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Senior PharmAssist’s Mission is to promote healthier living for Durham seniors by helping them obtain and better manage needed medications, and by providing health education, Medicare insurance counseling, community referral and advocacy.

Domain
Dementia, Care Transitions, Medication
Clinical Activity
Community Resources
Resource Website

Disasters strike without warning, and emergency situations often worsen symptoms of dementia. Living with Alzheimer’s disease and other dementias can make it hard to cope with disasters such as severe weather, fires, floods, earthquakes and other emergencies. The National Alzheimer’s and Dementia Resource Center, funded by the U.S.

Domain
Dementia
Clinical Activity
Management, Community Resources
Resource Website

ARMOR is a functional and interactive evidence-based tool that takes into account a patient’s clinical profile and functional status – its primary goal is to improve functional status and mobility. This tool also emphasizes quality of life as a key factor for making decisions on changing or discontinuing medications. 

Domain
Dementia, Medication
Clinical Activity
Screening, Assessment, Management
Resource Website

Web page that links to a series of 20 brief videos that showcase a series of couples dealing with challenges in dementia in the home.

Domain
Dementia
Clinical Activity
Management
Resource Website

Two page summary of a structured approach to managing transitions of care for outpatients with needs for complex chronic disease management used by Community Care of North Carolina.

References: 
1: Axon RN, Coleman EA. What Will It Take to Move the Needle on Hospital
Domain
Care Transitions
Clinical Activity
Management
Resource Website

Toolkit developed in 2017 for primary care providers that describes how to deliver person-centered care for people living with dementia, including guidance about codes for billing for services (CPT codes).

Domain
Dementia
Clinical Activity
Management
Resource Website

Brief, 4-minute video tape on how to address repetitive questioning in people living with dementia  in a respectful manner.
 

Domain
Dementia
Clinical Activity
Management
Resource Website

Brief, 4-minute  training videotape on how to address challenges when assisting a person living with dementia to bathe.

Domain
Dementia
Clinical Activity
Management
Resource Website

Brief video from UCLA Caregiver training series on how to address assisting with medications in dementia, without provoking symptoms

Domain
Dementia, Medication
Clinical Activity
Management
Resource Website

Toolkit for raising awareness about opiate misuse, including a 6-step process for engaging patients.

Domain
Medication
Clinical Activity
Screening, Management, Community Resources
Resource Website

The Montreal Cognitive Assessment (MoCA) was designed as a rapid screening instrument for mild cognitive impairment.

Domain
Dementia
Clinical Activity
Screening
Resource Website

AHRQ developed toolkit for outpatient care practices designed to enhance patient experience and improve safety for new patients transitioning into a practice.  The toolkit is composed of the following components, each of which is extensively referenced.

Domain
Care Transitions
Clinical Activity
Assessment, Management
Resource Website

RCT comparing effiacy of 3 approaches (2 non-pharm) to controlling itching among 23 hemodialysis patients  to reduce anticholinergic load from antipruitic medications.
Sample size was small, but all showed statistically significant reductions in itching intensity.

Domain
Dementia, Medication
Clinical Activity
Management
Resource Website

Toolkit (14 pages) developed by the Agency for Health Quality and Research (AHRQ) American Hospital Assoication's Research and Educational Trust.

Domain
Care Transitions
Clinical Activity
Management
Resource Website

This website sponsored by End Hunger Durham provides information about existing food distribution, facilitating collaboration among hunger fighting agencies, and advocating for food policies and initiatives aimed at ending poverty and hunger.

Domain
Care Transitions
Clinical Activity
Community Resources
Resource Website

Brief listing of transportation resources available to elders in Durham

Domain
Dementia, Care Transitions, Medication
Clinical Activity
Management, Community Resources
Resource Website

The sites listed at this link provide free incontinence supplies for older adults in Durham.

Domain
Dementia, Care Transitions
Clinical Activity
Management
Resource Website

Initial screening tool for cognitive changes.  The 3-item brief standardized cognitive measure “Mini-Cog” is a well validated starting point that can be done at the annual wellness visit or for patients 

Domain
Dementia
Clinical Activity
Screening, Assessment
Resource Website

This deprescribing protocol is comprised of 5 steps

  1. Determine all drugs the patient is currently taking and the reason for each one
  2. Consider overall risk of drug induced harm in individual patients
  3. Assess each drug in regard to its current or future potential benefit compared with its current or future potential harm
  4. Prioritize drugs for discontinuation with the lowest benefit/harm ratio and lowest likelihood of adverse withdrawal reactions or disease rebound
  5. Implement the discontinuation regimen and monitor patients closely
References: 
Scott, IA, Hilmer SN, Reeve, E, et al. Reducing Inappropriate Polypharmacy: The Process of Deprescribing. JAMA Intern Med. 2015;175(5):827-834
Domain
Dementia, Care Transitions, Medication
Clinical Activity
Screening, Assessment
Resource Website

NTOCC is a group of concerned organizations and individuals who together address the safety and quality of care for transitioning patients. This is a tool that could be used for organizational planning to create targeted action plans toward improving transitions of care.  

