Knowledge Will Improve Care
Despite a nationwide push by the Centers for Medicare & Medicaid Services (CMS), we are still not seeing the reduction in antipsychotic medications in older adults with dementia.
The Interim Report from the National Partnership to Improve Dementia Care in Nursing Homes: Q4 2011 – Q1 2014 was recently released by CMS. It outlines the history and current use of antipsychotic medication in older adults with dementia living in nursing homes. It concludes that “alternative, non-pharmacological approaches to optimize care for people with dementia living in nursing homes have not been widely implemented to date.”
Over the past two years, CMS and its partners have developed numerous resources and made them available in the public domain.
One of these resources is the “Hand-in-Hand Toolkit,” a series of six training DVDs. This toolkit is available at http://www.cms-handinhandtoolkit.info/Index.aspx
The toolkit was distributed free to every nursing home in the country and many facilities in Arkansas are using it. In June, one of the creators of this toolkit will be coming to Arkansas to speak. Watch for more information about this learning opportunity on our web site: http://aipp.afmc.org
“Toolbox for Improving Behavioral Health in Nursing Homes” is another toolkit for healthcare partners that is available to download at http://www.nursinghometoolkit.com
Another learning opportunity is to read the Minutes from the monthly conference call, held on April 8, 2014. They have been posted to our website http://aipp.afmc.org/AIPPResourceCenter/MonthlyConferenceCalls.aspx
The topic was “Antipsychotic therapy…then and now,” presented by Anthony M. Hughes, BS, PD, FASCP.
The recent and very successful AIPP Culture Change Workshop “Demystifying Resistance-Addressing Unmet Needs,” was presented by Teepa Snow on May 1. Handouts from the workshop will soon be available in the AIPP Resource Center at aipp.afmc.org
Many other free tools are available to download at www.afmc.org. These tools were developed to help care partners and families improve the quality of life for nursing home residents living with dementia.
We have the tools, so why is it taking so long to make the changes that CMS wants us to report? The answer may lie in an article entitled “Slow Change,” by Atul Gawande, a surgeon and a public-health researcher. The article explains how and why some innovations spread fast in the medical community, and others are slower to be implemented by healthcare workers. He says part of the problem with the spread of innovative ideas may be “the technical complexity.” Read the article at http://www.newyorker.com/reporting/2013/07/29/130729fa_fact_gawande?currentPage=all
“Slow change” is definitely part of the problem with attempts to reduce the use of antipsychotic medications in nursing homes and in the community. Dementia has a complicated disease process. The care of dementia patients can be a very complicated process, often exhausting for caregivers and facility staff.
With education and support, Arkansas care partners will continue to implement new ideas and innovative programs to improve the quality of life for nursing home residents.