Pharmacists are health care professionals responsible for the dispensation of prescription and nonprescription medications. They may advise physicians, nurses, or other health care professionals on the use of medications, and they also give patients instructions for taking and storing medicines. Senior care pharmacists have expert knowledge regarding the medical conditions of the elderly and the treatments for these conditions. Many factors must be considered when treating the elderly, making this a complicated process. One factor to keep in mind is that older bodies react differently to medications than younger bodies. In addition, many older people have more than one health problem and take more than one medication. According to the American Society of Consultant Pharmacists, people of ages 65 to 69 take an average of about 14 prescriptions a year, and as people get older that number only increases. Because of factors such as these, senior care pharmacists work closely with other members of health-care professionals in caring for a patient. Senior care pharmacists’ responsibilities include keeping records on their patients’ drug regimens, advising health professionals on what medicines to use and giving training on how to use them, and monitoring patients’ progress and adjusting medicines as needed.
History of Senior Care Pharmacist Career
The title of pharmacist can be traced to ancient Greece. During the time of Aristotle, those who compounded drugs were called pharmakons. The word has changed little from its original form and still means approximately the same thing: one who compounds drugs, medicines, or poisons.
Pharmacy as a profession grew slowly in the United States. It is said that one of our earliest pharmacists was Governor John Winthrop of the Massachusetts Bay Colony. He learned to compound drugs because there were no other sources in the colony for obtaining medicines. The first school established to teach pharmacy in this country was the Philadelphia College of Pharmacy, founded in 1822. It is still in operation today as a college of the University of the Sciences in Philadelphia.
In 1906, the Federal Pure Food and Drug Act was passed. The Food and Drug Administration (FDA) was created in 1931. This agency must approve any pharmaceutical before it can be offered for sale in the United States. The field of pharmacy continued to grow, but it was only later in the 20th century that geriatric pharmacy came into existence as a profession. By the 1950s, some pharmacists had begun to focus on providing pharmacy services to nursing homes. Government health official George Archambault, now known as the founding father of this profession, coined the term “consultant pharmacist” to refer to the pharmacists working (that is, consulting) with nursing homes.
Today, senior care pharmacists, as the consultant pharmacists became known, still provide pharmacy services to nursing facilities. In addition, senior care pharmacists may provide services for elderly people in other environments, such as assisted living facilities, hospices, and home-based care programs. Because our country has a large and growing senior population, the skills and expertise of senior care pharmacists should be increasingly in demand.
The Job of Senior Care Pharmacists
Senior care pharmacists have expert knowledge of drug products and their effects on elderly patients, the medical conditions affecting the elderly, and the treatments for these conditions. They work in a variety of settings, and their responsibilities vary based on the places of work. In general, however, senior care pharmacists’ duties involve consulting with nursing facilities or other long-term care facilities (such as assisted living facilities, hospices, and home-based care programs) about the condition and care of their patients. These pharmacists do on-site visits to meet with their patients, discuss any problems they may be having as well as to discuss a treatment plan, and meet with the other health care professionals who are part of a team caring for the patient.
An important aspect of the senior care pharmacist’s work is to conduct regular drug regimen reviews as required by law. For these reviews, senior care pharmacists gather and review information on a patient’s medical history, diagnosis, test results, and treatments. In general, they go over any information related to the person’s health, including his or her diet. The pharmacist also meets with the patient’s doctors, nurses, and any other health professional involved in the patient’s care to review treatment plans and goals. Senior care pharmacists then go over the medications prescribed for the patient, checking to make sure the patients are receiving the right medicines, in the right doses, and at the right times. If the senior care pharmacist discovers a problem with a medication being given, he or she figures out how to correct the situation.
Some of the unique knowledge senior care pharmacists must have includes knowing how a medicine will affect an older person’s body, knowing how different medicines will react together in clients who take more than one prescription, knowing if a medication will make an elderly person’s existing conditions worse, and, just as important, knowing the life circumstances of the patient. That is, the pharmacist should know the answer to questions such as: Is someone available to give the medication to the patient on a regular basis? Or, if the patient is in an assisted living facility, will he or she remember to take the medicine? Is the patient skipping doses to make a prescription last longer? Can the patient read the instruction label? Does the patient still need the medicine, or has he or she recovered from the illness the medicine was treating? Senior care pharmacists need to be aware of all such factors in order to find appropriate solutions to any problems that may arise.
