I am very excited to tell you about our antipsychotic reduction program. Our facility is 99 beds and 55 designated
scale beds, 44 long term beds. We took on this effort in 2012 because we were one
of the facilities that had the highest rate of antipsychotics and we wanted to
do something about it. The DON and I met, I met with the interdisciplinary team,
and our goal was to reduce our off-label antipsychotic use. When they first met
on this, for me personally, I thought it was a crazy idea so I said ok it's
going to be easy, I don't agree with it but I would give it a try.
So when I buy into it, then I have to go talk to my staff and it's exactly
what I said they said. That it's crazy, let's give it a try. We have to try and
that is how we came into the process of wanting to try the
antipsychotic reduction. We have been trying to communicate with the
specialist and the psychiatrist in order to reduce the use of antipsychotic
medications
by implementing various activities for the residents in the national and we
have been having the success rates by reducing antipsychotics and reducing
the falls and other complications that they can have by using the antipsychotic
medications. This is a model that I guess every other nursing home and rehab
can follow you know in order to reduce the falls, reduce other potential
hazards, the black box that we always talk about. It was more about
individualized care and less about reducing antipsychotics. So we were
surprised to find out after six months that our rates are suddenly, our rates
were below 25% in the state and once we realized that we were having all these
positive outcomes we started to pursue it even more because we knew the result
was positive for all our residents. What we found out was that taking them
off the medications were not causing them to have more behaviors it was doing the
opposite, it was giving them more life. To see them participating
more in activities, to see them more outgoing, to see them more engaged, to see
the staff more engaged with them. So consistent assignment was also one of
the things that we implemented because we found out that when residents with
dementia have consistency, they tend to have less behaviors. We all knew our
residents and it's just a whole culture for the facility. The family, we noticed that
our families were more satisfied when we call them. It's more of a family, they
seem to care, they care about him, and they care about us. They're very nice
people here, they're very caring and they like him, they like him.
They get along real well. You are my sunshine, my only sunshine.
Oh he loves music, he goes to church every Sunday and they involve him in church,
he sings, he loves to sing. When he had his memory, he used to sing happy
birthday to everybody here that had a birthday,
out here in the front, in the lobby. I'll think of you each day and when I dream,
when I am away. But that's it that's his most favorite thing he likes to do is sing.
Knowing he's being taken care of, I don't think he would've been living today if he hadn't
come here and got the care that he has here. The staff is just wonderful here. I
trust them with my brother. I really do and he likes them, and that's important too. Cause I'll ask him,
you want to go someplace else? No, no, no, no, no. He likes it here. I brought her here
because of her dementia and that she's a walker and she disappeared a couple of
times, which scared me so I brought her here so she'd be safe. Asked for her to be treated well you
know, for her symptoms, for her to be happy, and smile when I come in.
They'll involve you in all their activities. The best thing was the staffing and how well they take
care of her, and how better she is from when she had first came here. She's much better.
She's not medicated all the time.
That's a plus. I had a special moment when she was here maybe three, four years and she was voted
queen of the nursing home. You had a king and queen. I have pictures to show but she
was voted queen and that was special to me, that they liked her like that. She loved it.
So, this is what we started out to do. In the beginning, we had our quality assurance
meetings, we came up with a plan, based on the plan, we came up with goals for the
residents based on our assessment and we implemented those plans. The
implementation of our interventions was in place and then we followed through to
see what worked and what didn't work. But the common team that came back to us
was individualized care.