This is NOT OK

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This is NOT OK

Posted on October 27, 2021

Has the COVID-19 pandemic had a devastating impact on staffing and occupancy for senior living communities? It certainly has. In the face of these daunting obstacles, do we need to lean into supportive technologies that increase staff efficiency and satisfaction, and commit to relying on non-chemical social prescriptions to increase the health and wellbeing of our residents? Absolutely!

In July of this year, when CMS released the latest data from The National Partnership to Improve Dementia Care in Nursing Homes, the numbers showed that since Q4 of 2011 there has been a decrease of 39.4% in the national prevalence of long-stay nursing home residents receiving antipsychotic medication. They reported that just 14.5% of residents were receiving this kind of medication in Q4 of 2020 – for the first time ever, that proportion has increased since the previous quarter showing that we have reached a plateau and we need to consider what is blocking us and what is failing our Elders. It is important to note however that this data excludes residents diagnosed with schizophrenia, Huntington’s Disease or Tourette’s Syndrome; the three medical conditions that can be excluded from antipsychotic prescription reporting from long-term care communities to CMS.

Although this seems obvious, one would wonder why our industry has not been making any progress on decreasing the use of chemical restraints such as anti-psychotics. The Centers for Medicare and Medicaid Services (CMS) are committed to reducing the use of antipsychotics which are widely known to be dangerous for older adults and costly: approximately $250-$550 per prescription.

Despite this, there are still individuals and organizations working in the senior living industry who are not interested in joining this movement to reject the status quo and think it is still OK to medicate our Elders so much. They have little interest in optimizing meaningful and purposeful resident engagement and instead decide to use harmful chemical alternatives. This truth was brought to light once again in a deeply troubling investigative report from the New York Times last month, that outlined how a number of nursing homes nationwide are falsely diagnosing residents living with dementia with one of three types of medical conditions so that these prescriptions don’t need to be reported to CMS and their community’s rating in the five-star quality system is therefore not negatively impacted. This is not OK.

While the investigative report from the New York Times needs to be taken with a grain of salt, as Steven Littlehale reminds us in his recent guest column for McKnight’s Long-Term Care News, we cannot as an industry deny that this kind of abuse is taking place. Ultimately, these people feel emboldened to lie about diagnoses because the status quo of care is still being tolerated in our industry. This problem continues because many communities are plagued by ageism, a lack of adequate funding and no consistent benchmarks to measure success when it comes to meaningfully engaging residents.

Thankfully, there are many examples of advocacy organizations and long-term care communities that are using person-centered, non-drug engagement for residents with tremendously positive outcomes. For instance, between 2016-2017, 17% of residents living in the skilled nursing unit at Kendal on Hudson were being prescribed antipsychotic medication. Their team committed to a project called, “The Power of Zero,” and were able to reduce the use of unnecessary drugs to zero by the beginning of 2018 with the help of digital engagement technology and a community-wide focus on meaningful and purposeful resident engagement.

More recently, in the middle of a pandemic and amid the worst staffing crisis the industry has ever reported, Janean Kinzie, Director of Social Wellness & Enrichment led the American Senior Communities’ CARE Companions programs that dramatically reduced the use of anti-psychotics by more than 2% for their 59 skilled nursing and memory care facilities: average long-stay antipsychotic rate is now at 8.9%, compared to the national average of 14.2% reported by CMS.

Pioneer Network was founded in 1997 by a small group of long-term care professionals who were pioneers in changing the culture of aging, care, and support. They are now well known as the umbrella organization for the culture change movement and remain leaders in providing education and advocacy for person-centered care in all settings.

Hundreds of thousands of honest, passionate, hard-working individuals working in senior living communities across the United States agree and they are 100% dedicated to the well-being of the older adults in their care. Many of these individuals have joined the #ActivitiesStrong initiative started by Linked Senior in March 2020 in collaboration with Activity Connection, the National Association of Activity Professionals (NAAP) and the National Certification Council for Activity Professionals (NCCAP).

The Linked Senior team is committed to creating a world where people of all ages are respected and valued and embarked on a research project in 2017 with support from the Centre for Aging + Brain Health Innovation (CABHI) that showed just how powerful non-drug, technology enabled, meaningful engagement could be when it comes to increasing the health and wellbeing of older adults living in long-term care communities.

To continue to acknowledge, educate and empower activity and life enrichment professionals around the world beyond the #ActivitiesStrong initiative, Linked Senior recently  announced the launch of the Resident Engagement Institute (REI) as a way to promote the future of resident engagement as one that is built on social prescription instead of chemical restraints. The REI faculty include leading professionals in person-centered care including Dr. Jennifer Stelter, Rachelle Blough, Dr. Cameron Camp, Robert Espinoza, Dr. Emi Kiyota, Vicki de Klerk-Rubin Jessica Ryan, David Troxel and Kay Van Norman. It’s time for all of us to commit to rejecting the status quo that has been accepted for far too long.

What are you doing about it? Will you join us?