In addition to having a close relationship with other health care professionals, senior care pharmacists must have close relationships with their clients, treating each as an individual. Because an older person’s body processes medication differently than a younger person’s, senior care pharmacists must be able to customize medications for their patients so that they achieve the desired results. A pharmacist may suggest, for example, taking two doses of a medicine at different times during the day instead of one large dose that is more difficult for an older person’s body to absorb. Many older people regularly take more than one type of drug for a variety of problems. And senior care pharmacists must know when a 70-year-old man, for example, comes in with a prescription for a new arthritis medicine if this medicine will interfere with the effectiveness of the blood pressure medicine he is already taking. If the potential for harmful drug interaction exists, the pharmacist will consult with the doctor and suggest a more appropriate treatment.
Senior care pharmacists must also understand a patient’s overall health condition. Many older people, for example, have a poor sense of balance, limited vision, or are forgetful. Senior care pharmacists must know if a patient experiences any such problems so that they do not give a medicine that will make the situation worse. For example, if 82-year-old woman (who has osteoporosis and is unsteady walking) has a prescription for a medicine that has the side effect of causing dizziness, the pharmacist should realize this might aggravate her balance problem and lead to a fall that could cause broken bones. In such a case, the senior care pharmacist will advise her doctor about the problem and recommend a different medication.
Senior care pharmacists also keep detailed records of drugs dispensed to each client. This is extremely important because older people often see more than one doctor for a number of different conditions. The senior care pharmacist may be the only person keeping track of various medicines prescribed by several doctors for one patient. In these cases, the senior care pharmacist is the health care professional who is in the best position to spot a potential adverse drug interaction and recommend a prescription change.
Another responsibility of senior care pharmacists is to answer questions about medications and provide training to other health care workers on how to administer these medications. A senior care pharmacist may spend part of a day or an entire day, for example, giving nurses at a nursing home instruction on how to determine the proper dose of an antibiotic that will be given through an IV. Naturally, senior care pharmacists also spend time in the pharmacy, where their activities include reviewing and documenting incoming prescriptions, supervising pharmacy technicians, checking filled prescriptions for their correctness, and answering questions about medications.
Like all pharmacists, senior care pharmacists must be diligent in maintaining clean and ordered work areas. They must be exceedingly accurate and precise in their calculations, and possess a high degree of concentration in order to reduce the risk of error as they assemble prescriptions. They also must be proficient with a variety of technical devices and computer systems. In conjunction with these duties, senior care pharmacists need to complete continuing education on a regular basis to maintain their certification or licensing, as required by their states. Continuing education may be done through correspondence (written responses to educational material, usually done online) or by attending conferences, workshops, and seminars. Some states may also require continuing education in particular disease topics and treatments.
Senior Care Pharmacist Career Requirements
You can start preparing for this career while you are in high school. Begin by taking a college preparatory curriculum. Be sure to take four years of math courses, including algebra, geometry, and trigonometry, and four years of science, including biology, chemistry, and physics. Take computer science classes so that you are comfortable working with computers and English classes to develop your research and writing skills. You may also want to take business classes to learn management skills and business basics. Other courses you should take include history, government, a foreign language, and a social science, such as psychology.
The Accreditation Council for Pharmacy Education is the accrediting agency for professional programs in pharmacy offering the degree doctor of pharmacy (Pharm. D.). In the past, this agency also accredited programs that offered bachelor of science degrees in pharmacy (B.Pharm.). However, as of 2005, the Pharm.D. degree will completely replace the B.Pharm. degree, and all bachelor’s programs in this field are being terminated. So, if you want to become a pharmacist, you should plan on getting the doctorate degree, which generally takes six years to complete.
Your first year or two of study does not take place in a school of pharmacy but rather in a general college setting where you will complete pre-pharmacy classes. Studies typically include chemistry, organic chemistry, biology, physics, calculus, statistics, anatomy, English, and social science classes, such as psychology or sociology. After completing this undergraduate work, you will need to gain admission to a school of pharmacy. If you are attending a large university that has a school of pharmacy, you may want to apply there. You may also apply for admission to schools of pharmacy that are not part of your undergraduate school. In addition to completing pre-pharmacy course work, some pharmacy schools require applicants to take the Pharmacy College Admissions Test (P-CAT) to be considered for admission.
