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Centers for Medicare & Medicaid Services Announces Initiative to Reduce Use of Antipsychotic Drugs with Nursing Home Dementia Patients

Earlier this month, the federal Centers for Medicare & Medicaid Services (CMS) announced an initiative to reduce the use of antipsychotic drugs on nursing home patients with dementia by 15 percent by the end of the year. It’s an effort that will put the focus on trying other methods to control the behavior of patients with Alzheimer’s or other similar diseases, instead of relying on medication.

According to an article on the Post-Gazette.com, many dementia patients are known to lash out as part of their condition. But government officials, nursing home industry leaders, and patient care advocates agree that heavily medicating them is not the answer.

In the article, Jules Rose, chief of geriatric psychiatry at the University of Pittsburgh Medical Center, is quoted as saying, “It’s often related to care activities in which the [patient] becomes frightened, bewildered, apprehensive, very anxious – they don’t know what’s happening and may resist care or may actually strike out. What has happened culturally is the knee-jerk reaction of many staff and many doctors to prescribe these drugs, that it will calm them down. It serves that purpose for some people, and doesn’t for others.”

A report by CMS found that almost 40 percent of nursing home patients with signs of dementia in 2010 received antipsychotic drugs when they did not have any of the condition for which the medications were government-approved. Also, the report found that more than 17 percent of nursing home residents had daily doses of the drugs exceeding recommended levels.

The new initiative will focus on nursing homes assigning consistent staff that gets to know patients better so they can more readily understand their needs, since many dementia patients have problems expressing themselves. The initiative will also push for alternative behavioral solutions, such as music therapy, exercise, and other social activities.

In cases where drugs are necessary, officials want their use to be monitored, with the goal of weaning patients off the medications.