The antipsychotic drugs given to those with Alzheimer’s disease and related dementias are often known as “chemical restraints” for their ability to temper disruptive behaviors. But the cost for this induced calm is high.
The drugs, notorious for “zombie” effects that can accompany long-term use, too often rob patients and their families of the last moments of joy and recognition. The drugs’ use is also accompanied by increased mortality in elderly patients with dementia.
Health experts have long sounded the alarm about chemical restraints. And while change is slow — giving someone a pill is an easy option — a Minnesota-based senior services organization has created a pioneering program that dramatically reduces dependence on these medications and improves patients’ quality of life. Lauded nationally in March, it should become the standard of care across the nation as baby boomers swell senior ranks.
“Awakenings” is the name given to the program developed by Ecumen of Shoreview. It has implemented the effort at 15 nursing homes across Minnesota; Awakenings grew out of an experiment at one facility.
Staff concerned about chemical restraint drugs decided to do something about it. They delved deeply into patients’ histories to learn more about their needs and what might trigger their anxiety. Individual approaches such as scrutinizing noises or medication mixes that might cause angst — or using music or physical activity to help calm patients — worked.
With the help of a state grant, Ecumen expanded this pilot to all of its nursing homes, with impressive results. From 2010 to 2013, the program achieved a 97 percent reduction in residents’ antipsychotic use rate. Ecumen officials also estimate savings of $200,000 to $400,000 a month for Medicare and Medicaid drug purchasing.
In March, “Awakenings” received an excellence in dementia care award from a national association of senior service nonprofits. The challenge now is to export the program’s patient-centered approach elsewhere, not just to nursing homes but to assisted living and home care settings.
Ecumen can’t do it alone. Its hardworking staff needs assistance to do national outreach and education. Unfortunately, “less than 2 percent of private philanthropic dollars in Minnesota are invested in programs for seniors,’’ according to the Minnesota Council on Foundations.
That skimping ignores the aging wave on the way and represents a missed opportunity to use these resources in a way that has maximum impact. Ecumen’s program is effective and compassionate. A foundational partner now needs to step up and ensure that this care model goes beyond state borders.