Senior Care Pharmacy: One Exploding Population, Many Career Paths (Part 1)

The senior care market is exploding, as 10,000 people turn 65 every day in the United States and the first baby boomers are projected to turn 85 in 2031. Pharmacy students considering a career in a nontraditional pharmacy field should know that there are many opportunities to serve this unique and growing population.

During the 2018 American Society of Consultant Pharmacists (ASCP) Annual Meeting in National Harbor, Maryland, 4 amazing pharmacists working in senior care shared their career stories with a handful of pharmacy students. As a new employee of ASCP, I had the opportunity to be a fly on the wall and hear these pharmacists speak, and what struck me was realizing that although they all served senior patients in pharmacy, their experiences were radically different.

Throughout all issues of Pharmacy Careers® in 2019, I’ll explore each pharmacist’s story in-depth to provide students with a glimpse into the dynamic and diverse field of senior care pharmacy. Our first featured senior care pharmacist is Dee Antimisiaris, PharmD, CGP, FASCP, an associate professor in the University of Louisville Department of Pharmacology and Toxicology.

GROWING UP AND PHARMACY INFLUENCE

Dr. Antimisiaris grew up in Hawaii Kai, Hawaii, and Monterey Park, California, where she enjoyed biking, swimming and surfing. She had a passion for math and science, which led her father to influence her to go to pharmacy school.

“He told me that ‘pharmacy is a great profession for women,’ and he didn’t mean it in a biased way,” Dr. Antimisiaris said. “My mom was a judge, and observing her career and that of a physician, I found them to be options that would be difficult to keep in practice by working part time, especially with young children.”

GETTING INTO SENIOR CARE PHARMACY

After pharmacy school, Dr. Antimisiaris completed a clinical residency in geriatric pharmacy at the VA-Sepulveda Geriatric Pharmacy Residency Program in Los Angeles, during which she worked with innovators and leaders in senior care. After her residency, she returned to Hawaii and, inspired by her experience, decided to work in long-term care.

“Long-term care duty in Hawaii is an experience in rural health. The care homes do much with little, and as such, when the pharmacist [comes] in every month, sometimes they wanted me to help assess a patient or they would want me to help figure out what to use instead of another drug not easily available, since the pharmacy only delivered once daily,” Dr. Antimisiaris explained. “But, most of all, the rural care homes taught me the special meaning of caring for elders and those who can’t care for themselves in a tight knit community.”

ONE PHARMACIST IN SENIOR CARE: MULTIPLE GIGS

Dr. Antimisiaris currently leads the Fraizer Polypharmacy and Medication Management Program at the University of Louisville School of Medicine, where she educates students on polypharmacy-related topics, conducts research on polypharmacy and medication use, and performs outreach to nonacademic stake holders regarding polypharmacy.

“With the departmental shift to pharmacology and toxicology, my day-to-day has shifted from clinical care and the education of postgraduate learners to primarily research, with the same ongoing effort to collaborate outside of academia with other stakeholders,” she stated. “I always make sure to stay up-to-date with senior care practice. I provide case consults at our medication management clinic once a month, and I fill in for long-term care consulting pharmacists when they go on vacation.”

PASSION FOR SENIOR CARE PHARMACY

In addition to feeling grateful for the opportunity to work with and learn from her colleagues, Dr. Antimisiaris views serving seniors as a privilege and points to her patients as what she loves most about senior care.

“[I like] protecting older adults from the lack of appropriate oversight that the complex health care system of today offers,” she said. “Caring for older adults is a very meaningful practice, and it seems that there isn’t a day that goes by when I don’t feel like I’ve made a difference.”

CHALLENGES OF SENIOR CARE

All professions and areas of pharmacy practice have their challenges, and senior care is no exception. Dr. Antimisiaris cited legal regulations over medication, access, and affordability, as well the complexity of care, as some of the biggest challenges faced by pharmacists in the senior care setting. “Anything from formulary choices to long-term care regulations and lack of access to care are so frustrating for the senior care pharmacist,” she stated. “The subjectivity and complexity of regulations often result in barriers to adequate and appropriate care.”

A related frustration highlighted by Dr. Antimisiaris is the inability to influence those regulations, formularies, and access.

“At the level of the individual long-term care facility, we can help correct issues due to our face-to-face interaction with the staff and residents, but our successful collaborations and interventions cannot go beyond the care facility to impact broader and more permanent improvement,” she explained. “This illustrates the importance of your professional organizations and why we should support them. They do take the fixes we find in day-to-day practice, as well as the problems we identify, and give us a voice that can reach the outside stakeholders that adversely impact care.”

THE FUTURE LOOKS BRIGHT FOR SENIOR CARE PHARMACY

In spite of these concerns, Dr. Antimisiaris sees global opportunities to improve senior health.

“In addition to the aging of our population in the United States, the population is aging globally,” she said. “There are opportunities to collaborate internationally in order to share skills and solve ideas, as well as provide education, and there is always more research and collaborative work to do with the interprofessional health care team.”

ADVICE FOR STUDENTS INTERESTED IN SENIOR CARE PHARMACY PRACTICE

Dr. Antimisiaris recommended that students interested in pursuing a career in senior care first gain exposure to caring for older adults.

“Make sure that working with older adults is for you. Students can get this experience by working in the retail setting, a longterm care facility, or senior centers. Keep in mind that senior care is not limited to long-term care facilities and that senior care skills translate to just about any practice setting,” she advised. “Additionally, consider completing a residency in geriatrics and identify a mentor who works with older adults.” Dr. Antimisiaris concluded by sharing the best career advice she had ever received.

“Learn to appreciate the mundanity of excellence,” she said. “There is value in slowing down and doing the seemingly mundane tasks so you can truly digest topics and develop habits that lead to excellence or innovation.”

Senior care pharmacy offers many amazing career choices for the pharmacy student or practicing pharmacist who wants something different. As you can witness from Dr. Antimisiaris’ story alone, the sky is the only limit! ®

Erin Albert, PharmD, JD, MBA, PAHM, is a writer, pharmacist, attorney, and former professor. Follow her on Twitter (@ErinLAlbert) or at her website (erinalbert.com).