The Elderly need to go…

Everyone has the stereotypical elderly patient.
Comes in with a smile on her face, and a few flies buzzing around inside her empty head. She comes in, plunks down 10 bottles from 7 different pharmacies, then hands you a fistful of Rx’s and wants them all filled. About 3/4 of what doctor writes for isn’t covered, and she sits there an argues with you about why you need to call the doctor to get them changed.
Medicare part D has to be the cruelest joke that anyone could ever play on the elderly. Lets take a concept that takes working in the industry to fully understand, throw it at the segment of the population who cant tie their shoes without assistance, and see what happens. Add-on salesmen offering lapdances, free geritol, and 24 hours of Jag reruns and you have yourself a real problem.
People say “Well thats where the pharmacist comes in!”. Bullshit. We are not insurance agents, salesmen, or explainers. We do not get a fat check from AARP for helping these idiots out understanding the coverage gap or deductibles.
Theres really only a few problems when dealing with the old folk. When I say old-folk I mean in their late 70’s to 80’s. When you bring up that patient profile, see a fat age of 85, a piece of you dies as you pick up the phone to take the call.

  • Simple concepts become complex concepts. Deductibles are easy to understand. You pay $x out of your own pocket until your insurance kicks in. Simple. You have a better chance explaining quantum physics to Mrs Jones.
  • They dont listen. They are so damn stubborn they will sit there and ask the same question over and over and over. When you answer it, they ask it again! However they will listen to some douche on TV to call Liberty Health for free test machine but not their pharmacist. When you tell them that they dont need their Avandia filled because they picked it up 3 days ago, they will sit there and argue with you until they get it. When they finally stop stroking out and find it sitting right in front of them they wont even apologize for being so retarded.
  • Gullible as all hell (except when you talk). Salesman comes up to their door promising them a piece of gold the size of a thanksgiving turd if they switch to Wellcare. Guess who’s life got a bit harder when they come in for Rx refills? Of course it takes 30 questions, 3 hours of your time, and them bitching at you that their Rx’s arent covered for them to admit that they talked with a salesman (even though you told them not to).
  • Cheap as hell. They dont want to pay those $3.10 copays because they are on a “fixed income”. Yeah, if there wasn’t Medicare part D and you had nothing, you’d still be on a “fixed income”. Stop bitching and pay your fucking copays or i’ll glue your wheelchair to the ground.
  • Talking to them is like talking to a cow. Ever see the blank look a cow gives you? Ever see the blank look someone in their 80’s gives you?
  • Needy as all hell. They call you on a monday when you are swamped to tell you that they have not pooped in one day. They want you to call the doctor RIGHT NOW to get something so their bowels will move. Completely beside the fact they have not eaten anything since yesterday, poop somehow magically gets formed from nothing in their world. When you try to explain this to them, they obviously “dont get it” and just want some magical pill that will make their bowels explode. Thats when the Mag Citrate comes in. At least they’ll be shitting so hard they wont have a chance to get to the phone to call you.
  • They think they know more than anyone. Being around for 80+ years gives you a sense of empowerment and knowledge. Knowledge that somehow replaces going to grad school for 4 years and getting a degree.
  • They always lose/misplace/eat/destroy their medication. Of course it cant be like Lisinopril or something that costs pennies, but Avandia. They lose it like its going out of style. I swear that when half of my patients die I’m going to buy their house so I can recover the 1.3 million dollars of lost medications that are scattered about. Plus they refuse to acknowledge that they lost their medication! They just call in a refill 20 days early and expect you to fill it. Oh, did I mention that they dont wish to pay for said lost medication replacement?
    I hope that if I make it to 80+ years old (highly unlikely) that I can be a burden on everyone like our current aging population is. I figure that its just proper paybacks. Lord knows that I’ll never see a dime of the fistfuls of cash I’m throwing away on the current Medicare system.
    PS: I just got an email that some of the professors at UOP are angry at me for trashing their White Coat Ceremony. Guess who’s getting another entry!!!

