There are 23.2 million people aged 50-plus in the UK, more than a third of the total population, says Age UK, with 14.9 million aged 60-plus and 1.5 million aged 85-plus. In the next decade, life expectancy is forecast to rise by 19 per cent for people aged 65 and over and by 40 per cent for those aged 85 and over, according to the International Longevity Centre UK. In its report Tomorrow’s World: The Future Of Ageing In The UK, pensions expert Steven Baxter comments that our rising life expectancy has largely resulted from two things – the successful combating of infectious disease, medical advances and behavioural change.
For those born in the UK today, the chances of reaching 80 are better than at any time in history, says the ICL. Men born in 2015 are expected to live to 90 and women to 94. But while 27 per cent of men and 24 per cent of women aged 80-plus report good health, 44 per cent of women and 36 per cent of men have at least one limitation in mobility, while 50 per cent of men and 56 per cent of women have a chronic condition.
Healthy life expectancy is now 66 years for women and 64 for men. Men aged 65 can expect to live their last 7.5 years with a disability and women their last 9.7 years. If nothing is done about age-related disease, there will be 6.25 million older people with a chronic condition or disability by 2030, says Age UK.
Pete Stannett, at Arthritis Care, says 33 per cent of over-45s have osteoarthritis, while 49 per cent of women and 42 per cent of men aged 75-plus are affected. Projections suggest the number of people affected by arthritis is set to increase by 50 per cent by 2030. Musculoskeletal conditions are the largest contributor to disability in Britain and account for 31 per cent of all years lost to disability, says the charity.
Rachael Twomey, from Arthritis Care’s helpline team, says: “Pharmacists can maintain their awareness of local services that help people stay active and independent. There are various products that claim to help with mobility or strength. Pharmacists can use their professional knowledge to advise their customers on whether claims are correct and when to check with the GP.”
“Pharmacy can do a great deal, especially for customers with less serious problems, by advising on lifestyle changes to help them stay mobile and independent,” suggests Elvy Mardjono, Mentholatum senior product manager. “They can also advise on supplements that may help to maintain healthy joints and OTC medicines to help ease pain and discomfort.”
Amish Patel, pharmacist at Hodgson Pharmacy in Longfield, Kent, has a large elderly customer base. “Lots of medicines are available for joint pain, but make sure you’re giving advice on how to use them correctly and check patients are not abusing them,” he says. “If a customer comes back repeatedly for the same pain relief, suggest they see their GP for advice.”
The most important advice to get across to your customers with arthritis or joint pain is to stay active, have a healthy diet and make practical adaptions to their lives that reduce stress on joints, says Ms Twomey.
“Pharmacists can also give accurate information on the role of supplements, explaining that certain supplements can add nutrients to a diet where an older person is finding it hard to eat a balanced diet.”
Encouraging exercise is important. “From middle age, it’s helpful to get into a daily routine of exercises that promote joint mobility, as well as muscle strength and flexibility. Someone with arthritis should be able to see a physiotherapist on the NHS.”
A new report from the charity Independent Age has revealed that pensioners aged 75-plus are thousands of pounds a year worse off than younger pensioners and working-age adults.
An estimated 20 per cent of older pensioners live in poverty in the UK. The charity found that older pensioners are less likely to claim Pension Credit. Approximately 750,000 people aged over-75 are entitled to Pension Credit but are failing to claim, often unaware that they can get it.
This entitlement is something pharmacy staff could help to raise awareness of among older customers.
“Pain relief medicines can present problems for many older people because of interactions with other health conditions and medication,” says Ms Twomey. “The pharmacist’s role is about giving customers accurate information about the medicines they are taking, suggesting other medicines that may be more appropriate and directing to the GP where necessary. It would be useful if pharmacists were aware of pain clinics and services in their area.”
“If customers are using OTC topical products to help ease pain, it is very important that pharmacists and staff give easy-to-follow advice on the most appropriate products,” says Ms Mardjono. “They can also explain how topical analgesics can offer effective relief, targeted to the point of pain. Older customers may already be taking medication and the pharmacy can make sure when they need pain relief that they are using an effective painkiller which will not interact with their medication.”
Encouraging older customers to stay active and mobile is key to protecting their health, says pharmacist Lila Thakerar at Shaftesbury Pharmacy in Harrow. “We promote incentives from organisations that encourage local walking groups,” she says. “We hand out leaflets to our elderly customers, especially if they have chronic health conditions.”
Mr Patel says mobility aids are a large part of his business. “If your pharmacy is in an area with a large elderly population, it pays to stock mobility aids,” he says. “Larger items do take up space, so have a catalogue available that customers can browse and you can order items for them. Make sure your staff are properly trained to sell mobility aids. Role play is a great way to prepare.”
Kimby Osborne, leg health expert at Activa Healthcare, says: “Pharmacists can help by explaining that walking helps work the foot and calf muscle pumps, which helps circulate blood round the body, reducing the risk of aching and swollen legs.” Activa has produced downloadable PDFs outlining walks in the UK that are supported by presenter Angela Rippon.
“Due to the effects of ageing on the urinary system, the elderly can often experience disruption in the process of storing urine and emptying the bladder,” says Donna Wilson, training and brand manager at TENA. “Less elasticity can reduce the bladder’s capacity and lead to a more frequent need to urinate.”
