HUGE things happening in the small town of Perham

Much has been written about the documented dangers of prescribing antipsychotic drugs to elders diagnosed with dementia. This off-label use of these powerful drugs are often prescribed to "manage" "behavioral problems." Several of these commonly used drugs have had Black Box warnings from the Federal Drug Administration (FDA) for years. Those warnings include things like increased risk of death, stroke, and heart attack. There are numerous other unpleasant side effects from the use of any antipsychotic.

I have addressed this issue here at this blog several times. If you are new to the topic, those links are provided below. 

But first, hear Marilyn's wonderful success story, a story that reflects good nursing, good doctoring, and a good life for all those blessed to live in a place like Perham Living!

Marilyn wrote this just weeks agoabout the decreased use of antipsychotics at Perham Living in Perham, MN. where she served as Director of Nursing and was highly instrumental in initiating and implementing that nursing home's journey to Culture Change.


Marilyn Oellfke:
We at Perham Living saw a significant impact on the use of anti-psych meds with the implementation of the households. If we think about it, the household model meet all or most of the principles of dementia care: quiet setting of home; no distracting noises like overhead paging; normal conversations; and a routine that is based upon the resident's desires - rise at will, eat when and where the resident wants to, bath when the resident chooses and is ready, etc.


I think the fact that the residents are able to sleep better at night helps also. The resistance to care behaviors we used to see all but went away with the household routine. We went from 17% to 3% use of anti-psych meds and have maintained that rate since 2005. (Emphasis mine.)

We also spent time teaching the nurses not to call the physician with the first sign of behavioral symptoms - often the physician's first response (sometimes with the nurses urging) was a med. They look for the cause of the behavior "what are they trying to tell us" and modify the care plan. We also work with a Geriatric Psych NP who is very conservative when it comes to meds.

We find that it takes residents who are admitted with behavior issues a period of time to adjust - sometimes meds are needed initially - but once the resident is responding, we begin looking at how we can reduce and ultimately eliminate them. The few residents that we do have on meds are R/T a psych diagnosis requiring them.

FYI: Perham Living is a 96 bed skilled facility with 6 household of 16 residents each. We do not have designated memory care areas - all households are safe and prepared to meet the needs of residents with dementia. We have never had a separate dementia care unit and wanted to create a place where all residents could age in place without having to move because of change in diagnosis. It works well for us.


http://www.providencewomen.blogspot.com/2013/01/selling-well-being-in-pill.html

http://www.providencewomen.blogspot.com/2012/12/would-you-give-your-mother.html

http://www.providencewomen.blogspot.com/2012/10/information-about-psychoactive-drugs.html

http://www.providencewomen.blogspot.com/2012/10/are-you-advocate-for-someone-living-in.html

http://www.providencewomen.blogspot.com/2012/08/when-are-antipsychotic-medications.html

http://www.providencewomen.blogspot.com/2009/09/drugs-and-dementia-care-unnecessary.html