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  • 25 Comments

    1. Tim says:

      I have a good one:
      Elderly gentleman comes in one month with a script for Coreg CR. He has a coupon making this month free. He also has Medicare D, which (at least at the time) doesn’t cover Coreg CR, but did cover his regular coreg.
      So fine, we give him his free month of CR. Next month, he comes back for a refill with another one time use coupon for Coreg CR. It states clearly in the coupon that they sent another one incase he lost or misplaced the first one. Well he cannot comprehend why they would continue to send him more coupons if he can’t use them and starts yelling at me (because it’s my fault of course). The elderly… don’t worry, they’ll die soon

    2. Grasshopper says:

      Not all of the elderly are like that, though. Some are still coherent and understanding that things happen even though they may not understand Medicare. But you are right…that blank stare makes me ill, too.
      I can’t wait to here Whitecoat sessions #2!!!!

    3. Adam says:

      I understand that big time as I contimplate calling off of work a few hours from now. The great part is the problem is only going to get perpetually worse as the baby boomers begin to retire and age in a system that is not only unable to care for them, but is going to crash and burn around us.

    4. -Aaron_ says:

      My favorite is the little old lady that obliviously cuts in front of the 10 people standing in line because she didn’t “realize” they were there first or the one that walks out without paying because she didn’t “remember” not paying for them at the pharmacy.

    5. I feel your pain, brother.
      Most of the time I end up giving them a box of simvastatin, or something, just to shut them up.
      Although one old dear did bring me on two bottle of San Miguel once for being a “lovely young man”. Her words, not mine.

    6. RxStudent says:

      I like your PS talking about the white coat ceremony, after your last post I got to thinking that I had to buy a white coat before our “white coat ceremony” b/c one of my labs required professional dress, ie a white lab coat. So buy lab coat then buy another a year later for the ceremony. Not really sure why it works that way but whats a student supposed to do.

    7. Talking Head says:

      TAP,
      Can we not create a virus that simply lays dormant for 80 years in a persons body and then BAM…. goes into high gear? Let’s call it mass genocide of the Elderly.
      It’s Brilliant… you live your life, and the day you turn 80, your fucked, and once the virus kicks in, the only thing they remember is shitting their brains out until they simply stop breathing. I mean, every living creature shits when it dies… right?
      Anyways, good post. I agree with just about everything, The elderly for the most part are clueless, and the most difficult ones are the sweet old ladies that actually don’t get mad at you, but simply cannot comprehend what you are saying. In the end, you feel like a douchebag because you couldn’t help somebody but it was due to their own incompetence.
      You can only help so many people, for the most part, their salvation is out of your hands. They have to save themselves.

    8. Mark says:

      sorry AP cant agree with you there…i was talking about this very topic with my pharmacy staff the day before your post. If i ever become a bumbling, stubborn, irrational 80 year old man i’d prefer to be shot and put out of my (and everyone else’s misery). Needless to say that went over like a lead balloon with the girls in the dispensary…

    9. Jo says:

      Nothing drives me crazier are the elderly customers that won’t take medication that doesn’t have a generic. Why don’t they tell their doctor in advance that they want ONLY generic. Why must we always have to give the doctor a call for a alternate script. Are those my sleeping pills, i don’t trust the zolpidem, please change that to Ambien 10. But…you wanted all generics…You should KNOW what I want and i want BRAND for that!
      oh the elderly…

    10. Radish says:

      I just want to say that I love getting e-mail from “druglord”. Thanks. :)

    11. Mike says:

      A-mother-f*ckin’-men!!! I have one thing to say…. Snowbird season in Florida!! Welcome to my hell.. Can’t wait until January when they all go stupid and can’t remember their new plan info!

    12. Kay says:

      Now the government is putting all these elderly in a plan that requires more time for us to deal with insurance. Not only that but many of the plans are requiring these people to use mail-order. what a fiasco that will be. Who’s going to try to fix it? US!! ‘because we care’. I’m tired of caring and being shit on in the next breath.

    13. rph3664 says:

      I was working in retail when Medicare Part D(isaster) was announced, and our customers were very curious as to why we pharmacists were almost universally opposed to it.
      One of my co-workers, who has done retail pharmacy since 1976, said, “When it goes online, you will find out just how free it is.”
      And he was right.

