Filtered by tag: Dementia Remove Filter

Anticholinergics, Dementia, and the Need for Deprescribing

A recent study published in JAMA, August 2019 suggests that in a large population prior exposure to strong anticholinergic drugs is associated with the risk of dementia. Previous studies by Richardson et.al. (2018) and Gray et.al. (2015) were small case-control cohort studies while these studies suggested an association between anticholinergics and dementia the sample size were too small to draw conclusions.  The findings of this large middle-aged to elderly cohort study by Coupland, et.al. advocates for deprescribing of anticholinergic agents in middle-aged to older adults (e.g. 55 years and older) to reduce the risk of dementia. 

Read More

Passport to Better Care

I recently wrote an article for the WAVE on the potential value of sharing personal pictures on your smartphone, for developing relationships and engaging patients with dementia, prior to providing medication and care plan directed care.  

Read More

Are Weighted Blankets Worth Trying in Your Facility?

Recently, the American Geriatrics Society’s MyAGSOnline member forum posted a question about the use of weighted blankets for a dementia unit with patients who had poor judgment, impulsiveness, poor safety recall, and frequent falls.  Dr. Maureen Nash, Board Certified in Internal Medicine & Psychiatry (Portland, Oregon) wrote they can have a positive impact in some older patients offering comfort as long as they are not too heavy. They are not considered a restraint by CMS unless they are inappropriately heavy.  They provide gentle tactile stimulation to people who usually are not touched except in a clinical situation. She gave several references:

Read More

Update: California Dementia Partnership to Improve Dementia Care

On December 4th, 2018 our dementia partnership sponsored a webinar by Dr. Maureen Nash, a nationally recognized Gero-psychiatrist who presented the PowerPoint presentation (handout provided below) on “Helping those with Serious Mental Illness who now live in a LTC setting”. She advocated for use of best practices for persons with serious mental illness who require institutional care, most commonly because of their very high risk for cognitive impairment.  CMS’s campaign to improve dementia care by reduce antipsychotics at times may seem to compromise known best practice. She recommended following the American Psychiatric Association’s free best practice guidelines for treating: Major Depressive DO, Bipoloar DO, PTSD, OCD, Schizophrenia, and dementia persons with agitation and aggression. In these guidelines, recommendations for use of antipsychotics (many have FDA approval) represent best practice even though they may not be recognized in the excluded category by the CMS campaign.  

Read More