Re: Dementia without drugs (w/quick response)

[Guest guest]

writes:

<<Oh, , thank you for your response. I certainly understand. It never

occurred to me and of course you are right. I think that it would be good to

consult privately and thank you for your offer. Do I start the process by

completing the consulation form?

Ruth Ann>>

** Yes Ruth. That would be where to begin. I'm glad you see the sense in

this.

--

> >

> > *Moving Beyond Chemical Restraints in Nursing Homes

> > **(reprinted from the Star Tribune)

> >

> > **Nursing homes are seeking to end the stupor*

> > WARREN WOLFE, Star Tribune

> >

> > The aged woman had stopped biting aides and hitting other residents. That

> > was the good news.

> >

> > But in the North Shore nursing home's efforts to achieve peace, she and many

> > other residents were drugged into a stupor -- sleepy, lethargic, with little

> > interest in food, activities and other people.

> >

> > " You see that in just about any nursing home,'' said Eva Lanigan, a nurse

> > and resident care coordinator at Sunrise Home in Two Harbors, Minn. " But

> > what kind of quality of life is that? "

> >

> > Working with a psychiatrist and a pharmacist, Lanigan started a project last

> > year to find other ways to ease the yelling, moaning, crying, spitting,

> > biting and other disruptive behavior that sometimes accompany dementia.

> >

> > They wanted to replace drugs with aromatherapy, massage, games, exercise,

> > personal attention, better pain control and other techniques. The entire

> > staff was trained and encouraged to interact with residents with dementia.

> >

> > Within six months, they eliminated antipsychotic drugs and cut the use of

> > antidepressants by half. The result, Lanigan said: " The chaos level is down,

> > but the noise is up -- the noise of people laughing, talking, much more

> > engaged with life. It's amazing. "

> >

> > Now the home's operator, Shoreview-based Ecumen, has started a project

> > called Awakenings throughout its 15 long-term care nursing homes. It's based

> > on Lanigan's work and funded with a two-year, $3.7 million state grant.

> >

> > " We saw what Eva was doing -- something everybody in the industry talks

> > about -- and we were impressed, " said Mick Finn, an Ecumen vice president.

> > " We said, 'Hey, this is real. Can we all do this?' "

> >

> > The dangers of drugs

> >

> > Powerful antipsychotic drugs have been used for years to reduce agitation,

> > hallucinations and other debilitating symptoms among people with mental

> > illnesses.

> >

> > They also are widely used " off label " to quell disruptive behavior among

> > people with Alzheimer's disease and other forms of dementia.

> >

> > Medicare spends more than $5 billion a year on those drugs for its

> > beneficiaries, including about 30 percent of nursing home residents. Several

> > studies have concluded that more than half are prescribed inappropriately.

> > The drugs are especially hazardous to older people, raising the risk of

> > strokes, pneumonia, confusion, falls, diabetes and hospitalization.

> >

> > " There's a bunch of problems, not least of which is those drugs can kill

> > you, " said Dr. Mark Kunik at Baylor College of Medicine in Houston who spoke

> > last month at the Gerontological Society of America's annual meeting in New

> > Orleans.

> >

> > Instead of looking for causes of disruptive behavior among dementia

> > patients, doctors typically prescribe drugs to mask the symptoms, he said,

> > because " It's the easy thing to do. ... That's true in hospitals, in clinics

> > and in nursing homes. "

> >

> > Federal regulators are cracking down on homes that don't routinely reassess

> > residents on psychotropic drugs. But use remains widespread.

> >

> > " Whether you have Alzheimer's or not, there's a reason people get frustrated

> > or upset -- pain, urinary tract infections, hunger, fear of strangers or

> > loud noises or strange settings, maybe drug interactions,'' Kunik said. " If

> > you figure that out, you likely can find a safer, nonpharmacologic

> > treatment. "

> >

> > Treating loss with love

> >

> > About 150 miles south of Two Harbors, Bernice Brockelman, 91, was snacking

> > on cookies last Wednesday beside the Christmas tree at Ecumen Parmly

> > LifePointes, a nursing home in Center City -- all the while alternating

> > quickly from calm to worry to calm.

> >

> > " Can I stay here tonight? I don't know where to go. Can I stay with you? "

> > she asked Christy , the home's therapeutic recreation director.

> > Though reassured her, she asked the question again -- and again and

> > again.

> >

> > In an effort to calm her while preparing to wean her from pills, the Parmly

> > staff invited Brockelman into a game of Bingo and to recite the Polish

> > phrases she learned from her immigrant parents. Then she spotted a male

> > visitor.

> >

> > " Hey, is he married?'' she asked with a sparkle in her eye.

> >

> > " When she's feeling good, Mom's an outrageous flirt and she can be really

> > funny, " said her daughter, Judy Balthazor of Center City. " But often there

> > is the repetitive questions, the worry, sometimes just being washed out. I

> > can't wait for them to get her off her drugs. "

> >

> > Until the Awakenings project, few at the home knew Brockelman's whole story

> > -- the loss of both parents when she was in high school, of her husband at

> > age 46, then two sons, a close friend and a nephew. Found to have psychosis

> > and dementia, she " just shut down because she had so many losses, " Balthazor

> > said.

> >

> > Now, the Parmly staff is gaining deeper knowledge of 15 residents who are on

> > psychotropic drugs and who frequently are agitated or upset. They are about

> > to start weaning the residents from the drugs, but they've already started a

> > range of activities tailored to each.

> >

> > Some say nursing homes cannot afford to replace drugs with personal

> > attention because it requires too much staff time.

> >

> > " Our guess is that it will take the equivalent of two extra people at each

> > home, spread across all job categories, " said Finn, Ecuman's vice president.

> > " Can we afford it? We think we have to, because it's the right thing. "

> >

> > Brockelman, who lived nearly all of her life in northeast Minneapolis, loved

> > to bake, so now she helps make bread and cookies. She danced and was

> > physically active, so she walks with an aide and taps her toes to polka

> > music. A devout Catholic, she attends several weekly church services. She

> > plays Bingo with aide Jenna and sometimes other residents.

> >

> > " When [you] understand who Beatrice has been in the past, you know her a lot

> > better in the present, " said. " With the Awakenings project, I have

> > permission to spend the time I need with Bernice so she feels safe and

> > loved. "

> >

> >

http://www.startribune.com/lifestyle/health/111326224.html?page=1 & c=y<http://trk\

..cp20.com/Tracking/t.c?Gkgt-EPDw-Qy5fU8>

> >

> > --

> > Regards,

> >

> >

>