Page 79 - Retail Pharmacy Magazine October 2020

services through telehealth for this community,” Professor Bhar said. He adds that there were concerns “around physical and cognitive impairments” such as people in their late 80s not being adequately competent with technology to participate, as well as some prejudicial stereotypes around psychologists and counselling being prevalent. However, concerns proved irrelevant as the university was soon offering the service after an initial trial, which was conducted in seven residential aged care facilities in response to Covid-19 restrictions, yielding encouraging results. “We’ve been truly surprised as to how possible it has been to offer counselling services through telehealth as long as we have people to champion it – that is, the residential aged care staff in the form of lifestyle members, personal care workers and medical care staff, to help connect the counsellor to the resident through telehealth,” Professor Bhar said. “For example, a staff member could help place an iPad in front of the resident or connect the resident to the counsellor and make an appointment that way.” He adds that the university expected residents to prefer the “good old- fashioned telephone” when in fact it was a 50/50 split with teleconferencing, as residents felt it was “more personal” if they could see their counsellor. Swinburne student and one of the clinic’s provisional psychologists, Aida Brydon, comments that aged care residents have been “embracing” video communication because it gives them the opportunity to maintain social connections while learning how to use technology. “Lessons learnt here are not only relevant for people in residential aged care facilities, but for all elderly people who are struggling,” Professor Bhar said. Depressive symptoms Professor Bhar says the most common issues the university encounters in the aged involve depression, which doesn’t necessarily mean clinical depression, but depressive symptoms. Some people, he says, have death ideation and don’t want to get up the next day, or they have suicidal ideation, with anxiety and distress being very common. “Many of them have pre-existing mental health anxiety disorders, phobias, obsessive compulsive disorder and social anxiety, with the Covid-19 pandemic really amplifying the worry and anxiety some of them feel generally,” he said. “As we know, it can be relatively easy for older people to become isolated if they have some mental disorder – even mild at that – which makes them loath to meet other people because they’re afraid of what they might think of them or their social anxiety makes them want to be reclusive and hide in their room. Yes, loneliness and isolation are very common.” Professor Bhar points out that it could seem strange that a person in a residential setting could feel isolated and lonely, but that these feelings are not eliminated through them keeping busy or having people around. “What we’ve found makes a real difference is that the older person, wherever they may be, feels listened to,” he said. “I know it can be difficult for pharmacists to put some time aside in their busy schedule, but if they could make the time to hear what someone is going through – not to even offer a service or solve a problem but just to be a witness to what they’re going through – they could make a world of difference to that person.” Feeling visible and heard Professor Bhar says many elderly people have told the university over the past decade how special it has felt to talk to someone who is impartial and who is not a family member or friend, which makes them feel “visible and heard”. “That’s the first step,” he said. “The second step is referring individuals, if possible, so that they may get more specialised help. However, it’s worth pointing out that there are a couple of barriers here, such as stereotypes as to how older people will respond if counselling or psychological treatment is suggested. “I’ve grown up in the era of One Flew Over the Cuckoo’s Nest that brings with it all the negative prejudicial stereotypes about what it means to receive psychological treatment – in terms of lying strapped to a sofa, being hypnotised and psychoanalysed. Some of these images are very disempowering. “But it’s OK when it’s presented as MENTAL HEALTH 77 someone with whom they can have a helpful chat and who will listen to their issues and help them reflect on them, as opposed to something that will be done to them, which is often rejected.” Another barrier, he says, is knowing whom to refer the patient to, as not many practitioners specialise in geropsychology – the gap that the university fills in residential aged care.” “Organisations such as Beyond Blue and COTA \\\\\\\\\\\\\\\[also known as Council on the Ageing\\\\\\\\\\\\\\\] offer services, as well as many others, which can be localised or specialised,” Professor Bhar said. “If a pharmacist or healthcare worker is struggling to refer a patient, we’d be happy to help. The university’s telehealth service is accessible not only to residents but also to aged care staff, including pharmacists.” Refer to: swin.edu.au/telehealthcounselling Government support The issue of whether government is adequately supporting elderly people is a “topical and tricky issue”, Professor Bhar says. “Australia is at a turning point,” he said. “Just look at the royal commission into aged care quality and safety.” In July, the royal commission was given an extension of three months, with a further 6100 home care packages announced by the federal government. Professor Bhar says this measure was taken because more time is needed to ensure that all public concerns are heard, including the impact of the pandemic on those in residential aged care and home care. The royal commission has also begun to reveal some of the challenges in the system. Extending the reporting period will allow it to be as comprehensive as possible. “I think that when it comes out, we’ll start to see some revolutions within mental health and aged care,” Professor Bhar said. “For example, if you live in a residential aged care facility, you don’t have the same access to Medicare rebates or psychological treatment compared with someone living in the community. There’s a strong division in policies and funding for mental health between these two sectors, which many people aren’t aware of.” Professor Bhar also highlights that TO PAGE 78 RETAIL PHARMACY • OCT 2020