The July 2012 issue of Provider, a magazine published by the American Health Care Association and the National Center for Assisted Living, has a cover story on finding alternatives to antipsychotics for long-term care facility residents with dementia. The article urges staff members to understand behaviors as communication and to “play detective” to resolve them rather than turning to dangerous antipsychotic drugs to sedate residents.
Without a hint of irony, the article begins by stating that the recent national focus on antipsychotics in nursing homes has caused “headaches” for facilities. Residents who have been drugged with antipsychotics could teach facilities a thing or two about headaches. But then the article turns to its theme – encouraging staff to get to know residents and then use the knowledge to remedy behavioral issues. “Knowing residents can make all the difference.”
The article lists many instances where facility staff members have thought creatively to discern what is causing a perceived resident “behavior” and then devised an intervention that fixes the problem without an antipsychotic or other psychotropic drug. Robin Anicar, a nurse in Maryland finds “that many behaviors in residents with dementia are the result of unmet basic needs. By going through a lot of possibilities – hunger, pain, cold, hot, wet, lonely, and so on – staff can resolve the behavior or rule out the possible reason for it.” Empowering nurses to engage their own interventions without turning to a physician (and his or her prescription pad) is a key.
After recounting several examples of good nursing home staff sleuthing to get at the root cause of a resident’s behavior or agitation, the article concludes by quoting Dr. Matthew Wayne of Ohio: “this really isn’t about antipsychotics. It’s about good quality, person-centered care.”
We couldn’t agree more and we’re thrilled that Provider has dedicated its July cover story to the least medicating approach to dementia care.