NTOCC completed a project to determine seven crucial elements that are involved in every quality transition of care. 

Domain
Care Transitions
Clinical Activity
Screening, Assessment, Management
Resource Website

The Montreal Cognitive Assessment MoCA is a brief cognitive screening tool for Mild Cognitive Impairment.  

Domain
Dementia
Clinical Activity
Screening, Assessment
Resource Website

The Medication Appropriateness Index (MAI) measures the appropriateness of prescribing for elderly patients, using 10 criteria for each medication prescribed. For each criterion, the evaluator rates whether the medication is appropriate, marginally appropriate, or in- appropriate.

Domain
Medication
Clinical Activity
Screening, Assessment, Management
Resource Website

Meals on Wheels of Durham, Inc. is a non-profit agency committed to enhancing the quality of life for eligible homebound adults in our community. Their mission is to serve the elderly, frail, disabled, convalescing and others who cannot provide proper nutrition for themselves with the objective of improving the nutritional status and health of these individuals.

Domain
Dementia, Care Transitions
Clinical Activity
Community Resources
Resource Website

Since 1986, the Memory Disorders Clinic has been treating a wide range of memory problems arising from diverse medical causes including neurodegenerative diseases (Alzheimer's disease), vascular problems, and other neurological disorders).  As part of the Joseph and Kathleen Bryan Alzheimer's Disease Research Center at Duke University Medical Center, the clinic provides diagnostic expertise, cutting-edge treatment, and research for memory problems. 

Domain
Dementia
Clinical Activity
Management, Community Resources
Resource Website

Duke Geriatric Behavioral Health offers a variety of geriatric mental health clinics and services.

Domain
Dementia
Clinical Activity
Management, Community Resources
Resource Website

A state-wide resource for family members of patients with Alzheimer’s and other memory disorders. The Duke Family Support Program serves families and professionals concerned about or caring for persons with memory disorders in North Carolina, and Duke employees seeking help with elder care decisions. A point of contact for all North Carolina families to help navigate next steps in care and gain more information about resources and support in the community.

Domain
Dementia, Care Transitions
Clinical Activity
Screening, Community Resources
Resource Website

Helps consumer select and evaluate long term care setings 

Domain
Dementia, Care Transitions
Clinical Activity
Community Resources
Resource Website

The Beers Criteria was designed:

  • To identify potentially inappropriate medications that should be avoided in many older adults
  • To reduce adverse drug events and drug related problems, and to improve medication selection and medication use in older adults
  • Designed for use in any clinical setting; also used as an educational, quality, and research tool
Domain
Dementia, Medication
Clinical Activity
Screening, Assessment, Management
Resource Website

The National Institute on Aging’s ADEAR Center offers information and publications for families, caregivers, and professionals on Alzheimer’s disease research, diagnosis, treatment, patient care, caregiver needs, long-term care, education, and training.  This Fact Sheet provides information on medication used to manage symptoms of Alzheimer's Disease. 

Domain
Dementia, Medication
Clinical Activity
Management
Resource Website

BenefitsCheckUp is a free service of the National Council on Aging (NCOA), a nonprofit service and advocacy organization in Arlington, VA.

Domain
Dementia, Care Transitions, Medication
Clinical Activity
Community Resources
Resource Website

The MIS is a brief screening tool to assess memory. It is one of three tools recommended for use in the Medicare Annual Wellness Visit by the Alzheimer's Association.

 

Domain
Dementia
Clinical Activity
Screening
Resource Website

Duke Connected Care (DCC) is a community-based, physician-led network that aims to improve the quality of healthcare while addressing the national challenge of rising healthcare costs.

Duke Connected Care is an Accountable Care Organization (ACO). An ACO is a group of doctors, hospitals and other healthcare providers who are working together with health plans, like Medicare, to give patients high-quality, coordinated service and care.

Domain
Dementia, Care Transitions, Medication
Clinical Activity
Community Resources
Resource Website

The General Practitioner assessment of Cognition (GPCOG) is a screening tool for cognitive impairment. It has been designed for general practitioners, primary care physicians, and family doctors.

Domain
Dementia
Clinical Activity
Screening
Resource Website

Canadian International Pharmacy Association (CIPA) is a Canadian association of licensed, retail pharmacies.  These pharmacies sell pharmaceuticals and maintenance medications (but not controlled substances) in 90-day quantities to both Canadian and U.S. citizens. Each CIPA pharmacy member is licensed and regulated by the government for safety.

Domain
Medication
Clinical Activity
Community Resources
Resource Website

The Rapid Geriatric Assessment (RGA) is a new screening tool developed by the Geriatrics Division of Saint Louis University.  The RGA includes assessment of Frailty, Nutrition, Loss of Muscle Mass (Sarcopenia), and Cognitive Function. It is part of the HRSA-funded Geriatric Workforce Enhancement Program (GWEP) to improve the health of older Missourians by training primary care health providers in Geriatric Medicine

Domain
Dementia
Clinical Activity
Screening
Resource Website

NeedyMeds is a 501(c)(3) national non-profit information resource dedicated to helping people locate assistance programs to help them afford their medications and other healthcare costs.

