The National Partnership to Improve Dementia Care seeks to optimize the quality of life for residents in America’s nursing homes by improving care for all residents, especially those with dementia. Critical to nursing home residents’ quality of life is eliminating the inappropriate use of antipsychotic medications, especially when trying to control the behavioral symptoms of dementia. In 2012, the Partnership, a public-private coalition, established a national goal of reducing the use of antipschotic medications in nursing home residents and using other approaches that are safer and more effective.
The Partnership includes the Centers for Medicare and Medicaid Services (CMS), nursing home residents and their family members, advocacy organizations, providers and professional associations. Each state also has a coalition of stakeholders, referred to as Local Area Networks for Excellence (LANE), promoting this goal locally.
In the last quarter of 2011, almost 1 in four nursing home residents (23.9 percent) were receiving an antipsychotic medication. Since then there has been a decrease of 35 percent to a national prevalence of 15.5 percent in the second quarter of 2017. Many nursing homes worked diligently to individualize care for every nursing home resident thereby lowering their use of inappropriate antipsychotics. Other homes had low rates in the beginning and have maintained these rates and shared their approaches.
Elsberry Health Care Center is leading the way in this important endeavor here in Missouri. Recently the home was recognized by the Missouri Local Area Network for Excellence (MoLANE) for their low rates of antipsychotic use.
With the increase in awareness of unnecessary usage of antipschotice, Elsberry Health Care Center was able to take a step back, watch, listen, and observe our residents who are having behaviors or at risk for behaviors. We were able, with the help of in-service training and education, to understand that the behaviors they were exhibiting were actually due to some underlying need that was not being met. Unfortunately, because of their dementia they could not express their needs to us through language we understood. Getting to know our residents is the key to our success! We make sure to interview family, previous caregivers and friends to find out what they liked, what they didn’t like, and how they spent their days. What a normal routine was for them when they were younger. Gathering this information gives us insight to how we can better assist them and anticipate their needs. As they continue their stay with us, we often talk with the direct care staff, laundry, housekeeping, dietary, and maintenance to see if they are seeing anything that out nurses are not to help identify causes for behaviors. We learned that wit hthe input of everyone on our team, we are better able to serve our residents and meet their needs thus reducing their behaviors and their need for “unnecessary” medications.