California Nursing Home Abuse Lawyer BlogAccording to the Alzheimer’s Association, over 5.3 million people over the age of 65 have been diagnosed with Alzheimer’s disease in the United States. Alzheimer’s is a disease that not only inhibits the patient’s mental capacity, but also can be a severe burden on family and friends close to the Alzheimer’s patient. Having a loved one with Alzheimer’s is both emotionally draining and physically burdensome due to the constant physical care a patient requires. For patients with mild cognitive decline to moderate cognitive decline, a loss of independence may be the most frightening aspect of an Alzheimer’s diagnosis. Presently, there are multiple elder technology companies creating innovative products to delay the patients’ admission to a skilled nursing facility. Continue Reading
Articles Posted in Cognitive Issues
Caregivers Unable to Sue for Injuries Sustained by an Alzheimer’s Patient
According to the Alzheimer’s Association, “Alzheimer’s is a type of dementia that causes problems with memory, thinking and behavior”. Alzheimer’s affects 5 million US citizens, which in turn, establishes the disease as the 6th leading cause of death in the country. Alzheimer’s disease has no known cure, prevention, or treatment. Although an overwhelming majority of the population suffer from the disease, caregivers and at home aids—whom are trained in proper care techniques of Dementia patients— are apprehensive when responsible for an Alzheimer’s patient. Severe behavioral changes, coupled with extreme disorientation, results in the hesitation of caring for an Alzheimer’s patient. Continue Reading
Blood Test to Predict the Onset of Alzheimer’s
According to the Alzheimer’s Association, Alzheimer’s affects 40% of the American population, constituting the disease as the 6th leading cause of death in the United States. Due to the staggering amount of people affected, coupled with the severity of the disease, scientists are allocating more resources to Alzheimer’s research. Proteome Sciences, a leading biomarker agency located in England together with scientists at Oxford University and Kings College of London, have developed a blood test that can potentially predict the onset of Alzheimer’s within a year. This blood test identifies 10 proteins that have the capacity of predicting the onset of Alzheimer’s disease with 87% accuracy. Continue Reading
Implementing Non-Pharmacological Interventions for Dementia
It is becoming increasingly evident that pharmacological interventions should be a last resort when treating patients with dementia. Due to a lack of resources and staff most skilled nursing home facilities overlook non-pharmacological options. However, studies have shown that non-pharmacological treatments are a safer alternative for patients. While pharmacological interventions are an effortless option for nursing homes and hospitals, they fail to improve the state of the resident. These medications might look like they are improving the condition of the patient however, these drugs sedate them as their condition worsens. In some cases, it could cause sufferers of cognitive disorders to deteriorate rapidly and act out.
The staff at a facility may often focus on the cognitive deterioration of the sufferers of dementia. As such, other symptoms that are linked to dementia may be overlooked. These symptoms generally manifest themselves in the forms of agitation, aggression, eating disorders, loss of appetite, and abnormal vocalization. Many of these symptoms may also grow to be the cause of death. For example, eating disorders and loss of appetite can lead to malnutrition. Furthermore, the use of medications have side-effects including sedation, psychosis, tremors, and may even lead to falls. More recent cases show that the pharmacological treatment of dementia leads to reduced resident well-being and quality of life, and may even accelerate cognitive decline.
Non-Pharmacological Mealtime Interventions for Sufferers of Dementia
Of the symptoms associated with dementia, one of the most common is agitation. It is common for sufferers of dementia to be increasingly agitated at meal times. According to an article in the Journal of American Medical Directors Association, “Effectiveness of Mealtime Interventions on Behavior Symptoms of People with Dementia Living in Care Homes: A Systematic Review,” multiple skilled nursing facilities participated in a study. Four different methods were used to reduce agitation at meals. The goal of this study was to improve behavioral symptoms in elderly people who suffer from dementia in these facilities. These four interventions included playing music during mealtimes, changing the lighting and increasing visual stimulation, providing more options, and promoting conversation. All of these interventions made great alternatives to medicinal interventions, as many studies demonstrate that tranquilizing dementia patients medicinally when they are agitated worsens their condition.
A resident who suffers from dementia could come to cause a scene during a meal which in turn could lead to a loss of appetite and ultimately lead to weight loss and malnutrition. Increased stress and anxiety during meals reduces the sufferer’s ability to meet their nutritional needs, and interrupts other residents from enjoying their meals. This is something that could stress the staff as well. Weight loss and malnutrition are known to be common issues for those who suffer from dementia. Simple and effective non-pharmacological interventions which attempt to improve the mealtime environment could lessen outbursts, increase eating times, and lead to better nutrition, benefitting both the residents and the staff.
Nursing Homes Required to Obtain Informed Consent When Administering Psychotropic Drugs
Many nursing homes often substitute individualized care with the use of psychotropic drugs to make up for the lack of adequate staffing in their facilities. As a result, nursing homes often misuse psychotropic drugs by administering them to residents in order to sedate or control them. This has the tragic result of reducing a resident’s quality of life, because many hazardous side effects accompany the use of these drugs, including death. There are several major classes of psychotropic drugs: antipsychotics such as Risperdal and Haldol, anti-depressants, and anti-anxiety medications. Due to the dangers associated with their use, the FDA issued a black-box warning for anti-psychotics, warning consumers of the increased risk of death for those with dementia, as such drugs have not been approved for this use. Dangerous side effects include, but are not limited to, excessive sedation, weight loss, heart attack, stroke, delirium, agitation, and increased risk of pneumonia.
