An innovative solution to dementia treatment

Dementia sufferers that strike and kick other care home inhabitants along with staff members oftentimes tend to be prescribed potent medicine to control their particular conduct, nevertheless these drugs come with unsafe and in some cases dangerous side effects.

Today, new information coming from Boston researchers proposes one way which will appreciably minimize use of these powerful sedatives: simply by linking care home employees with experts in dementia treatment, by using video consultation services.


In a small number of Massachusetts nursing facilities where employees made use of the twice monthly online video meetings, residents ended up being 17 percent less inclined to be given the antipsychotic drugs, weighed against residents in nursing facilities not within the method, based on the research by research workers at Beth Israel Deaconess Medical Center and Hebrew SeniorLife.

“There is a method to try and get antipsychotic utilization down with carrots and sticks, and with penalizing. The other is to try to supply individuals tools to do this,” stated Dr. Stephen Gordon, a geriatrician at Beth Israel Deaconess and head writer of the analysis published inside the May Journal of the American Medical Directors Organization.

With dementia afflicting a substantial and increasing variety of older adults, nursing homes are struggling with more sufferers that have challenging behaviours. Simultaneously, the volume of physicians who are experts in dementia and senior care isn't keeping pace, based on the American Geriatrics Society. Researchers saw videoconferencing as a means to help, by simply linking these specialists, who generally work within hospitals, to nursing homes in which the specialists’ know-how is greatly desired.

The desire to lower utilization of antipsychotic medications in nursing facilities is hardly brand new. Excessive use of the medications continues to be a problem 4 years after Massachusetts and federal regulators released a campaign to turn back the practice.

Approximately one in five Massachusetts care home residents gets antipsychotic medicine, according to the newest federal information. Countrywide, the percentage of nursing home residents getting this kind of medications is lower, at approximately 17.5 percent.


The medicines raise the likelihood of bacterial infections and cardiovascular difficulties in older sufferers, in accordance with federal authorities. The drugs could also cause dizziness, a sudden decline in blood pressure levels, abnormal heart rhythms, blurry eyesight, as well as urinary issues.

To examine the efficiency of videoconferencing in reducing antipsychotic utilization, the researchers picked 11 Massachusetts nursing facilities for the 18 month project, giving staffers sessions twice a month with health care professionals who specialize in elder care, which includes a psychiatrist, neurologist, and social worker.

They picked Twenty two other nursing homes that did not participate in videoconferencing, but were comparable in size and also other important characteristics towards the 11 in the scientific study group.

Within the initial three months of this study, the utilization of antipsychotics in the Eleven nursing facilities decreased by 12.5 percent, the researchers observed. Which translated to a decrease from 321 residents given antipsychotics to 286

In the meantime, use of the drugs in the nursing facilities that did not receive the external help went up by about 4 percent during that period of time.

The utilization of antipsychotics in nursing facilities that took part in video conferences carried on to decline steadily over the remaining Fifteen months of this project, while the other nursing facilities also decreased consumption, though slightly.

Scientists and nursing home leaders not involved with the analysis said the conclusions, whilst centered on a small number of nursing facilities, are encouraging. They also observed, however, the nursing homes selected within the scientific study weren't picked at random, raising the possibility the facilities that consented to be in the video conferencing may have already been more committed to lowering antipsychotic use.

‘Even very minimal initiatives at education and problem solving could go a long way to bettering care for people who have dementia.’

Dr. Jonathan Evans, American Medical Directors Association past president
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“Given the constraints, they were still capable of finding changes, and that’s very suggestive we will want to look at this [approach] even more,” said Becky Briesacher, an associate professor and health services researcher at Northeastern University.

Briesacher’s studies have discovered that inhabitants in nursing facilities with a history of regular antipsychotic use tended to end up on these medications more frequently than patients in different facilities, even if the sufferers didn’t require the medications.

Dr. Jonathan Evans, past president of the American Medical Directors Association as well as a medical director of 2 nursing homes in Virginia, said the study indicates nursing facilities can do better in limiting use of antipsychotics.

