You have moved your parents into a nursing home and removed those worries from your plate. But do you really know what is going on in their lives now?
As our parents age, it is difficult to know what is best for them. Most people want to remain in their homes as long as possible, and understandably so. When discomfort starts to set in, familiar surroundings can bring comfort to help soften the blow.
Unfortunately, as parents lose their ability to be independent, remaining at home comes with a huge set of challenges. Who will make their meals? Who will clean their house? Is there someone close by that can come at the drop of a hat if they fall or get hurt? How will someone know if they fell? Who will bathe them? Most children do not live next door to their parents, and even if they did, they do not have the time to become a caretaker on top of all of their other duties. This is why we have devoted an entire profession to caretaking. In today’s demanding world, we simply don’t have the time.
Although most children want to see their parents live out the rest of their days at home, when it comes down to it, it is not always possible. Nursing homes can be an easy answer to all of the above questions. When a loved one is under the care of nursing home staff, you can forget about your concerns and leave those things to them.
This is where nursing homes can become problematic. When things are out of our hands, we don’t know what is going on. A growing problem in nursing homes is the improper and over-administration of antipsychotic drugs.
NPR reported on this problem back in December, but it is a problem that has been around before that. According to the NPR article, nearly 300,000 nursing home residents are currently receiving antipsychotic drugs. In most of these cases, the drugs are used to suppress the anxiety or aggression that comes with forms of dementia, like Alzheimer’s disease.
However, these drugs come with a warning stating that they can increase the risk for heart failure, infections, and death in those with dementia-related psychosis.
According to coverage by NBC News, more than 5.2 million Americans live with Alzheimer’s and 200,000 have early-onset, which can strike as early as the 30s.
It is one of the top ten deadliest diseases and the only one in the top ten without a cure, a way to prevent it, or a way to slow it down.
So what are we to do? For many, drugs are the answer. But this is the easy way out. There are much healthier ways to cope with this thief of a disease, but the thing is that they take time and care.
Alzheimer’s patients and other patients with dementia are not the only ones at risk. Oftentimes, nursing home staff will prescribe antipsychotics for emergency situations, but they will keep the patients on these drugs long after they should have been weaned off of them.
Back in 2009, Dr. Tracy Tomac and her colleague at an Ecumen nursing home decided to try and reduce their use of antipsychotics. By the end of six months, they were able to completely get all of their residents off of these drugs. They extended the policy to all of Ecumen’s nursing homes the next year, and after one year, they were able to reduce their antipsychotic use by 97 percent. But the proof is in the pudding: their residents improved drastically. Those who had fell silent started speaking again. Shelley Matthes is head of quality assurance for Ecumen, and as she said, “They came alive and awakened.”
Thus their Awakenings program was born. As their website says, antipsychotic drugs “mask behavioral problems rather than addressing them.” They acknowledge that antipsychotics are necessary and very helpful at certain times, but they are not to be used for long period of times, as they so many times are. At Awakenings centers, the entire staff is trained and expected to discover “unmet needs that often trigger behavioral symptoms,” and they then address these triggers with non-pharmaceutical approaches.
For instance, instead of arguing with a patient who insists that his deceased mother is in the room and trying to convince that patient that she is not, the staff would “enter the reality” along with the patient, asking questions about his mother or even joining in the conversation with the imaginary mother. Fighting and arguing with patients who suffer from dementia can bring them unnecessary anxiety and agitation. They are going through enough, and if it takes letting them believe a lie, sometimes that is the best approach. At least they are able to live free of the prison of mind-altering medications.
Another approach might be replacing a light that is bothersome to a patient with a light that is more calming to their nervous system. According to the NPR coverage, people who suffer from dementia often are looking for something but don’t know what. So one Awakenings community hid “treasures” in each drawer of a cupboard and told their residents about it, giving them a productive way to calm their nervous energy as opposed to suppressing it with drugs.
Unfortunately, most nursing homes do not follow this same train of thought. If you are looking for a place near you that has a similar approach, one might be coming soon. Plans have been approved for an Ecumen-managed senior living community near the Cleveland Clinic in Avon, Ohio.
If that is too far away for you, you might consider using NPR’s interactive database that has records of antipsychotic drug usage at nursing homes in your area (this tool can be found in either of the NPR articles linked above). Many of our local Dayton nursing homes have lower rates than the national and state averages while other do not. Here are the most recent numbers of long-stay residents who received an antipsychotic medication:
- Grafton Oaks Nursing and Rehabilitation Center: 15.8%
- Bethany Village: 12%
- Forest View Care and Rehabilitation Center: 23.1%
- Riverside Nursing and Rehabilitation Center: 8.8%
For more information on nursing home planning, contact the nursing home planning attorneys at Lovett & House Co., LPA in Dayton, Ohio. We can walk you through the process of planning for your parents’ future care to make sure that they are in the best hands possible.