Know People Frame Insights

Whats Inside?

Medical Non-Adherence and specifically the 65+ age group have many surrounding stakeholders. In this book we must gain more empathy for each of these surrounding and supporting stakeholders to better understand the integral role each plays in our context. This book contains key interviews and takeaways that will help direct a well designed solution.

Sections
Participant Map Analogous Models Key Interviews ERAF Systems

Contents

Notes

How it Works: The map has 4 quadrants. Each represents a different type of stakeholder and their relation to our primary (65+) stakeholder. For example: The Mail Man may see our stakeholder once a day but he or she can notice if something is wrong or out of the ordinary(Secondary/ Social Care). A Doctor would give more primary health related care.

Primary Care
Doctors Children Social Worker Caregivers Pharmacist Health Clinics Nurses

Medical

Social
Grandchild Friends Neighbors Meals On Wheels Mail Man Bus Driver Pets Co-Worker Fireman Policeman

Medicare/ Medcaid Insurance Company

Secondary Care

Participant Map

Resistant

Helpless

Tired

Dependent

Frustrated

Emotions of Non-Adherence 65+ Age Group

Belittled

Confused

Weak of Mind

Depressed

Worried

Analogous Models

Remembering to Take Medication

Transportation

-Memory loss -Are you in a location/situation that medication is easily accessible -How often is medication taken throughout day? -How many pills? Too many?

-Getting to doctor, pharmacy, PT, etc. -Public transport, walking, driving, etc. -Physical difficulty & safety -Are people available to drive you? -Cost of hiring forms of transportation

Living

Medication Labels
-Eye sight fading, ability to read the text -Comprehension of labels and warnings -Location and size of important information -Does medication need to be taken with food?

Emotions of Non-Adherence 65+ Age Group

House -Independent vs. Dependent on children? -Must pay bills -House cleaning and maitenance -Food shopping and preparation -Lonely -Transportation Hospital -Strict -Stressful -Scared -Length of stay -Specific time for visitors? -Roommates? Nursing Home -Additional care -Expensive -Limited privacy -Feeling of dependence -Structured

-Insurance (Medicare?) -Personal income level -Retired? -Generic medicine available? -Cost of medication suppliments (pill crusher, pill box, etc.)

Cost of Medication

-Following the instructions given by doctors and nurses -Accepting the fact that you are getting older -Letting people do things for you that you once did: drive, dress, make decisions, etc.

Acceptance

Analogous Models

Resentful

-Hate all aspects of job -Start to hate it -Begin to slack on work -Resentful of your boss/those in superior positions

Forced

-Loss of free will -Choices are made for you -Bills need to be paid -Other people are effected if you dont work

Discouraged Medical Non-Adherence compared to Going To Work (job you hate)

-No satisfaction is gained -No raise or change in position -No motivation -No recognition of hard work

Tired

-Stress impacting sleep -Vacation days? -Repetative work -Long hours

Analogous Models

Johanna & Cynthia Department of Aging and Youth Syracuse, New York
People dont ask enough questions at the doctors office. Bringing a family member or friend to help ask questions is suggested. It is also recommended that you go to your doctor with a printed list of questions you know you should ask. Non-Compliance vs. Non-Adherence: Similar wording and context but completely different message. People associate adherence with something that they are doing wrong. Adherence is a harsher word. Compliance is softer and more friendly to the user. Do I buy food this month? Or do I buy medication? Many find it difficult to choose between buying their medications or food. Some only buy some of their medications and not others which can lead to complications.

Dianne Hirsch Nurse at St. Josephs Hospital Ypsilanti, Michigan

Too little on prevention. Once one medical issue becomes a problem, others can be triggered. Especially with older people, you can get very sick when your immune system is comprimised.
The social worker is a bridge between the patient and the hospital. When a patient cannot afford medicine/doesnt have insurance, the hospital calls a social worker to help the patient receive the proper care. The nurse to patient ratio is 6-8 patients for every one nurse. Nurses have a lot of patients to tend to, so it can be difficult to make sure that each patient fully understands their medication/what they must do. Often appearances dont match a patients story. There is a suggestion of non-adherence when a patient continuously sees a doctor for the same reason (snow ball cases). A doctor can visually see that the patient isnt taking the prescribed medication.

There is the lack of insurance coverage for things such as an annual physical. Annual physicals could help catch illnesses sooner and keep people healthier in the long run. Save money in the future by spending money now; like preventative maintenance on a car.

Key Interviews

Hospital Doctor Government Elderly Insurance Company Medication Family/ Caregiver Transportation

Opportunity Space

Pharmacist/ Pharmacy

ERAF Systems

Hospital Doctor Government Elderly Insurance Company Medication Family/ Caregiver Transportation Family/ Caregiver Insurance Company Government

Hospital Doctor Government Elderly Insurance Company Medication Family/ Caregiver

Hospital Doctor

Elderly

Medication

Pharmacist/ Pharmacy

Transportation

Pharmacist/ Pharmacy

Transportation

Pharmacist/ Pharmacy

Hospital Doctor Government Elderly Insurance Company Medication Family/ Caregiver Transportation Family/ Caregiver Insurance Company Government

Hospital Doctor

Elderly

Medication

Pharmacist/ Pharmacy

Transportation

Pharmacist/ Pharmacy

ERAF Systems