    14. PharmIntern says:

      I love the fixed income line. I get that more from the gateway pts avoiding a 1.00 copay for a $400 prescription.
      We have an elderly patient who often calls to tell us “I was holding my lantus and I was walking to put it in the icebox and I fell and it broke.” This is usually a day or two after shes picked it up.

    15. canoehead says:

      It’s all true, you’ve got to love them because you can’t take ’em out back and shoot them. When I heard about the doughnut hole I thanked my lucky stars I wasn’t a pharmacist and in a position to explain that mess.
      Thanks for the work you do.

    16. knitalot3 says:

      At least you are not related to them…

    17. Jonathan says:

      re. your last statement
      Cheers for the whole message.
      My faculty made my class do that whole “white coat ceremony” thing which was incredibly lame and I wanted to skip. Seriously, who thinks this is a good idea, and that it instils proper beliefs/morals/etc in people. It’s lame and a waste of time. I’d rather be a home playing a video game or playing basketball or something.

    18. Kelly says:

      I had an elderly man today ask if he could take his nitrates with his viagra. Needless to say we said no and once we told him that he said “fine I won’t be taking my nitrates then”
      looks like someone is going to have a heartattck while having some fun.

    19. Holly says:

      You’ll love this one – you know how Lilly changed their packaging on insulin – the boxes are bigger, etc. Well I knew one of the patients I hate more than anything on this planet was going to call questioning this – so I was ready. What I was not ready for was her accusing me of tampering with her insulin (if it was only so easy to kill that bitch) because when she opened the box, in red letters, it says “this box has been opened” It took me 10 minutes of screaming at her at the top of my lungs to explain that it says that because YOU OPENED THE FUCKING BOX!!!!! Jesus Christ! And she still thought I was lying!

    20. Tyler says:

      Jesus Christ!! Just got home from work, and at the end of the day a skeleton of a 95 year old woman walked up to the counter and didn’t say hi or anything, but screamed “ACTONEL” at me. I looked up the profile for the actonel which was for her husband. I tell them it will be a few minutes while we get it ready for her. He 101 year old husband starts freaking out, yelling “You don’t have to do anything!!” and “Actonel isn’t a prescription”!! Myself and another pharmacist assure him that it is, in fact a prescription, we have one on file for him. He Screams that it is OTC and that next time he will get it somewhere else! We just say, okay, but goodluck trying to get it without a prescription. How fucking out of it do these people have to be, not to listen to two pharmacists, and be so fricking rude. After they left we laughed, because really the joke is on them… soon they’ll be dead :)

    21. marph says:

      I freakin’ hate that moment…about 90 seconds into a conversation with an 85 year old when you realize you are going to have to invest the next 15 minutes trying and trying to explain the simplest concept imaginable, all the while KNOWING that either they will fail to comprehend it completely or they will get it for a split second and then ask you the exact same question you already answered. How many times have you had the following conversation: Millie: “What is Aricept for?” RPh: “Well, Millie, it’s for your memory.” Millie: “There’s nothing wrong with my memory.” RPh: “Well, Dr Jones wrote the rx for Aricept, which is for memory.” Millie: “What is Aricept for?” I feel cruel saying it, but what’s even more cruel is wasting my time when I have 1001 other things waiting for me when there is NOTHING I can do to make this poor woman’s life better. This is not our job. These people need assisted living and I would like to know where the hell their family is!!!!

    22. Tmama says:

      Quoting Marph: ****”These people need assisted living and I would like to know where the hell their family is!!!!” **********
      Lessee, they got paranoia with their dementia, and do their best to conceal their problems from far away family members. And HIPAA regs forbid us from telling their family members.
      This system makes those elderly dead faster and saves on social security. Immoral, yes, but effective.

    23. Mike says:

      What a bunch of losers. Quit complaining and go get a real job. I hope you don’t treat your elderly parents like you do the ones coming into “your” pharmacy.

    24. KT says:

      I spent 30 minutes helping this 80 something old man find Vitamin D3 in the aisles. Whilst I was waving the bottle in front of him he kept saying: Yes, but I need Vitamin D3.

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