Once you are in pharmacy school, you will take courses such as the principles of pharmacology, biochemistry, pharmacy law and ethics, and pharmaceutical care. Because geriatric pharmacy is a growing field, more and more schools are offering courses with a focus on the elderly and their pharmaceutical care needs. In addition, your education should include an internship, sometimes known as a clerkship, in which you work under the supervision of a professional pharmacist. When deciding on a school to attend, it is advisable that you consult the Accreditation Council for Pharmacy Education’s Annual Directory of Accredited Professional Programs of Colleges and Schools of Pharmacy. Paper copies of this directory are available (at no charge) from the council, and directory information is also available on the council’s Web site, https://www.acpe-accredit.org/ .
Certification or Licensing
The Commission for Certification in Geriatric Pharmacy offers voluntary certification to pharmacists who serve geriatric populations. To become certified, pharmacists must take a written exam that focuses on geriatric pharmacy practice. Those who pass receive the designation Certified Geriatric Pharmacist (CGP). While this is a voluntary certification, professionals in the field highly recommend obtaining it as a demonstration of your specialized skills and knowledge.
All 50 states, the District of Columbia, and U.S. territories require practicing pharmacists to be licensed. To become licensed, candidates must have graduated from an accredited pharmacy program, completed an internship under a licensed pharmacist, and passed their state’s board examination.
Naturally, senior care pharmacists need to be detail-oriented as well as organized. They also need strong communication and people skills since they interact with doctors, nurses, other health professionals, elderly people who are ill, and sometimes an elderly person’s family as well. They must be able to work professionally and often patiently when explaining what a medicine will do, how to take it, when to take it, and so on. Senior care pharmacists should also enjoy being around older people and want to help them. These pharmacists must be committed to a lifetime of learning because the field of medicine continues to grow, making new treatments and new methods of treatment available.
Exploring Senior Care Pharmacist Career
One way to learn more about this profession is to read publications and visit Web sites dedicated to geriatric pharmacy. (You can start with the organizations’ sites listed at the end of this article.) Another option is to get experience in a pharmacy environment by finding part-time or summer work at a drugstore. Even if you aren’t working in the pharmacy, you can get valuable experience dealing with customers and observing the kind of work pharmacists do. If you are a hard worker and demonstrate responsibility, you may be given the chance to assist in the pharmacy, such as entering data in customer computer records, taking inventory on pharmaceuticals, bottles, and vials, preparing labels, or making deliveries to customers. Part-time or summer work in a nutrition and vitamin store can also give you the opportunity to learn a great deal about dietary supplements and herbal alternatives to pharmaceuticals.
It is also important that you explore how much you enjoy working with the elderly. Part-time or summer work in a nursing home is one way of doing this. In addition, many volunteer opportunities exist for helping older people. These opportunities can be found with organizations and agencies such as the American Red Cross, states’ departments of aging, and local Catholic Charities agencies, to name a few. You will benefit from getting involved with helping older people, because you will begin to learn about their particular concerns and needs.
Senior care pharmacists traditionally work for nursing home facilities. According to the American Society of Consultant Pharmacists, a number of employers exist within this setting. For example, a senior care pharmacist may work for a small long-term care provider, which provides pharmacy services to several nursing facilities in a small area. A senior care pharmacist can also work for a large long-term care provider, which is a pharmacy providing services to a large number of nursing facilities in a region. A pharmacist in geriatric care can also be hospital-based, working in a hospital’s pharmacy and providing services to nursing facilities that are owned or run by the hospital.
There are also a growing number of senior care pharmacists employed in nontraditional settings. These pharmacists may provide services to employers such as assisted living facilities, hospice agencies, and home health programs. In addition, senior care pharmacists may be academically based, teaching at schools of pharmacy; may work in industry for drug companies as administrators or researchers; or may be self-employed, running their own consulting businesses and working with care providers such as nursing facilities, geriatric care managers, and hospice agencies.
The American Society of Consultant Pharmacists, which is the leading organization for those involved in geriatric pharmacy, reports a membership of more than 7,000. While membership is voluntary, this figure gives an idea of the number of pharmacists involved in the field.
Ward Lenart, a certified geriatric pharmacist in Chicago, Illinois, says of his career path, “I started . . . in a retail pharmacy located in a neighborhood with many geriatric customers. One day at work I noticed a customer sitting on a bench as her caregiver yelled at her, ‘You need to go into a nursing home!’ and ‘You can’t take care of yourself!’ I thought to myself that there had to be more I could do [to help] . . . . I made a career change when an opportunity opened at a long-term care pharmacy. After only a few days I realized this was the type of work I went to school for.” Those in geriatric pharmacy often cite the desire to provide in-depth help to their older clients as one reason for starting out in this field.
