
center

The center cannot afford to hire many

caretakers
 TRANSPORTATION
The centre does not provide any
transportation for the old folks to go to the
center

Also does not provide transport to the

hospital and the old folks have to travel on
their own to get their own medication supply
 POLYPHARMACY
Common diseases of the old folks are:
- Hypertension
- High cholesterol level
- Joint pain
- Gastric
-Diabetes

Patients usually go to the nearby clinic to get their medication

They may also go to government hospital for further health evaluation.

These patients often seek treatment from a number of physicians without any
collaboration.

Some patients might take 4 or 5 medicines to treat same disease because they consult
a number of physician

Serious drug-drug interaction may occur.

 PATIENT COMPLIANCE
The old folks usually have problems in complying with their
drug treatment.

Sometimes they forget or fail to take their medication.

Some old folks stop taking their medication when they begin
to feel better, regardless of the instruction which requires
them to finish all the medication.

Some old folks who forget to take one or more doses of their
medication in a day, may try to make up for their missed dose
by taking two or three times the usual dose all at once.
 SELF-MEDICATION
The old folks in the center use their own money to buy
medication

Some refuse to seek doctors when they have minor ailments

because they want to save costs

Some old folks might continue to self-medicate themselves,

thinking that they just had minor disease without uncovering
the serious underlying disease.

The old folks do not have adequate knowledge about OTC

products. Some OTC medication can potentially interact with
drug prescribed by doctor( prescription drugs)
 INADEQUATE HEALTH-RELATED KNOWLEDGE

• Some old folks complain they do not understand the doctor’s

instruction when taking the medication from hospital.

• Some are confused about the indication of each medicine

because they are taking many medication at the same time

• Some of them also take modern medication with alternative

medicines (herbal or traditional product) and OTC drugs
without consulting their doctor first

• Serious drug-herb interaction can occur

 SUGGESTIONS

Medication Patient
Caretaker
record knowledge

Transportation Balance meal

 Medical record
The centre should keep a medical record of each old folks
regarding their current medical conditions

easy to know the health status of the old folks and the
caretakers can identify which patients need to be given
more attention

easy to handle should any emergency occurs

this serves as a medical review for future diagnosis and

treatment process when doctors or pharmacist came to
visit.
 Caretaker
The management should hire more caretakers to take care
of all the needs of the old folks and to help them manage
their daily life

The caretaker hired should be well-trained

They also have to monitor the diet of the old folks as some
of them may have diet restriction due to their disease

They can also help to improve the drug compliance of the

old folks by reminding them to take their medication so
that missed dose does not occur
 Health knowledge
Regular visit of health care professional to the old folk home is important to
educate and improve knowledge of elderly about the importance of a healthy
life

Role of pharmacists:
• provide counseling regarding medication related problems such as medication
use, storage, compliance and side effects
• review patients medication history
• Review old folks dietary habit
• Monitor the effectiveness of the drugs
• Monitor outcome of the treatment
• Identify if there are any possible drug-herbs interactions, drug-food
interactions or drug-drug interactions

This will help to reduce the medication errors and non compliance
 Balanced meals
The center must provide a balanced meal for the old folks

must take into consideration about the health status of

the elderly such as what kind of food they need to
increase in their diet and which food they have to avoid in
their diet

the caretaker who prepares the meal must have basic

knowledge about the nutrition and the health status of
the old folks
 Transportation
The centre needs to provide transports in case any emergencies occur

necessary to bring the elderly to the nearest ‘klinik kesihatan’ if the

healthcare professional cannot make a visit

it will be easier for the elderly who need to take their medication
regularly from a hospital

The centre can provide transport such as bus or van so that the old
folks can go to any places or activities organized by the center.

This can improve the quality of life of old folks and they will not feel
bored by just staying at the center.
 Others Suggestion:
• Organize more activities for the old folks such as aerobic
exercise, “Tai Chi” to promote healthy lifestyle and to
improve quality of life among the old folks.

• Find more sponsors whether from NGO or non-NGO to

improve the financial status of the centre so that better
facilities or accomodations can be provided and more
activities can be planned for them in order to improve their
quality of life.
INTERVIEW……
CASE STUDY
Name: Yong Soo Shin
Gender: Female
Age: 68 years old
Hometown: Cheras, KL
Race: Chinese
Years joining: 2 years
Disease : Hypertension, Gout, Gastric, Hyperlipidemia, Flu

Medicines : Atenolol, Allopurinol, Cimetidine, Pravastatin,

Tripolidine HCl and Pseudoephedrine (Actifed),
Ascorbic acid

Hospital visited: Hospital Ampang , nearer clinic

Missed dose:
Yes. Sometimes she forgets to take her medicines.
Action: Just continue taking the medication on the next day

Storage of medication: Medication box

 Pharmaceutical Care Issues
1. Polypharmacy. Take more than 5 drugs
a day. Chances to get drug-drug
interaction.
2. She sometimes complains of not being
able to understand what the pharmacist
tells her when taking the medication
from hospital.
3. She forgets to take her medication on
a regular basis due to poor memory.
4. She complains about the side effects
of drowsiness when taking her flu
medication.
Suggested Pharmaceutical care plan
Ask patient to bring all medication to
hospital and consult the pharmacist.
Spend more time with the pharmacist on
counseling
The caretaker needs to remind her to
take her medication and pharmacists
need to counsel patient what to do if
missed dose.
Pharmacist should advise her to avoid
driving and operate dangerous machine
while taking that flu medication. She
should just get some rest and drink
plenty of water
 CASE STUDY
 Name: Lim Ah Poh
 Age: 68
 Condition: Hypertension (10 years),
hyperlipidemia
 Medications: -T. Captopril
-T. Aspirin
-T. Adalet
- T. Pravastatin
 Hospital visited: private clinic near home,
once in 4 months
 Missed dose: sometimes, just continue with
the next dose and forget the missed dose
 Pharmaceutical Care Issues
1. Lack of knowledge on the
purpose/indication of each medication
2. He forgets to take medicine on a regular
basis
3. Not willing to talk to
doctors/pharmacists/caretaker when feels
uncomfortable after taking medications
Suggested Pharmaceutical care plan
Consult a pharmacist for more information
on medication
Caretaker should remind him to take his
medications while at the centre
Pharmacists should always maintain a
caring attitude and try to explain by using
simple terms and layman language so that
patients can easily understand and feel
comfortable to share their drug-related
problems.
THANK YOU