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Stephanie Gelber
Stephanie Gelber
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CMS Partnership to Improve Dementia Care in Nursing Homes

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I just read an article that tugged at my heartstrings because it addessed one of my greatest fears — what would happen to me if I were ever placed in a nursing home because of Alzheimer's or dementia? Despite the hope that my children will take me in and personally care for me should the need arise, I am realistic enough to understand that it is more likely than not that at some point (way) down the road, I might be in need of an assisted living facility. Of course, I would hope to be well cared for and not left to mentally waste away, but I can't help revisiting the nightmare of what we too often read about as the reality of current day care in such facilities. Then a whole new level of horror was brought to my attention in this article — the over use of antipsychotic drugs in nursing homes to "help" dementia residents with various behavioral issues! Query whether the use of these powerful drugs is, at times, more for the ease of the nursing home employees than the betterment of the residents. Might there not be better ways, through personal attention, lesser medications, therapy or exercise, to help our seniors? Should we not revere rather than reject our great grandparents, grandparents and parents, when the need arises?

I then saw that others who have known about this nursing home "abuse" for a lot longer than me have taken steps to address what has become a national issue. Enter the CMS "Partnership to Improve Dementia Care in Nursing Homes". On May 30, 2012, Centers for Medicare and Medicaid Services (CMS) Acting Administrator, Marilyn Tavenner, announced this initiative to ensure appropriate care and use of antipsychotic medications for nursing home patients. CMS data shows that in 2010 more than 17 percent of nursing home patients had daily doses exceeding recommended levels. The partnership, between federal and state groups, nursing homes, advocacy groups and caregivers, has set a national goal of reducing use of antipsychotic drugs in nursing home residents by 15 percent by the end of 2012. The national effort to reduce the use of antipsychotics came after legislation with the same intended effect failed to pass the U.S. Senate this year.

According to CMS they, along with industry and advocacy partners, are taking several steps to achieve this goal of improved care by looking at the following:

Enhanced training: CMS has developed Hand in Hand, a training series for nursing homes that emphasizes person-centered care, prevention of abuse, and high-quality care for residents. CMS is also providing training focused on behavioral health to state and federal surveyors;

Increased transparency: CMS is making data on each nursing home's antipsychotic drug use available on Nursing Home Compare starting in July of this year, and will update this data;

Alternatives to antipsychotic medication: CMS is emphasizing non-pharmacological alternatives for nursing home residents, including potential approaches such as consistent staff assignments, increased exercise or time outdoors, monitoring and managing acute and chronic pain, and planning individualized activities.

This is one initiative I will be following, both because I am convinced that we need to be far more attentive to the needs of the elderly in America and because I personally want to have dreams, rather than nightmares, about my golden years.

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  1. nancy lang says:
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    I am very interested in this topic having gone through caring for my mother-in-law with dementia.. That being said she was put into a dementia care facility in Williamsville and I cannot stress enough the fact that a facility that does not specialize in dementia cannot give the care they need. Clearly we need more of these types of facilities or staff that specializes. Dementia patients thrive when they are surrounded by other dementia patients. The facility we were at did not use antipsychotic therapy unless the family thought it was needed and then and only then it had to go through the patients primary doctor nor were there any other patients without dementia.