Minnesota Nursing Homes Seek to End the Stupor

How’s this for unconventional: The Ecumen chain of 15 Minnesota nursing homes has launched Project Awakenings, which calls for treating residents’ behavioral problems without resorting to antipsychotic drugs. The problems are real. Residents have physical and mental disorders, and they are often in pain, frightened, alone, and confused. In the worst cases, they react with violence (including biting or hitting), screaming, crying, moaning, and other troublesome behavior.

Typically, nursing facilities treat these disruptive residents by medicating them with antipsychotic medication. As reported by an article on StarTribune.com, to achieve peace, residents were often:

…drugged into a stupor — sleepy, lethargic, with little interest in food, activities and other people.

“You see that in just about any nursing home,” said Eva Lanigan, a nurse and resident care coordinator at Sunrise Home in Two Harbors, Minnesota. “But what kind of quality of life is that?”

Lanigan worked with experts and physicians to find a better way. Instead of treating (or over-treating) with drugs, Lanigan’s facility began treating residents with aromatherapy, massage, games, exercise, personal attention, better pain control, and other therapies. So revolutionary! So ridiculously simple!

Within six months, this new type of therapy went from “experimental” to “innovative.” Antipsychotic drugs were eliminated, and antidepressant use was cut by half.

The result, Lanigan said: “The chaos level is down, but the noise is up — the noise of people laughing, talking, much more engaged with life. It’s amazing.”

Now the home’s operator, Shoreview-based Ecumen, has started a project called Awakenings throughout its 15 long-term care nursing homes. It’s based on Lanigan’s work and funded with a two-year, $3.7 million state grant.

According to the article, doctors simply prescribe sedating drugs because it is the easiest, quickest way to achieve behavioral calm. And some nursing home owners say they can’t afford to replace drugs with personal attention because it requires too much staff time. That argument, however, doesn’t hold up.

“Our guess is that it will take the equivalent of two extra people at each home, spread across all job categories,” said Finn, Ecuman’s vice president. “Can we afford it? We think we have to, because it’s the right thing.”

Now weigh the cost of two employees agains- the more than $5 billion Medicare spends each year on antipsychotic drugs…at least half of which are prescribed inappropriately. But if it keeps the residents calm, what’s the big deal?

“There’s a bunch of problems, not least of which is those drugs can kill you,” said Dr. Mark Kunik at Baylor College of Medicine in Houston who spoke last month at the Gerontological Society of America’s annual meeting in New Orleans.

Even people with well-documented illnesses can be helped with the treatments of Project Awakenings.

“Whether you have Alzheimer’s or not, there’s a reason people get frustrated or upset — pain, urinary tract infections, hunger, fear of strangers or loud noises or strange settings, maybe drug interactions,” Kunik said. “If you figure that out, you likely can find a safer, nonpharmacologic treatment.”

What a brilliant idea this is! Lanigan should get nationwide recognition for taking the initiative to solve a problem that plagued the patients, the nursing home, and — by extension — all the rest of us through Medicare costs.

The attorneys of HensonFuerst look forward to the day when overmedicating difficult patients to the point of sedation is universally reviled. All it takes is a little compassion and empathy. If it were you…or your parents…or your brother, which treatment would you prefer? Pills that knock you out, cause side effects, and perhaps make your health worse? Or personalized attention, pain control, massage, and exercise programs that let you enjoy life once again? It’s a no-brainer.

Stories like this are why HensonFuerst Attorneys fight everyday for the rights of nursing home residents who may have been abused, neglected, or harmed by inappropriate treatment. We will continue to be the voice of nursing home residents who cannot yet speak for themselves.

If you suspect that someone you know has been the victim of any mistreatment in a nursing home, HensonFuerst is proud to offer dedicated nursing home abuse information on our website (https://www.hensonfuerst.com/). And our attorneys are available by phone 24/7 at 1-800-4LAW-MED. If you have questions, HensonFuerst has answers.

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