 

Domain
Care Transitions, Medication
Clinical Activity
Community Resources
Resource Website

NC MedAssist is a nonprofit pharmacy program providing access to lifesaving prescription medications, patient support, advocacy and related services to poor, vulnerable, and uninsured North Carolina residents.

 

Domain
Care Transitions, Medication
Clinical Activity
Community Resources
Resource Website

A Helping Hand provides in-home assistance for people age 60+ with temporary or permanent disabilities or those recovering from accidents or injuries, paid companions provide respite care, companion care, transportation escort to medical appointments, meal preparation, light housekeeping, correspondence, laundry, and medication reminders.

Domain
Care Transitions
Clinical Activity
Community Resources
Resource Website

A therapeutic service where the participants are often experiencing difficulties associated with dementia, stroke, isolation, and confusion. Approximately 79 percent of participants in the center maintained or improved their cognitive condition due to the structure and stimulation of activities within the center. Participants enjoy a safe and comfortable surrounding and are provided stimulating activities designed to meet the physical, social, emotional, and mental needs of the adults.

Domain
Dementia
Clinical Activity
Community Resources
Resource Website

Information and Assistance (I&A) services empowers adults age 60 and over to find referrals, information and solutions for problems they face at the right time. Assistance is provided by nationally certified Information and Referral specialists and is completely confidential. 

Domain
Dementia, Care Transitions, Medication
Clinical Activity
Community Resources
Resource Website

The Durham Center for Senior Life offers congregate meal services at three satellite Senior Centers in Durham. he Congregate Meal Services are intended to promote social, emotional, and physical well-being in older adults age 60 years plus. We do this by providing a nutritional lunch 5 days a week as well as socialization activities. 

In order to participate in our the Congregate Meal Service, you must be 60 or older and complete a registration application. 

Domain
Care Transitions
Clinical Activity
Community Resources
Resource Website

FREE health equipment like walkers, wheelchairs, crutches and bedside commodes for loan. Gently used donations also accepted. 

Durham citizens can borrow equipment or bring their donations on Tuesdays from 11am - 3pm and Fridays from 2 - 6pm to the front door of The Scrap Exchange.

Domain
Care Transitions
Clinical Activity
Community Resources
Resource Website

The NC Community Pharmacy Enhanced Services Network (CPESN) includes community pharmacies that have volunteered to collaborate with Community Care of North Carolina to provide enhanced pharmacy services to Medicaid and dually eligible Medicare-Medicaid beneficiaries. All participating pharmacies will provide the following required services, in addition to the optional services indicated for each pharmacy.

Domain
Care Transitions, Medication
Clinical Activity
Community Resources
Resource Website

The Anticholinergic Risk Scale (ARS) is a ranked categorical list of commonly prescribed medications with anticholinergic potential. The higher the score the higher the risk of anticholinergic adverse effects in older adults.

References: 
Rudolph JL, Salow MJ, Angelini MC, et al. The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med. 2008;168(5):508-513
Domain
Dementia, Medication
Clinical Activity
Screening, Assessment, Management
Resource Website

A state wide resource for families dealing with Alzheimer's in North Carolina.  The website is useful for locating support groups, finding outreach activities, and helping families find information about various types of dementia and helping with caregiver stress.

 

Domain
Dementia
Clinical Activity
Community Resources
Resource Website

Four Page, efficiently organized overview of providing care for patients with cognitive changes.

Domain
Dementia, Medication
Clinical Activity
Screening, Assessment, Management
Resource Website

ACT on Alzheimer's® has a collection of training videos for administering cognitive assessments and reviewing diagnostic pitfalls that can occur.  The 3-item brief standardized cognitive measure “Mini-Cog” is a well validated starting point that can be done at the annual wellness visit or for patients with cognitive complaints.  

Domain
Dementia
Clinical Activity
Screening, Assessment
Resource Website

The Saint Louis Mental Status Exam (SLUMS) was developed at the Saint Louis Veterans Affairs Medical Center as a tool for cognitive screening.  It takes slightly less time to administer compared to the Montreal Cognitive Assessment (MoCA), 8 minutes as opposed to 12 on average.  

Domain
Dementia
Clinical Activity
Screening, Assessment
Resource Website

START (Screening Tool to Alert doctors to the Right Treatment)

STOPP (Screening Tool of Older People’s potentially inappropriate Prescriptions)

Provides explicit, evidence based rules of avoidance of commonly encountered instances of potentially inappropriate prescribing and potential prescribing omissions.

Domain
Dementia, Care Transitions, Medication
Clinical Activity
Screening, Assessment, Management
Resource Website

Succinct two-page handout for clinicians from the Veterans Administration explaining “Dementia Warning Signs” and elements of the diagnostic evaluation. Delivers an explanation of warning signs, why they are important to document, and next steps for assessment and management. This is a nice teaching tool for learners and a good review regarding the initial outpatient management of patients who may have memory problems. 

Domain
Dementia
Clinical Activity
Screening, Assessment, Management
Resource Website