Those just graduating from pharmacy school should be able to get help locating jobs through their schools’ placement offices. Professional organizations are also sources of information; the American Society of Consultant Pharmacists provides a listing of companies that hire recent graduates as well as employment listings on its Web site.
Graduates can also apply to and complete residency programs in geriatric pharmacy. Such a residency will give you further training for working in this field and enhance your credentials. The American Society of Health-System Pharmacists offers several residencies, including residencies in pharmacy practice and residencies in geriatric pharmacy. During a residency, which usually lasts one year, pharmacists work full-time and earn a stipend. Residents who complete their programs have excellent employment prospects. Sometimes they are offered jobs at the places of their residencies.
Another option is, like Lenart, to begin working in a pharmacy that provides services to a general population, gain work experience, and move into geriatric pharmacy practice when the opportunity presents itself.
Senior care pharmacists can advance by moving to larger pharmacies for more responsibilities, such as managing a larger staff of pharmacy technicians and working with more nursing facilities than they had in their past jobs. Other senior care pharmacists may consider it an advancement to move into a different area of consulting, for example, changing from nursing facility consulting to long-term care facility consulting. Those in academia advance by becoming full professors, and those in industry may advance by obtaining positions with increased management responsibilities. Some senior care pharmacists with experience may decide to form their own consulting businesses, either alone or in partnership with other pharmacists.
According to Ward Lenart, salaries for senior care pharmacists are generally on par with what other pharmacists earn. He does note, though, that “some pharmacies view [senior care pharmacists] as a sort of sales representative in addition to their duties as pharmacists.” In these cases, senior care pharmacists are usually at the higher end of the pay scale. Other factors that influence salaries include location and type of employer and the pharmacist’s experience.
According to the U.S. Department of Labor, pharmacists had median yearly incomes of $84,900 in 2004. The department also reported that the lowest paid 10 percent earned less than $61,200, while the highest paid 10 percent made more than $109,850 annually.
Pharmacists, in addition to salary, often enjoy fringe benefits such as paid vacation time, medical and dental insurance, retirement plans, and sometimes bonuses, depending on the size and type of employer.
Pharmacies must be clean and orderly as well as well lighted and well ventilated. They are frequently busy places and this is especially true for those serving a large number of geriatric patients, since older people often take more than one medication at a time. In addition to working in a pharmacy, senior care pharmacists also visit their patients and consult with other members of the patient’s health care team. This means there is often travel involved in the senior care pharmacist’s work. Additionally, because these pharmacists are in contact with such a variety of people, from elderly people in pain to concerned family members to other health care professionals, they may often need to be diplomatic when advising on why and how medications should be taken.
The two most unfavorable conditions of the pharmacist’s practice are the long hours and the necessity to stay on one’s feet. Most state laws covering the practice of pharmacy require that there be a pharmacist on duty at all times when a pharmacy is open. This may mean long shifts as, for example, hospital pharmacies are continuously open. Despite these factors, most senior care pharmacists appreciate being involved in health care where they can use their medical and scientific knowledge to help older patients feel better.
Those who run their own businesses have management and financial responsibilities. They must hire employees, keep records on patients, and keep track of costs. They must make rent or mortgage payments and pay insurance premiums and taxes.
Senior Care Pharmacist Career Outlook
The U.S. Department of Labor predicts that job opportunities for pharmacists will grow faster than the average through 2014. The number of available positions is expected to exceed the number of people entering the field, mainly due to pharmacists who are retiring or otherwise leaving the field. Although the U.S. Department of Labor does not provide an employment outlook specifically for senior care pharmacists, it does cite the growing elderly population in the United States as a reason for the good job prospects for pharmacists. Senior citizens are expected to take an increasing number of prescription medications as a result of continuing medical advances and new drug research.
The demand for pharmacists in hospitals will not be as great as other areas of the industry, since hospitals are increasing the amount of outpatient visits and decreasing the length of patient stays; this prompts people to purchase prescriptions from other retail venues, such as drug store and supermarket pharmacies, where job outlooks will be quite good. Other avenues for geriatric pharmacists include working for pharmaceutical manufacturing companies, especially those that manufacture drugs designed to treat ailments that affect senior citizens. In such contexts, pharmacists can work in research and development, or even in the marketing and advertising of new drug products.