“Even very modest efforts at education and problem-solving can go a long way to enhancing care for people with dementia and reducing improper habits in the care of these types of patients,” Evans said. “There is no question there's a enormous absence of training on the part of doctors, nurses, take your pick, on understanding dementia.”

At Beatitudes Campus, a nursing home and retirement living network in Phoenix, leaders have grabbed national recognition for their innovative procedure for dementia treatment. The focus has not been on reducing the use of antipsychotics, but on getting every resident as comfortable as is possible. Baths, dinners, and fun-based activities are structured around residents’ preferences as opposed to staff schedules. Along the way, antipsychotic use has continuously dropped.

“For a very long time, people were saying there is nothing we are able to do, we just need to medicate” nursing home residents, said Tena Alonzo, Beatitude’s director of research and dementia education. “This study says there's something else, and that is a extremely effective declaration in terms of social justice.”

Extra care critical for elderly struggling with severe loneliness

A new study has recently emphasised the need for communicating with elderly people and furthermore guaranteeing they receive the best suited standard of care and support they need.

A new report, authored by Age UK, discovered that hundreds of older individuals are contending with a "double whammy" of problems, having to deal with constant isolation and furthermore cope with unmet care needs.

Accessing a large selection of services, regardless if within a care home or nearby in the community, is an critical component of ensuring that the elderly might experience fulfilling and interesting lives.

Services that specialize in elderly care can certainly make sure that the elderly have their physical and mental health and wellness needs fulfilled, whilst engaging with him or her to restrict all feelings of loneliness they happen to be going through.

The published information provided by Age UK found that those who have health care specifications who are not receiving any kind of support are nearly two-thirds more likely to have gone through feelings of loneliness in the past few days in comparison to somebody who is getting some level of care or support.

Charity director of Age UK Caroline Abrahams explained: "It’s bad enough to be having difficulties caused by a care need and going without any support, however it turns out that an appreciable number of senior citizens in this position are generally presented with a “double whammy” since they're persistently lonely at the same time."

She said it is much more likely that many of these types of elderly people live life by themselves and in very isolating circumstances, unable to contact family members, friends or even others who live nearby for support if and when they need it.

Ms Abrahams revealed that the "overriding objective" of social care is to satisfy somebody's needs however for senior citizens - that do not generally have the option or ability to leave their home - this kind of care is usually "extremely important" as it might be the sole interaction they have all day.

However, she asserted the system was unable to keep pace with the expanding numbers of older people, which results in numerous going without any sort of basic support. The research suggests that this is certainly exacerbating the substantial challenge of acute loneliness among elderly people too.

Based on the research, around 300,000 older individuals across the nation are struggling with loneliness as well as the added pressure of having care needs which aren't being fulfilled.

Research has shown that isolation itself could have a substantial effect on an individuals wellbeing and health, making them more prone to sickness. For this reason treating the issue would not only enhance the standard of living for older people but will also lessen the financial impact on the health care system.

Learning from those people who are dying: the key to wonderful palliative care social work

3 weeks into my social work training I started a placement in a hospice. In the 50 days that I worked there, just about everyone who I worked with passed away. I begun wanting to know what social work can supply to men and women that are dying. I concluded the position wishing each and every social worker got the chance to learn from folks confronting death. Their experience of loss and resilience, and the possibility to uncover methods to be alongside individuals in those circumstances, goes to the heart of what social work does well.

I have just been linked to an interesting working group that has developed a brand new resource for social workers: The role of social work in palliative, end of life and bereavement treatment. This resource goals to ensure individuals take advantage of great social work at the end of their life, and that family and friends close to them are supported during this period and into death.

Lived experience

The resource has been jointly generated by social workers and individuals with lived experience of end-of-life care. Throughout, it explains to you those experiences and these showcase the ways that social workers can easily make a difference when working alongside those who are dying or bereaved.

