Cutting Down on Antipsychotics

Over-Prescribed

CMS, the Centers for Medicare & Medicaid, announced in May that they are embarking on a multi-year initiative to cut the use of antipsychotic drugs in skilled nursing facilities by 15% by the end of this year. CMS cited statistics showing that nearly 40% of residents with dementia were getting antipsychotics even though they did not have a diagnosis supporting their use.

Other statistics from CMS indicate that in 2010 more than 17% of SNF residents received antipsychotic doses that were over the recommended levels.

“In 2013 we will set another goal,’’ said Alice Bonner, director of the nursing home division of CMS. “At that point, we will be looking at even more significant reductions.’’

CMS plans to achieve the cuts through training state inspectors and nursing home staff on alternatives to using antipsychotics for agitation and aggressive behaviors.  Participation in the reduction program is voluntary, but SNF trade groups pledged to work with CMS.

“We believe these antipsychotics are overprescribed,’’ said Dr. David Gifford, senior vice president of quality and regulatory affairs at the American Health Care Association, a SNF trade group. “Many clinicians, physicians, and family members believe these medications are useful and necessary, but data show otherwise.’’

This article was originally published in Pathways & Partners Newsletter - Issue 25.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

Vitamin D May Reduce Falls in the Elderly in SNFs

Dietary Supplements

Recent studies indicate that adding Vitamin D supplements to the diets of nursing home residents may reduce the frequency of falls, a leading cause of death and disability in the elderly.

Vitamin D deficiency is associated with muscle weakness, which can contribute to falls and fractures. Nursing home residents are especially vulnerable to falling due to advanced age, health problems, and weakened eyesight. In fact, approximately 50% of nursing home residents fall every year, and those who are injured become even more prone to future falls.

Although exercise, appropriate equipment, adequate staffing and a risk-free environment are important, research done at the Sydney Medical School at the University of Sydney in Ryde, Australia found that Vitamin D was a effective measure, although they are not sure why. 

Fall Prevention Resources, Available Online

In an effort to increase awareness about fall prevention hazards the Fall Improvement Taskforce (FIT) at Pathways created colorful flyers that can be printed and used as check-off lists to ensure your environment remains safe and to minimize the risk of falls.

Topics include: “Did you know that clothing can contribute to falls?”; “Medications can increase the risk of falls”’; and “People with vision deficits are twice as likely to fall”.

These helpful resources can be downloaded via our website at www.pathwayshealth.org/resources.