Sales of bladder weakness products are growing fast, with sales up by 14.4 per cent last year. “Older customers may lack the mobility to travel to large multiples to purchase bladder products, so they rely on their local pharmacy, says Ms Wilson.
Pharmacists should be aware of the fastgrowing men’s market, which increased by 51 per cent last year. “Despite this commonality, many men still assume that bladder weakness products are only available for women, so will ignore the issue or improvise,” says Ms Wilson. “To help address this issue, pharmacists could trial dual-siting products so men who are looking to purchase urine leakage products can look in the male fixture before the intimate hygiene fixture. This would help capture men, and also women or care-giving relatives who are purchasing products.”
TENA Lady Mini Night gives customers the choice of a smaller, more discreet pad for nighttime use. Designed for moderate bladder weakness, its Lie Down protection provides extra absorbency and protection during the night. TENA Lady Pants Discreet offers integrated protection for women experiencing moderate bladder weakness. It features a thinner core and integrated leakage barriers for improved fit and comfort.
Thousands of blind and partially sighted older people are not receiving any social care support, say Age UK and RNIB. Findings presented in Age UK and RNIB’s joint report Improving Later Life For People With Sight Loss, show that older people have been more affected by the loss of community-based services due to funding cuts. Older people with sight loss are twice as likely to fall and have a higher risk of injury.
“Poor uptake of sight tests is the biggest threat to poor vision in the UK, so if a customer says they’ve been experiencing problems with their vision or suffering headaches or had a recent fall, ask when they last had a sight test,” says Kelly Plahay, optometrist and vice chair of the Eyecare Trust. “Customers who smoke should be advised of the links between smoking and sight loss – research by the BMJ highlights how as many as one in five cases of age-related macular degeneration is caused by tobacco – and be encouraged to join a pharmacy smoking cessation programme.”
Education is key. “Take time to reinforce what the patient would have been told by their optometrist about their condition, the importance of taking prescribed medication and how best to administer it,” says Ms Plahay.
Offering access to an ordering service for mobility equipment and aids is a key opportunity for community pharmacy. “We hire out larger disability aids such as wheelchairs to our customers, which they really appreciate as many will not want to buy one, especially if they’ll only need it for a short time,” says Ms Thakerar. “Make sure the fixture is easily accessible to customers with mobility problems.”
“Site mobility aids next to incontinence products in store as the two often go together,” suggests Mr Patel. “Make sure the category looks appealing and is easy to navigate and access. Train your staff to pick up the conversation about mobility aids and incontinence. Help them to overcome embarrassment and take pride when it comes to admitting they need these products to improve their quality of life.”
Ms Wilson advises on the positioning of bladder weakness products in the pharmacy, in order to achieve a balance of visibility and privacy for this growing category. “These products are viewed as essentials, so should be visible from the front of the pharmacy but in a discreet enough position to encourage additional dwell time for those who want to browse. This will also enable pharmacy staff to easily spot when a customer looks like they require help. If a highly visible location isn’t possible, use POS materials to draw attention to the fixture. Use clear and concise merchandising to help customers quickly locate the right product. Use product samples of incontinence products to demonstrate how products work and explain benefits.”
“Pharmacists and their teams are ideally positioned to help customers with untreated swelling of the limbs and changes in appearance of skin on lower limbs,” says Ms Osborne. “If customers complain of tired, aching or swollen legs, this is a great opportunity to suggest they try compression hosiery.”
Fiona McElrea, Whithorn Pharmacy, Whithorn “To be honest, looking at mobility products, we don’t stock many, as they take up a lot of space and can be quite expensive. But we do have our wholesaler’s catalogue readily available. Customers and patients can browse through, find the items they want and then get fast delivery. We do stock certain things, such as non-spill easy-grip cups for people who can’t sit up well, and small urinal pots. However, most business in this category is done through the catalogue. There is so much in this category, and we only get a request every few months, so it doesn’t make sense to keep more in store. Some pharmacies specialise in this area, but this arrangement makes much more sense for us.”
Rena Dadra, Village Pharmacy, Harlington “This is not a big category in this particular store, as there is quite a young population in this area, but we do have another pharmacy in Harefield where age and mobility products are more popular. It depends on the needs of the local population. However, the cost of these items can be high and they also take up a lot of space, so we tend not to keep them in the pharmacy. I would say that the most important consideration is giving the correct counselling and advice, and making sure that we refer customers to the right people for purchasing the mobility equipment they need.”
Sultan “Sid” Dajani, Wainwrights Chemist, Bishopstoke “I would say that this category is hugely and strategically important. It’s time for pharmacy to show some courage and get proactive. We often get queries about independent living. You can’t stock it all, so stock a core range and make sure you are aware of what’s available and ensure a quick turnaround with the companies you decide to deal with. I use different suppliers as they all differ in what they can provide. Strategically, the long-term view is don’t lose your patients to others. In addition to NHS Choices, our website and our window information board, I’m trying to crack awareness at the local hall and even at the care and nursing homes. Timing of delivery and awareness of the range are the most critical things in this category. Offer literature that also promotes the other services you offer, including screening and medicines optimisation services.”