The problem of misuse of psychotropic drugs in nursing homes is hitting a bit harder in the media this week. Here’s a two-part series from the
Chicago Tribune. Part 1: and
Part 2:
Psychotropic drugs for people with dementia are the “Emperor’s New Clothes” of geriatric medicine. With increasing consumer and media pressure, maybe people will start taking things seriously.
Of course, this isn’t merely a problem of cruel, uncaring people. There are many systemic problems that lead to the overmedication of people with dementia in long-term care. The problem extends beyond nursing home walls as well. In a survey of people admitted to St. John’s Home over a year’s time, I compared each person’s admission “mini-mental status test” with the medications they were taking at home before the event that led to their hospitalization and/or nursing home placement. In those with more severe dementia (a score of 10/30 or less), 50% were taking antipsychotic drugs at home.
In future weeks, I’ll post more excerpts from my upcoming book on the real solution to this growing problem.
How is this real solution being utilized at your facility and what impact is it having?
We’re an Eden home, so many of out transformational steps have helped the care process (for example, we eliminated agency staff in 2004 and our full-time staff turnover last year dropped to only 8.6% – for an urban home with over 900 employees – the improved relationships have helped us get to know people and better understand their needs).
We are still moving slowly through the change process and have many institutonal trappings, but even so I was able to lower my use of antipsychotic drugs in my ~100 patients with dementia to 7-8% (c/w 40% of people with dementia in most homes). With my book, I plan to roll out an education program to help all staff learn the skills needed to make this a more sustainable result throughout the home.