A PREVENTION PROGRAM ADDRESSING MEDICATION ABUSE AND MISUSE IN OLDER ADULTS: A GRANT PROPOSAL

1. A PREVENTION PROGRAM ADDRESSING MEDICATION ABUSE AND MISUSE IN OLDER ADULTS: A GRANT PROPOSAL By Arwen Cho California State University at Long Beach May 2012

2. Introduction • The use of prescription medications and over-the-counter drugs by older adults can increase their risk for adverse health effects and potentially even death. • There are two main areas of risk for older adults regarding the use of prescription medications; accidental misuse of prescription medications and over-the-counter drugs (Rolita & Freedman, 2008) and the abuse of psychoactive substances originally prescribed to manage pain or other mental health conditions (Simoni-Wastila & Yang, 2006). • Given the prevalence of use and potential for abuse, the purpose of this project was to prepare a grant proposal to seek funding for an educational outreach program within the city of Whittier, California for the prevention of prescription medication misuse and abuse among older adults.

3. Social Work Relevance • The risk for older adults to accidentally misuse prescription medications and over-the-counter drugs and the potential for the abuse of psychoactive substances originally prescribed to manage pain or other mental health conditions is clear (Rolita & Freedman, 2008; Simoni-Wastila & Yang, 2006). • Older adults have been marginalized from receiving the attention they require to age successfully and (Blow, 1998). • There exists a need for social workers and healthcare providers to be culturally competent in addressing the geriatric and ethnic needs of this population to develop best practices that support optimum access of the resources that are available to them in order to adhere to the ethics set forth by the field of social work.

4. Cross-cultural Relevance • According to the Administration on Aging (2005), the older adult Latino population will grow 254% from the year 2004 to 2030. • Studies focused on the impact of ethnicity on issues of poly-pharmacy and psychoactive drug abuse show that the Latino population follows the national trends of non-Hispanic Whites (Espino et al., 2006; Loya, González-Stuart & Rivera, 2009; Ojeda & McGuire, 2006). • However, Latino populations have been found to access healthcare and mental health related services for problems including poly-pharmacy and substance abuse at lower rates; Latinos access mental healthcare resources at one third the rate of their non-Hispanic White counterparts (Sorkin, Pham, & Quyen, 2009).

5. Methods • Target Population: 19,000 adults over the age of 55 living in the city of Whittier, which account for approximately 22% of the total population. The program will also be open to individuals from the surrounding communities of Pico Rivera, Santa Fe Springs, Downey, Norwalk, Hacienda Heights, Rowland Heights, and La Mirada. • Strategies Used to Identify Funding Source: The process of identifying funding support for the proposed program included a comprehensive search utilizing national, state and local resources. The resource librarian was consulted at California State University, Long Beach and the services of the library at the Long Beach Nonprofit Partnership were also utilized. The World Wide Web was accessed using the search engines Google and Yahoo to search websites that act as clearinghouses for public and private funding sources.

6. Methods (continued) • Projected Budget Range: The estimated budget and amount of funding requested for the proposed program and subsequent evaluation is $64,814.00. The funding will include salaries, direct and in-direct program costs and will support facilitation, administration and evaluation of both components of the SafeMeds program. • Funding Source: The California Wellness Foundation was chosen due to its specific call for grant applications to promote healthy aging in the capacity of preventive services that include in-home services and specifically state that they are focused on providing funds to be used for core operating support which align well with the proposed program design and needs of this grant proposal.

7. Grant Proposal • Program Summary and Description: The primary focus of this project is to educate and empower older adult members living within and in the surrounding communities of the city of Whittier to safely manage their use of prescription and over-the-counter medications. The SafeMeds program will (1) provide an interactive educational experience to increase awareness and practice of medication safety, and (2) will provide in-home assessment and follow-up care for members of the community at higher risk for complications with medication use and abuse. • Population Served: The SafeMeds program will be administrated by the Whittier Senior Center which is an arm of the Community Services branch of the City of Whittier. The target population for this funding request is adults over the age of 55 living within and in the surrounding communities of the city of Whittier, California.

8. Grant Proposal (continued) • Program Goals: The SafeMeds program will (1) provide an interactive educational experience to increase awareness and practice of medication safety, and (2) will provide in-home assessment and follow-up care for members of the community at higher risk for complications with medication use and abuse. • Program Evaluation: Evaluation of the SafeMeds program will include evaluation of attendance records of interactive educational experiences, records of referrals and completed assessments for the In-Home Medication Safety Assessment component will be maintained, Surveys of each participants’ (Interactive Educational Presentations and/or In-Home Medication Safety Assessment) experience of Adverse Drug Effects (ADEs) will be tracked from their initial response to the survey with a follow up survey 3 months later to determine the rate of post-intervention ADE occurrence.

9. Implications for Social Work • In the field of social work and especially in an economic downturn, it becomes apparent that the already competitive field of grant writing will become even more so. When cuts are made, a vital asset to an agency is a professional who can ferret out resources, including grants. Social workers appear to be ideal candidates for the task in that the training of accredited schools requires a broad knowledge base and cultural competency and this aligns with what most foundations state that they are looking for in programs. • A social worker who can assess what would benefit the community through a comprehensive needs assessment, who can complete an exhaustive and thorough literature review and then design a program to meet those needs will not only be in demand for their skills but will be able to impact their community, upholding the ethics and professionalism of the field of social work. • Traditional public service announcements or informational seminars do not have the depth or reach necessary to impact this often isolated population. Innovative techniques must be used to engage, educate and motivate an older adult to receive the help they may need in the environment they are most comfortable (Benza et al., 2010). The SafeMeds program has the potential to effectively impact older adults in the community of Whittier and potentially any community it is implemented. The academic and professional standards of the social work profession as applied to the grant writing process will ensure its’ success.

10. References Administration on Aging. (2005). Aprofile of older Americans: 2005. Department of Health and Human Services. Washington, DC: U.S. Government Printing Office. Benza, A., Calvert, S., & McQuown, C. (2010). Prevention BINGO: Reducing medication and alcohol use risks for older adults. Aging & Mental Health, 14(8), 1008-1014. Blow, F. (1998). Substance Abuse Among Older Adults (Treatment Improvement Protocol (TIP) Series, No. 26 ed.). Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. Espino, D. V., Bazaldua, O. V., Palmer, R. F., Mouton, C. P., Parchman, M. L., Miles, T. P., & Markides, K. (2006). Suboptimal medication use and mortality in an older adult community-based cohort: Results from the hispanic EPESE study. Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 61A(2), 170-175. Loya, A. M., González-Stuart, A., & Rivera, J. O. (2009). Prevalence of polypharmacy, polyherbacy, nutritional supplement use and potential product interactions among older adults living on the United States-Mexico border: A descriptive, questionnaire-based study. Drugs & Aging, 26(5), 423-436. Ojeda, V. D., & McGuire, T. G. (2006). Gender and racial/ethnic differences in use of outpatient mental health and substance use services by depressed adults. Psychiatric Quarterly, 77(3), 211-222. Rolita, L., & Freedman, M. (2008). Over-the-counter medication use in older adults. Journal of Gerontological Nursing, 34(4), 8-17. Simoni-Wastila, L., & Yang, H. (2006). Psychoactive drug abuse in older adults. American Journal of Geriatric Pharmacotherapy (AJGP), 4(4), 380-394. Sorkin, D. H., Pham, E., & Quyen, N. (2009). Racial and ethnic differences in the mental health needs and access to care of older adults in California. Journal of the American Geriatrics Society, 57(12), 2311-2317.