Here are a few of the key messages from the resource for social work practice, plus the voices of individuals with lived experience:

1. ‘I would like health workers to be optimistic and express what's going on in the right way without getting negative. I am really positive about my life.’ (Phone interview with woman who uses a drop in centre). Social workers can understand people’s desire for acknowledgement and for a person to listen to them. We can display confidence and sensitivity in obtaining the appropriate time to speak about death and dying, making sure that individuals can be in control, plan in advance and also accomplish what is important to them.

2. ‘It is going to be my wife who makes decisions for me, whenever I’m no longer able. Nevertheless I have it all written down, things of significance to me. It’s all down on paper.’ (Man in his eighties attending a hospice day centre). Social workers can help people to make decisions, advocate for, and challenge with and on behalf of folks. Where necessary, we are able to make use of the law to enable men and women to take control.

3. ‘Enabling individuals to live their life just as they want - it’s more than the medicine, it is something aside from treatment. Ease and comfort? Peacefulness?’ (Bereaved man in his 60's). Social workers can be sure that someone’s experience is at the centre of what transpires. We are able to make use of evidence, legislation and systems to allow folks to live the lifestyles they want.

4. ‘I don’t want sympathy, simply help and support. I don’t want people feeling remorseful for me. It’s some support, I suppose, practical help and support.’ (Woman attending a drop in centre, age unknown). Social workers can help folks to understand their own capabilities and mobilise their own resources, provide information and facts and also practical support, synchronize services and also negotiate solutions. Where necessary, we are able to deal with paperwork.

5. ‘I don't like it, whenever people who have not been sick say to you ‘Oh you are so brave!’ I hate that. I just want to be treated as me. Just see me as I was and forget cancer. It’s not all that I am.’ (Lady in her 60's/70's in a hospice day centre). Social workers can help folks to sustain their identity despite change. We can easily help individuals to accumulate memories and to leave memories behind.

6. ‘It continues to be hard to ask for help, I didn’t want to and I couldn’t ? The good news is I am coming round. Yes, it is terminal and I know I need assistance now.’ (Woman in her sixties/seventies inside a hospice day centre). Social workers may embrace diversified requirements and develop different ways of supporting people. We are able to explain how care works and assist people discover how to access emergency help and support.

7. ‘People need to learn how bloody hard this is likely to be. We shouldn’t guard men and women. This isn’t likely to be easy. It’s going to be bloody hard.’ (Bereaved husband in his sixties). Social workers can really help men and women close to someone that is passing away to discover the support they need. We can help people take care of practicalities soon after death and follow up with people who are bereaved in the way that works best for them.

Vision for palliative care social work

Our vision for social work in palliative, end-of-life and death care is: people will gain access to a palliative care social worker with the capabilities and resources to help them whenever they need it, and also all social workers should be able to assist people, their own families, and people close to them to realize the value of what they can do and give to each other at the end of their life and during bereavement, and also to obtain the help and support they need.


Here is exactly what a few of the social workers we spoke said about their role:

‘Tom had an impact on the entire staff team and I arranged a reflective space the next week for employees to share memories and ideas of their work with him and also the family. It was well attended and allowed us all to state our feelings. Rest In Peace Tom.’ (End-of-life care social worker). Palliative care social workers are a source of expertise and support for some other professions and agencies. They could boost awareness, mentor and still provide advice to other people. They can perform investigation and get together evidence of precisely what allows for a good passing.

‘We work holistically, combining emotional and practical expertise, to permit people to achieve what matters most to them. We are active in improving things, we're flexible and adaptive, and we're at our best as enablers when we're least conspicuous.’ (Resource working team). All social workers need to be prepared to support those who are dying, going through loss or bereaved.

The social work contribution

We hope that the resource will be made use of by palliative care social workers to enhance understanding of their function and the involvement they can make, and by those people who are dying and those close to them to request social work support. We hope that social workers will make use of the resource to examine their practice, and also to identify the support they need to develop their knowledge and skills.

Business employers, leaders, commissioners, funders, colleagues from alternative professions and educators may use this resource to discover the contribution that social workers could make, also to detect how to support and develop this area of practice.

Above all, we hope that the accounts of people’s ordeals will make it possible for social workers to improve our ability to support folks at this challenging and greatly human moment.