Over the last several years, many nursing homes have worked to reduce the number of physical restraints used by residents. Today, only devices that are necessary and doctor-ordered to ensure the safety of the resident, such as lap belts on wheel chairs, are being used regularly. However, there is growing concern that some nursing homes have become dependent upon chemical restraints, meaning they are using powerful narcotics and antipsychotics to sedate residents and control their behaviors.
According to a recent article in US News and World Report, an alarming number of dementia patients have been receiving doses of antipsychotic medication above recommended levels. The Centers for Medicare and Medicaid Services is reporting that 17 percent of dementia patients living in a skilled nursing center are being overmedicated with mood- and behavior-altering drugs.
These patients, many of whom are physically capable of harming themselves or others, are often unaware of how their behaviors are affecting staff, other residents and their loved ones.
Partnership to Improve Dementia Care
In an attempt to combat the overuse of antipsychotic drugs in long-term care, CMS is launching a new initiative called the Partnership to Improve Dementia Care. This program has been established to help reduce the usage of chemical restraints in nursing facilities and provide a higher quality of care and life for residents suffering from dementia with behavioral issues.
CMS plans to launch the education and training program to help care providers meet the needs of their patients. The program is designed to educate the general public, as well as nursing home staff, and will include:
- Training for quality care within nursing home settings.
- Publishing data on antipsychotic drug use on the website Nursing Home Compare.
- Providing alternatives to antipsychotic use such as exercise, outdoor time, pain management and other planned activities.
Is this just the beginning?
However, in a statement by the American Psychiatric Association, it is noted that the evidence suggesting alternatives to pharmacological interventions is weak, especially for those suffering from dementia.
The CMS initiative may be the start of a slippery slope in long-term care. According to the Matt Bennett, senior vice president of the Pharmaceutical Research and Manufacturers of America, this is a real concern and although the organization supports the appropriate use of medications, they are hoping this initiative does not inadvertently limit access to necessary pharmacological treatments.
Bennett told the American Medical News, “Research shows that use of appropriately prescribed medicines can dramatically improve patient health as well as reduce avoidable and costly medical care, such as unnecessary hospitalizations and nursing home admissions.”
The CMS program will do one thing for certain. It will educate those who are caring for patients with dementia; providing much needed resources to the millions of caregivers, both professional and unpaid, who are helping provide a better quality of life for those with memory impairment.
Do you think the CMS program will hurt or hinder the care being received in nursing homes?
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