It is difficult for most of us to imagine what it would be like to not recognize your own sister, husband or child or to wake up and not know where you are or what year it is. Confusion, disorientation and natural frustration are emotions that those with Alzheimer’s and dementia can feel on a daily basis. If a resident at an assisted living community is having a difficult day and lashing out physically and emotionally, how should a caregiver react?
Behavior modification for Alzheimer’s and dementia patients is a sensitive and debated topic. Some assisted living companies use restraints and antipsychotic medications as ways to make their patients more compliant while others believe that behaviors can be improved through positive reinforcement, understanding and treating people with dignity.
Yesterday news broke that, the US attorney in Boston has recently filed suit against the world’s largest maker of health products, Johnson & Johnson, for using kickbacks to get more nursing home patients onto its drugs. The government’s primary complaint is that the company acted in a predatory manner to increase sales for its products including a drug, Risperdal, and antipsychotic drug often used to control Alzheimer’s and dementia patients. In 2005, the FDA cautioned against the use of this drug and included a black-box warning because there were too many fatal incidents in elderly patients.
While this is a serious issue the underlying problem goes back as far as 1986. The Institute of Medicine found that understaffed nursing homes “may make excessive use of antipsychotic drugs to substitute for inadequate numbers of nursing staff.” The following year, Congress mandated that nursing homes protect the rights of residents to be free of, “Chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.”
While Johnson & Johnson maintains its conduct was “lawful and appropriate” this case is now in the hands of the court. While disheartening, cases like this bring to light the important issue of behavior modification methods in assisted living facilities. Some companies like Silverado Senior Living have taken a stance against the use of restraints and excessive use of prescription medications in their communities. Instead they have high resident-to-caregiver ratios, trained their staff to deal specifically with memory-impairing illnesses, and have taken and innovative LOVE is greater than fear philosophy to treat all people with dignity and respect. Hopefully, both lawmakers and other nursing homes of the future will begin to protect the rights of elderly people suffering from dementia and start treating them with compassion instead of medication.
To read more about Silverado’s Clinical Outcomes visit: http://bit.ly/dgrsPJ
For tips communicating with those suffering from memory-impairing illnesses visit: http://bit.ly/94Xyhq
To read more about the case in Boston visit: http://bit.ly/8JEVx5
