On Wednesday, the Centers for Medicare & Medicaid Services (CMS) announced the "Partnership to Improve Dementia Care." This partnership among federal and state partners, nursing homes and other providers, has set a national goal of reducing the use of anti-psychotic drugs in nursing homes by 15 percent by the end of 2012.
According to Dr. Gifford of the American Health Care Association (AHCA) this would result in taking 18,000 individuals off these medications.The CMS is not just concerned with the numbers receiving prescriptions (40 percent of nursing home residents), but also inappropriate dosage (17 percent are taking more than recommended), also their unnecessarily extended use.
Anti-psychotics are primarily intended for those with bipolar disease or schizophrenia and are not indicated for use in those with dementia. In a CMS national media conference call, Clare Curry of Legal Aid Justice said that "hundreds of thousands are drugged inappropriately" amounting to "chemical restraint" for difficult behaviors. She added that the drugs carry a "black box warning," or an increased risk of death, from the Food and Drug Administration for those with dementia.
The partnership aims to achieve its goal by using various behavioral, non-pharmacological strategies. These include:
- Nursing homes using consistent assignments, having the same staff, who know the behaviors and problems;
- Focusing on interaction involving meaningful activities and individualized exercise
- Increased training on behavioral techniques for nursing home staff
- Changing the environment, e.g. noise levels and lighting
By July, the CMS hopes to have rates of anti-psychotic drug use on its nursing home compare web site, www.medicare.gov
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