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Assisted Living Staff Should Refrain From Prescribing Antipsychotic Medications For Dementia Patients

Assisted living has become one of the primary providers of long-term residential care to the growing older adult population, especially elderly individuals with cognitive illnesses such as dementia.  According to statistics, close to one million adults reside in over 30,000 assisted living residences throughout the United States, with some housing more than 100 residents at a time.  Moreover, the use of health care resources is high among assisted living residents; an estimated 20% are Medicaid beneficiaries (although currently, only some states offer Medicaid support to assisted living residents); and recent statistics show that between 42 and 70% of residents are cognitively impaired, but only 13% of beds are designated for dementia special care units.  There are many concerns regarding the practices of prescribing medication for this patient population, and recent concerns have focused on the use of antipsychotic drugs to manage assisted living residents shoring dementia-based behaviors.

Due to the fact that no previous research that was based on clinical records of care providers had been done, a recent study sought to analyze medical records from a long-term care medical practice in order to identify the prevalence of dementia, the use of treatment with dementia-targeting medications and antipsychotic drugs, and the different ways of prescribing by assisted living facilities and resident characteristics.  Examining actual clinical records of care providers is believed to be the best indicator of assisted living residents’ health status and needs pertaining to medical care.  Although the data was used from only one medical practice, they offer critical insights into the assessment and management of dementia in the clinical setting by physicians, physician assistants, and nurse practitioners who evaluate patients in their own environment and offer comprehensive, continuous care as the patient’s direct care clinician.  The researchers wanted their results of their study to serve as a foundation for comparison for other services that provide care for assisted living patients with dementia due to the fact that no established standard of care in regards to medication management of dementia and its behavioral consequences existed. The researchers hoped that their findings would promote the development of best practices that could be particularly imperative for providers who are not as engaged with, or trained enough to sense, the care needs of elderly patients who live in assisted living facilities.

Currently, no medication management standards for dementia exist in assisted living facilities.  Researchers found that the prescription of antipsychotic medication was significantly higher in assisted living facilities that had memory care units, as well as for residents being prescribed with medications for depression and/or anxiety, for whom were given antipsychotics as a form of adjunctive treatment.  However, antipsychotic medications were found to not always be the most appropriate form of treatment for this patient population.  In fact, there is a critical need to substantially reduce antipsychotic prescribing in assisted living facilities. If you or a loved one has been inappropriately given antipsychotic drugs while under the care of an assisted living facility (or nursing home facility), such as one in Cudahy or Culver City, California, contact our office today for a free consultation.