KCUR had an interesting article on how one Kansas facility has reduced dangerous antipsychotic drugs provided to nursing home residents.
Antipsychotic medications are commonly used to treat mental illness, but they’re not approved for treating dementia. The U.S. Food and Drug Administration has issued a “black box” warning outlining the significant side effects the medications can have if used improperly.
The federal Centers for Medicare and Medicaid Services launched an initiative to reduce their use in nursing homes in 2011, when nearly 24 percent of long-stay nursing home residents nationwide were on the drugs.
Janell Wohler and Kate Rieth of the Linn Community Nursing Home believes that it doesn’t have to be that way. Wohler is the administrator and Rieth is the director of nursing at the facility, which has eliminated off-label use of antipsychotics for residents over the last five years. The two led a presentation on “Antipsychotic Reduction in Action” at a conference of Kansas nursing home administrators in Manhattan.
Rieth said it’s a matter of educating staff to look for the underlying reasons behind residents’ non-compliant behavior and addressing those, rather than reaching for a phone to call a doctor who can prescribe a “chemical restraint.”
“Doctors are fixers,” Rieth said. “And how do they fix things? With medicine.”
The “fix” can do more harm than good, with side effects that include increased risk of infections, blood clots, stroke and death. In addition to meeting basic needs like hunger and thirst, they said their facility focuses on keeping residents with dementia busy with activities, including a “Music and Memory” program.
The solution in these situations is more staffing and better training, not medications. Rieth and Wohler said it had not been an easy process to wean staff from the quick fix of calling a doctor, but it’s worth it.