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White House Seeks Improved Nursing Home Care for Dementia Patients

Posted on August 24, 2015 by Kelly Wolford
senior woman waiting for nurse

The White House recently proposed changes to the ways nursing homes care for residents with dementia, including placing restrictions on the use of antipsychotic medications, which often are used in a manner that amounts to nursing home abuse and neglect.

The recent White House Conference on Aging included several other proposals that are aimed at improving the quality of care and enhancing the safety of residents in nursing homes that receive federal funding through Medicaid and Medicare – in other words, the majority of nursing homes in New York State and across the country.

In addition to minimizing the use of antipsychotic (or “psychotropic”) drugs among residents with dementia, the proposal would require nurses in long-term residential care settings to undergo special training in the care of those with dementia.

However, as National Public Radio (NPR) notes, the proposals do not set minimum nurse-to-resident staffing ratios. Many elder care advocates cite insufficient staffing as a leading reason for the abuse and neglect of nursing home residents with dementia.

Use of Antipsychotic Medications in Nursing Homes is Major Concern

The Alzheimer’s Association states that “dementia” is a blanket term which is used to describe the many different symptoms associated with a person’s decline in memory and thinking. The most common types of dementia are Alzheimer’s disease and vascular dementia, which often results from a stroke.

Because dementia residents may wander or become aggressive due to their condition, nursing homes that are inadequately staffed may give them antipsychotic medications, which are powerful sedatives.

When medically unwarranted, the administration of an antipsychotic medication may violate a nursing home resident’s right to be free of chemical restraints.

Additionally, antipsychotic medications and antidepressants are known to increase the risk of death among dementia patients, including exposing them to the heightened risk of suffering a fall, according to a recent NPR report.

The U.S. Food and Drug Administration (FDA) clearly states that it has never approved of using antipsychotics to treat dementia-related psychosis.

“Furthermore,” the FDA states, “there is no approved drug for the treatment of dementia-related psychosis. Healthcare professionals should consider other management options.”

Proposal Focuses on Staff Training, Monitoring of Antipsychotic Medications

Under the recent White House proposal, a nursing home’s staff would be required to receive proper training in the care of residents with dementia and in preventing elder abuse. Each nursing home would be allowed to determine the proper length and format of the training.

The Centers for Medicare and Medicaid Services (CMS) has published a dementia education and abuse prevention training series online. The CMS states that nursing homes can use the series and avoid additional costs for training materials.

The White House has also proposed a rule that would require nursing home pharmacists to monitor drugs prescribed to residents for excessive periods of time or with other irregularities, and it would require that the resident’s physician explain the need for the medication in the resident’s records.

More than 15,000 nursing homes and other long-term residential care facilities that depend on Medicare and Medicaid payments to fund the care of 1.5 million residents would be affected by the proposed rule changes, the U.S. Department of Health and Human Services (HHS) states.

As required by law, the proposed rules are subject to a 60-day public comment period before final adoption. You can check out the Federal Register to review the Reform of Requirements for Long-Term Care Facilities (CMS-3260-P) that are being proposed.

To comment, simply visit www.regulations.gov before September 15, enter the ID number and click on “Submit a Comment.”

If you believe that your elderly loved one has suffered abuse in a nursing home in Albany, Syracuse or surrounding areas in New York State, please contact Powers & Santola, LLP, to receive a free review of your case.