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AMDA Long Term Care Medicine - 2014


304 - Function and Behavior Focused Care: Decreasing Inappropriate Use of Antipsychotics While Optimizing Function and Physical Activity for Residents with Dementia


Mar 1, 2014 11:00am ‐ Mar 1, 2014 12:30pm

Standard: $24.00

Description

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates this Internet Enduring Material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of clinical 1.5 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
This session will discuss details on two successful approaches to engage staff in ways to decrease inappropriate use of antipsychotic medications and optimize function and physical activity among long-term care residents with dementia. These include: 1) use of AMDA’s Antipsychotic Use in Dementia Assessment tool; and 2) implementation of a function and behavior focused approach to care. In addition to theoretical background and discussion of beneficial outcomes, implementation materials and steps for how to integrate these care practices and quality improvement initiatives into real world settings will be provided to participants.

Learning Objective(s):

  • Recognize that merely because a deficiency was cited by surveyors does not mean that it (they), in fact, exists.
  • Demonstrate that quality care was rendered, rather than care constituting a deficient practice, and thereby reduce or eliminate liability.
  • Describe the process by which contested deficiencies may be successfully challenged through a combination of IDR, IIDR and appeals to HHS Departmental Appeals Board.
  • Utilize the fact that CMS can – and often is convinced that negative clinical outcomes do not necessarily suggest inadequate care.
  • Appreciate the fact that personal injury lawyers often rely on the CMS Statement of Deficiencies as “evidence” of negligence.

Speaker(s):
Elizabeth Galik, PhD, CRNP; Barbara Resnick, PhD, CRNP; Kelly Wolfe, DNP, CRNP

Disclosure(s):
None

Reference(s):
1. 2012 Alzheimer's disease facts and figures. Alzheimer's Dementia 8, 131–168 (2012). 2. Voyer, P. et al. Prevalence of physical and verbal aggressive behaviours and associated factors among older adults in long-term care facilities. BMC Geriatr 5, 13 (2005). 3. Schreiner, A. S. Aggressive behaviors among demented nursing home residents in Japan. International Journal of Geriatric Psychiatry 16, 209–215 (2001). 4. Cohen-Mansfield, J. et al. The relationships of environment and personal characteristics to agitated behaviors in nursing home residents with dementia. J Clin Psychiatry 73, 392–399 (2012). 5. Volicer, L., Bass, E. A. & Luther, S. L. Agitation and resistiveness to care are two separate behavioral syndromes of dementia. J Am Med Dir Assoc 8, 527–532 (2007). 6. Volicer, L., Van der Steen, J. T. & Frijters, D. H. M. Modifiable factors related to abusive behaviors in nursing home residents with dementia. J Am Med Dir Assoc 10, 617–622 (2009). 7. Kamble, P., Chen, H., Sherer, J. T. & Aparasu, R. R. Use of antipsychotics among elderly nursing home residents with dementia in the US: an analysis of National Survey Data. Drugs Aging 26, 483;492 (2009). 8. Tak, S., Sweeney, M. H., Alterman, T., Baron, S. & Calvert, G. M. Workplace assaults on nursing assistants in US nursing homes: a multilevel analysis. Am J Public Health 100, 1938–1945 (2010).9. Harris, M., Richards, K. C. & Grando, V. T. The effects of slow-stroke back massage on minutes of nighttime sleep in persons with dementia and sleep disturbances in the nursing home: a pilot study. J Holist Nurs 30, 255–263 (2012).10. Subramaniam,P. & Woods, B. The impact of individual reminiscence therapy for people with dementia: systematic review. Expert Rev Neurother 12, 545–555 (2012).11. Ho,S.-Y. et al. The effects of researcher-composed music at mealtime on agitation in nursing home residents with dementia. Arch Psychiatr Nurs 25, e49–55 (2011).12. Kuske, B. et al. 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