Pharmacy training at Legacy House opens new doors

Preceptor Annie Lam and two volunteers at the holiday luncheon for the Legacy House congregate meal plan.

With support from the UW’s Tools for Transformation program, the School of Pharmacy has established a Consulting Pharmacy Service at Legacy House, an assisted living facility built as part of the Village Square Project in the International District.

In operation only since December, the consulting service is helping residents of the facility, providing new training options for students, and opening doors for other new projects.

The project was set up by Dr. Jackie Gardner, associate professor of pharmacy, to link the needs of low-income elderly in the International District for better management of medications with the increasing desire of students to understand how pharmacy is practiced outside hospitals and stores.

Gardner, who had lived in Asia for several years, was already working as a volunteer in the International District. She found students were interested in working with this population. Wendy Watenabe, who Gardner knew through volunteer work, became director of the newly-built Legacy House. So they decided to try to set up a UW Consulting Pharmacy Service for the facility.

In addition to the Tools for Transformation funds, which support the full-time consultant at Legacy House, the project was aided by a small grant from the Seattle Foundation to equip the office.

Since much of the Legacy House population is Chinese-speaking, finding a bi-lingual pharmacist was a top priority. Annie Lam, who speaks three Chinese dialects and earned her Pharm.D. degree from the UW in 1997, seems like a perfect fit. She had returned to school after working for many years as a medical technologist in Canada. After graduating as a pharmacist, she had worked at a hospital and the Seattle-King Co. Health Department. She was pleased to be able to use her new skills working with people who needed her ability to communicate with them.

The direct, close contact with residents of the facility and others in the community is important to Lam. In addition to Legacy House itself, there is an Adult Day House program for people with functional disability and low incomes, and a lunch program for those who are living in the community. Lam and her students attend these too, taking blood pressures and talking with participants.

“I’ve seen many of the participants warm up to me because I can speak their language,” she says. “It’s really heartwarming.”

And sometimes it can be lifesaving. Because of the language and cultural obstacles, many elderly Asians feel that they “can’t talk to doctors.” As a result, they may be going without urgently needed medication or medical care. Lam recalled one elderly man with diabetes who had collapsed. As it turned out, he and his family had believed that his disease was cured. Because they hadn’t understood the information they were given, he had stopped taking the medication he needed.

Students training in the program are working toward their Pharm. D. (doctor of pharmacy) degrees or a specialized certificate in geriatric practice. They come to Legacy House for an eight-week rotation, twice as long as the usual term. Along with routine tasks such as checking in medications from the outside pharmacy, the students work on the sometimes complex medication profiles for chronically ill residents to avoid interactions and other drug-related problems.

“Because of the nature of the work, we find a longer rotation is better,” Lam says. It gives the students a chance to see the effects of their interventions and develop relationships. “Seeing how our work helps the residents function better is a big reward,” she adds.

Gardner, the associate professor who started the program, says that their ultimate objective is to make it self-sustaining through payments for the care given.

Pharm.D. student Debbie Woo with a Legacy House resident in the Activities Room. Photos courtesty of Annie Lam.

In the meantime, the link with the School of Pharmacy is producing benefits at both ends. Lam, in conjunction with her work at Legacy House, is a lecturer in the Department of Pharmacy and is teaching a course here on Long-Term Care. In addition, Lam’s language abilities and the base in the International District community open possibilities for new research there, Gardner says. ¶

Claire Dietz