Three tips to reduce antipsychotics use by promoting patient centered care

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Three tips to reduce antipsychotics use by promoting patient centered care

Posted on October 29, 2012

Government audits on the usage of antipsychotics were conducted throughout nursing homes nationwide in 2011. Their findings show that nearly one in seven residents who showed some form of dementia were given antipsychotic drugs, although they were never actually diagnosed with psychosis. Daniel R. Levinson, inspector general of the Department of Health and Human Services said that the long term side effects of some antipsychotic medications can become “potentially lethal”, while the government audits found that the medications actually increased the risk of death, and were not approved for treatment in dementia or Alzheimer’s. Since these findings the Center for Medicare & Medicaid Services has announced that they would be taking initiatives to cut back on the usage of unnecessary antipsychotic drugs in nursing homes and find other alternatives to improve behavioral health problems.

With the positive response to their findings, resident care providers are going to need to be on their toes in finding creative ways to deal with behavioral problems within their communities.

When an individual makes a transition from their home to a nursing, or retirement community, many of their daily routines, interests, and decisions are automatically disrupted. This can naturally cause stress, alter their needs, make their needs more difficult to be met and can often create disturbances in ones behavior. Patient centered care is your best bet in trying to manage these behaviors without the use of unnecessary antipsychotic drugs.

Patient centered care is the engagement of every level of care to ensure that the residents’ individualized needs, wants, and preferences are being attended to and respected. Naturally a resident’s needs range from psychological (food, water, comfort), the desire for safety (feeling secure and stable in their surroundings), fulfillment of social needs (desire to belong and maintain their individual preferences), desire self-esteem and respect along with allowing for self-fulfillment.

Here are three tips to help you provide patient centered care, ease the stress and some behaviors in your residents and do your part to assist in cutting back the unnecessary usage amounts of antipsychotic medications.

  1. Redirect your focus: Instead of focusing on the behavior of the resident, start looking around to find what may be causing them stress. Whether it is caused by the atmosphere, surrounding people, pain, hunger, systems or procedures, finding the root of the problem will help you to eliminate the distress of the resident and naturally help ease the behavior.
  2. Know your resident: Proper assessments, interviews, and conversations with your residents will allow you the opportunity to learn more about them. The more you know about a resident as an individual, the more you will be in tune with their needs and better prepare yourself to eliminate stressors that may surface in the transition of living situations. Information about their background and personal preferences, even daily routines, hobbies and where they find their joy can help you establish the tools to provide better individualized care. Be informed of their specific hobbies and or interests and present them with opportunities to get involved in leisure programs of interest.
  3. Know their strengths and allow them to participate in their care: Focus on what a resident can do and not on what a resident can’t do. Encourage them and praise them for all that they accomplish with the effort that they do put forward. Assist them where they need assistance and allow them to continue to do things that they can for themselves. By allowing residents to do things such as wheeling themselves to activity programs, we are assisting them in maintaining their highest level of function. Also allowing them to continue to do things for themselves will enhance their sense of independence, self confidence, and self esteem. Make adjustments in some of your community routines to better fit the needs of the daily routine of your residents if possible, such as taking special time out to allow them to sit outside or wheel themselves through the garden if that is what they enjoy.

By implementing these care methods, you are creating the opportunity and atmosphere to improve the quality of care and quality of life in each of your residents’ lives. Also, be sure to remember that the more the resident is engaged in leisure programs, the more time and energy they will spend focused on the activity instead of the atmosphere. An example of this type of initiative is Comfort First, a program at Beatitudes Campus in Phoenix, that manages dementia care through a comfort care model that has virtually eliminated the use of antipsychotics in their organization.