Despite knowing and understanding the dangers such drugs pose to residents, they are still administered to sedate residents, particularly in facilities that are understaffed or those that have caregivers who are not qualified or trained. Advocacy group CANHR compiled a database of the nursing homes located in California, and each facility’s rates of psychotropic drug use. Therefore, consumers and their loved ones may find such information particularly useful when conducting a search for nursing homes, as this data may help consumers find a facility without a drugging issue.
Experts Seek to Shift Perceptions of Behaviors Associated With Dementia Patients
Elderly individuals suffering from dementia often exhibit certain behaviors, such as aggression, agitation, or anxiety, which many people consider to be symptoms of dementia. However, experts have noted that categorizing these behaviors as ‘symptoms’ and applying such terminology to these behaviors may be misleading or mistaken. This is because research has demonstrated that many behavioral expressions by dementia patients are actually a result of certain situational triggers or due to physical, social, or psychological needs that are unmet. Therefore, experts are now recommending that the term ‘behavioral expression‘ be used in place of ‘behavior symptoms or problems.’
This is in hopes that a terminology shift will lead to a change in the methods caretakers implement when trying to address these behaviors, moving away from medication as the only treatment method. Experts believe that resorting to pharmacological methods and attributing dementia patients’ behavioral issues primarily to dementia alone will remove focus from the underlying social situations which may be triggering the behavior, thus placing the focus on the dementia patient’s brain pathology alone. However, focus should be placed upon improving dementia care through patient-centered, individualized methods.
NIH Increases Funding to Promote Nationwide Effort in the Fight Against Alzheimer’s Disease
The U.S. National Institute of Health (NIH) recently announced that it would be providing $45 million in funding for researchers to test novel drugs and therapies towards Alzheimer’s disease prevention, promoting a nationwide effort to find a solution to this prevalent degenerative disease. The NIH hopes this funding will help support research to find ways in which to stop the onset of Alzheimer’s, or at least delay its destructive progression. The United States has currently invested around $400 million to date in the fight against Alzheimer’s.
Alzheimer’s disease is currently the most prevalent form of dementia plaguing the elderly population and affects an individual’s ability to engage in daily activities. This aspect of the disease is devastating as it greatly impairs an individual’s independence. According to the Centers for Disease Control and Prevention (CDC), there are currently about 5 million Americans living with Alzheimer’s disease. Our elderly loved ones are at higher risk of being affected by Alzheimer’s disease, as age is currently the most significant known risk factor correlated with the disease.
Remedying Aggressive Behavior in Elderly Dementia Patients
Those suffering from dementia are generally members of the elderly population, and as life expectancy continues to increase, the need to address dementia and its complications also increases. Dementia is comprised of a variety of symptoms, some of which include memory loss, impaired judgment, and difficulties with language and motor function. However, other issues also plague dementia patients and their families. For example, those suffering from dementia have been found to exhibit aggressive behavior, such as biting, hitting, or shoving when angry, scared, or confused.
A recent New York Times article explored the aggressive behaviors associated with dementia, stating that physically aggressive behavior generally occurs in a considerable minority of those suffering from dementia. Therefore, caretakers of dementia patients in hospitals and nursing homes may feel the need to use physical and chemical restraints or anti-psychotic drugs in order to control aggressive behaviors. However, this may be highly inappropriate. While the justifications for their actions may arise from fears that dementia patients may hurt themselves or those around them, it has been found that behavioral approaches are more effective in soothing aggressive behavior compared to inappropriate use of drugs and restraints in order to remedy the issue.
Reducing Unnecessary Antipsychotic Drug Use in Nursing Homes
The Department of Health and Human Services Office of Inspector General (OIG) released a report in 2011 finding that antipsychotic drugs given to elderly residents of nursing homes were not administered in compliance with standards set forth by the Center for Medicare and Medicaid Services (CMS). Such medications, when used properly, can be effective in aiding a patient’s mental and physical well-being. However, unnecessary antipsychotic drug administration is dangerous and not appropriate in the care of the elderly. Unnecessary drug administration practices may include excessive dose administrations, drugs provided in excessive durations, lack of adequate monitoring, or the administration of drugs in the presence of adverse effects which show the dosage should be lowered or discontinued. It has been found that improper or excessive administration of antipsychotic drugs may not only result in death but may lead to unnecessary hospitalization, falls, heart attacks, strokes, and other complications.
Unfortunately, because many elderly nursing home residents currently suffer from dementia, there has been a growing concern that antipsychotic medication has been administered inappropriately to control behavioral problems related to dementia. To combat this issue, CMS launched a National Partnership to Improve Dementia Care in 2012 with the goal of protecting the elderly receiving dementia care in nursing homes and other healthcare settings. Specifically, the partnership sought to protect against unnecessary antipsychotic drug use unless there was a valid, clinical purpose. The partnership also sought to encourage nursing homes and others providing dementia care to consider non-pharmacological alternatives for the elderly.
