Anti-Psychotic Medications in the Elderly: New Trends to Decrease Use – Bobbi Duffy

• Assessment and Documentation Following Current Guidelines
• When and How to Reduce or Eliminate Current Prescriptions
• Ensuring Patient & Staff Safety
• Non-Pharmacologic Strategies for Difficult Behaviors

A large number of older individuals are living with some type of dementia. For these individuals, and as illness progresses, behavior often becomes a key form of communication. This can be challenging for families and staff, and too often, antipsychotic medication is used in an attempt to modify behavior. The use of antipsychotic medication to treat behavior associated with dementia is not supported clinically and is considered off-label by the FDA, which issued a “black box” warning for the elderly with dementia.

Antipsychotic drugs are expensive, costing hundreds of millions of Medicare dollars. They also increase the risk of death, falls with fractures, hospitalizations and other complications resulting in poor health and high costs. The intent of recent regulatory changes is to safely reduce the off-label use of antipsychotics and encourage alternative strategies for responding to challenging geriatric behaviors.

Join expert speaker, Bobbi Duffy, CRNP-PMH, APRN, MSN, for an information-packed day that will provide you with strategies to assess and manage psychotropic medication use. If older adults are routinely under your care, don’t miss this opportunity to learn tips and tools to implement immediately to improve the care you provide to your geriatric patients.

OUTLINE

Common Behaviors of Focus & Use of Antipsychotic Medications

• Inappropriate Sexual Behaviors
  • Inappropriate Sexual Behaviors vs. Normal Sexual Desires
  • Organizational Policies for Sexuality
  • Sexuality and the Cognitively-Impaired
• Agitation/Aggression
  • Impaired Impulse Control
  • Identify the Problem
  • Explore Environmental Reasons
  • Identify Causes of Escalation
• Wandering/Pacing
  • Ideas to Help Keep the Wandering Patient Safe
• Frequent Complaints
• Repetitive Statements/Questions
• Psychosis/Paranoia
• Refusal of Medications & Treatments
• Manipulation & Attention Seeking
• Refusal to Bathe
• Exit Seeking
• Falls
• Sleep/Wake Disturbances
• Apathy vs. Depression
• Uncontrolled Yelling/Crying

Accurate Assessment

• Identifying the Root Cause

Ethical Considerations

• Managing the Emotional Reaction

Effective Documentation

• Regulatory and Compliance Changes

Reducing and Eliminating Antipsychotic Medication

• Assessment Strategies
• Non-pharmacologic Strategies

Medication Management

• Classes & Dosages
• Appropriate Use – Risk/Benefits
• Special Considerations
• Black Box Warnings
• Gradual Dose Reduction

Alzheimer’s Disease & Dementias: Challenges, Goals & Interventions

• Reducing the Risk Factors
• Various Types of Dementias
• Early Onset Alzheimer’s Disease
• Getting a Diagnosis Through Diagnostic Testing
• Pharmacological Treatment Options
• Behaviors Commonly Associated with Alzheimer’s Disease

The Fine Line Between Anxiety & Depression

• Medical Illnesses That Increase the Risk for Depression & Treatment Strategies
• Antidepressant and Antianxiety Medications
• The Various Forms of Anxiety

The Caregiver Concerns

• Caregiver emotions: Sadness, Fear, Worry, Anger, Guilt, Fatigue
• Assisting the Caregiver to Meet the Needs of Their Loved One

OBJECTIVES

• Define strategies to reduce or eliminate no longer clinically indicated psychiatric medications, including antipsychotics.
• Investigate the root cause of difficult behaviors and determine the appropriate interventions.
• State the signs and symptoms of the various dementias, including Alzheimer’s disease, and how they relate to difficult geriatric behaviors.
• Recognize the unique challenges faced by caregivers of the elderly and develop strategies for providing assistance.
• Identify the causes of an escalation in physically-aggressive behaviors and recommend interventions that will help to remedy the situation.
• Describe how validation can be used to display empathy for the patient with frequent complaints.
• Explain why every facility should have established policies regarding sexual behavior.
• Create solid documentation strategies to support use of antipsychotics when appropriate and avoid survey deficiencies.
• Develop a better understanding of the when, why & how of utilizing antipsychotic medications.