A new study published in the Journal of American Medical Directors Association, looks into the care of dementia in nursing homes. The researchers focused the diagnosis and treatment aspects of dementia, finding very low levels of each in nursing homes in the US and across Europe. Knowledge about dementia and how to properly care for those suffering is an important issue in nursing homes, as there is usually a high percentage of dementia patients. This means that nursing home staff must be trained and knowledgeable in how to identify, care for, and properly medicate dementia patients.
In America, patients suffering from diagnosed dementia generally make up from 26 to 48% of nursing home populations. This number is probably even higher as patients with general cognitive impairment are not included. Many residents also go undiagnosed, mainly due to a lack of knowledge about the condition on the part of nursing home staff. This recent study has identified that roughly 1/3 of all dementia go undiagnosed, resulting in them never receiving any treatment or specialized care. Official diagnosis with dementia is important as it shapes how the individual care plan is formed. Dementia patients are more susceptible to falls, so special precautions and observation need to be used to prevent such events. More direct care is needed to care for nursing home residents diagnosed with dementia.
Direct care staff are frequently untrained in the identification and care of common nursing home ailments, including dementia. There are two main medications recommended for dementia: cholinesterase inhibitors (ChEIs) and memantine, an N-methyl-D-aspartate receptor antagonist. These two treatments work especially for dementia due to Alzheimer’s and Parkinson’s. The drug can help lessen behavioral problems and aggressive outbursts, meaning that the patient does not have to be restrained and can maintain a more normal and freer lifestyle. This means that the intensity of direct care necessary is lessened, decreasing the possibility of staff burn-out, which is more common when caring for dementia patients. And yet 26 to 60% of patients remain untreated. And even when they are prescribed, it is not uncommon for their use to be discontinued, commonly due to lack of funding. These medications can be beneficial to the patient, and the nursing home facility, so it is important that staff are well informed about their use and in identifying which patients have dementia and are thus can be helped by their use.
Unfortunately due to understaffing and the lack of training in care facilities, there are not enough qualified nursing staff to adequately monitor and assist these patients and unnecessary physical restraints are used to subdue them. Antipsychotic drugs used excessively can act as chemical restraints and benefit from these medications is usually outweighed by the harmful side effects of the drugs. It is important that medication should be individually tailored to each patient’s health needs and not used recklessly and improperly, as happens when used as a chemical restraint. The use of uncalled for restraints, due to a dearth of trained nursing staff, is against the Patients’ Bill of Rights. Nursing homes are required to employ enough staff to individually care for all of their residents. Understaffing can also result in the preventable spread of common diseases and pressure ulcers.
If your loved one is suffering because of understaffing, or is having unnecessary chemical and physical restraints used upon them, please contact us today to see how we can help ease your loved ones suffering. At the Law Offices of Ben Yeroushalmi, we believe that no one should have to be the victim of nursing home neglect and that those abusing their residents should not be allowed to continue. Please discuss your situation with us at a free consultation at our offices, or if you cannot come to us we are happy to visit your home or hospital bed.