We all follow strict protocol
when prescribing psychotropics
Now, it’s time to consider
intervention alternatives
The use of psychotropic drugs in nursing homes has steadily increased over the past 20 years. Many administrators work hard to ensure safe, proper prescription, but still, the problem persists all across America. Residents suffering from depression, dementia and other behavioral disorders can be difficult to manage, causing staff to order unnecessary drugs as a fast, effective solution. And while the practice may protect other patients, it ultimately diminishes the individual’s quality of care—and indeed, their quality of life.
THE OVER-PRESCRIPTION
OVERLOAD
in numbers
*Stats furnished by The Center
for Medicare Advocacy and
The New York Times
Avoiding Unnecessary
Drugs: 101
To help long-term care providers better understand patient behavior and appropriate treatment methods, Linda Elizaitis, President of the CMS Compliance Group, compiled a thorough crash course. Beyond assessment procedures, she outlines non-pharmacological strategies for eliminating patient stressors, environmental distractions and other factors that may be impacting their dangerous behaviors.
Here’s a recap:
Expectation assessment
First, remember to identify whether or not a patient’s basic
expectations are being met. Are your facility and staff protecting
their individual rights to autonomy, individuality, safety, assistance
and interaction? Lack of security and sense of community may
contribute to their misconduct.
Relevant stressors
Assess common causes of problem behavior including fatigue,
pain, hunger, thirst, illness, boredom and changes of
environment. If a resident’s privacy has been violated, or if
there’s been a major disruption to his or her daily routine, he or
she may have reason to act in dangerous or hostile ways.
Staffing issues
Decide if the resident’s behavior may be improved with
personnel changes. For instance, giving the person a consistent
staff assignment or matching them with a more compatible
caregiver could help alleviate underlying problems. Commit to
more meticulous monitoring of staff in the future.
Environmental approaches
In lieu of psychotropic drugs, facilities can ensure safety for
resident wanderers by reducing clutter and crowding, offering
more engaging hands-on activities (based on individual
needs), providing more stimulating wall décor and putting
identifying room markers in place.
Therapeutic approaches
Outside the realm of Rx, other pro interventions include
Reminiscence Therapy, Music Therapy, massage, bonding
and communication with staff/peers, hobby-based programs,
animal-assisted therapy, baking/decorating activities and
other traditional de-escalation procedures.