“We work with one or two patients at a time and have an interdisciplinary team with a physician, nurse, pharmacist and others to reduce the medications, and then we watch to see whether it is damaging or helping the patient,” Braxton said. “We also try non-medication approaches such as increasing their activities and bringing in their family to find out what the patients liked to do in the past. Then we try to gear activities to what they used to do.”
There is no easy solution, administrators said. In fact, Linda Bowersox, vice president of clinical services at the Advanced Care Center at Lakeview in Wayne, N.J., said it was unlikely her home would ever be able to meet the 15 percent reduction set by the federal government— 23.1 percent of its patients were on these medications in 2012, according to federal data.
“I don’t think we’re going to get our number down much more than 18 percent,” she said.
“We work with two patients a month to try and reduce their medications — all the staff is on board,” she said. “Sometimes we’re successful and, honestly, sometimes we’re not.”
It’s not as simple as taking patients off their pills. Administrators say the only way to stop drugging patients is for homes to completely reimagine their approach to elderly care. That could require sweeping changes in everything from programs and staffing to the architecture of the facilities.
Sunni Herman, executive vice-president of the Jewish Home at Rockleigh, said her home has tried several new programs in the past year in an attempt to reduce their drug use from 25.5 percent.
“We’ve implemented non-medical programs … such as our Harp to Heart program, where we bought 20 harps that the residents can play,” Herman said. “We also purchased 50 iPods. … You can’t believe how it calms residents during periods of agitation.”