Articles Posted in Dementia

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New Alzheimer’s Drug Could Receive National Coverage Policy, Now Under Medicare Review

On July 12, 2021, the Centers for Medicare & Medicaid Services (CMS) announced the opening of a National Coverage Determination (NCD) analysis. The government agency says the process will allow an advanced and careful review to determine whether Medicare will establish a national coverage policy for monoclonal antibodies targeting Alzheimer’s disease. Monoclonal antibodies may prevent beta-amyloid from clumping into plaques or remove beta-amyloid plaques that have formed and help the body clear the beta-amyloid from the brain, found in patients diagnosed with Alzheimer’s.

  • When someone is diagnosed with Alzheimer’s (or dementia), they will require more care, patience, and support as they grow older.

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Harmful Medication Overuse Often First Line of Defense for Managing Behaviorally Challenged Nursing Home Residents

There is excessive and unnecessary use of antipsychotics and psychoactive medications in U.S. nursing homes. These powerful drugs are sometimes given to patients living in long-term care facilities to calm behaviors associated with behavior disruptions and mental health illnesses. Antipsychotics can be so powerful that they sedate residents to the point where they become listless and unresponsive. Residents may be slumped in chairs or unable to get up from bed; they may no longer participate in activities like feeding themselves or engaging in routines they enjoy, or even talk with their loved ones. They are also overly-prescribed to residents who may be marked unruly or disruptive or when staff feel overworked and unable to support and service all residents due to understaffing or high turnover rates. Care teams will seek out specific medications that make patients with these issues easier to handle – or sadly, just to quiet them and make them lethargic and sleepy. Nursing home doctors have also been caught on relying heavily on the recommendation of nurses and other care staff when making these medication decisions.

  • According to the Office of the Inspector General for the Department of Health and Human Services, more than half of atypical antipsychotic medications that affect at least 105,000 nursing home residents annually are being incorrectly paid for by Medicare, despite the drugs being deemed ineffective and potentially dangerous for the elderly population.

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How Families Can Help Identify the Early Signs of Memory Loss and Dementia in Loved Ones

Unfortunately, many nursing home workers are not trained to identify the warning signs of declining cognitive abilities. And worrisome activities of a resident with dementia, a form of Alzheimer’s Disease, are too easily missed by overworked and poorly resourced care teams. This leaves many residents struggling due to the extra supervision and management of their daily activities, health and mental wellness, medications, and financial needs. Family members and friends are typically the first to request help after noticing a loved one’s behavioral changes or one or more of the concerning events listed below.

  1. Unable To Carry Conversation

alzheimer's awareness month

June is Alzheimer’s and Brain Awareness Month, Join Levin & Perconti by Going Purple

Today, more than 6 million Americans are living with Alzheimer’s and other dementias. In Illinois, more than 230,000 are battling the disease. When someone is diagnosed with Alzheimer’s Disease, they will require more care, patience, and support as they grow older. The emotional burden and financial costs are overwhelming on those diagnosed, their caregivers, long-term care workers, and even the nation’s health care system. The Alzheimer’s Association reports that in 2021, Alzheimer’s and other dementias will cost the nation $355 billion. And by 2050, costs could rise as high as $1.1 trillion.

As much as 75% of those diagnosed with Alzheimer’s will eventually become entirely dependent on someone else to care for them. At times, this support can only be found in a facility such as a nursing home or memory care center. Unfortunately, our experience has shown us that Alzheimer’s residents can be too easily ignored, abused, or neglected within these homes.

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Nursing Home Residents Require Additional Rehabilitative Care After Suffering from a Stroke

If someone living in a nursing home has a stroke, they should be treated in an inpatient rehabilitation facility rather than remain in the nursing home. The resident may need intensive, multidisciplinary treatment, and initial rehabilitation should take place in a facility equipped with the appropriate care staff. Advanced specialty care is especially needed if negligent nursing home workers missed the early signs of stroke in a resident, causing a delay in treatment. The National Institute of Neurological Disorders explains the types of strokes most common to nursing home patients.

  1. Cerebral Hemorrhage: Caused by the sudden rupture of an artery in the brain, blood spills out and compresses brain structures. Approximately 20% of strokes are caused by bleeding. Preventable falls may be behind a cerebral hemorrhage.

nursing home residents wandering away

With More Nursing Home Residents Vaccinated Against Coronavirus, Summer Season Calls Greater Attention to Wandering Risk

As Illinois continues to open up and more of the state’s population becomes vaccinated from COVID-19, including those over 65 living in skilled nursing facilities, it is expected that many individuals will want to spend time outdoors to help increase both activity and their mood. With that excitement should be a reminder that Chicago will also have its regular summer heatwaves and hot days – making outside temperatures dangerous for some. For the elderly who travel outdoors, take certain medications that alter the body’s ability to regulate temperatures, or are without the appropriate indoor cooling areas, many will negatively react to high-temperature exposures.

To identify any heat-related illness, nursing home staff should watch out for:

can dehydration cause delirium
An altered mental status is a difficult condition for nursing home residents to manage on their own, especially when symptoms can present slowly and brushed off for age-related memory loss, stress, medication side-effects, lack of sleep, or other conditions like dementia. Delirium, sometimes referred to as “sundowning” or “psychosis”, is one of those conditions that if misdiagnosed or treated with overmedication, can worsen quickly with irreversible outcomes including long-term cognitive impairments.

Delirium has been defined by The American Delirium Society (ADS) as a state of confusion that comes on very suddenly and lasts hours to days. If a nursing home resident becomes delirious, they may have hallucinations, disorganized thinking, difficulty understanding daily tasks, and inability to pay attention and be unaware of their environment or trust of the people in it. Delirium affects nearly 18% of long-term care residents and has a staggering 40% one-year mortality rate.

Nursing homes have been known to manage residents with disruptive behaviors in less productive ways, and many things can make delirium (and other mental conditions) worse, such as:

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Identifying Dementia Warning Signs in Nursing Home Residents

Dementia denial from caregivers is real and dangerous. And unfortunately, many nursing home owners find it easier to have staff ignore the warning signs of declining cognitive abilities rather than provide additional support. Dementia diagnoses can also be missed when overworked, and poorly resourced care teams are not trained to evaluate struggling residents who require extra supervision and management of their daily activities, medications, and financial needs. Eventually, these residents need to move to a 24-hour assisted specialized environment to keep them safe, especially as their disease progresses into later stages. Family members and friends are typically the first to request help after noticing a loved one’s behavioral changes or one or more of the concerning events listed below.

#1. Early Stage Memory Loss

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Drug Overuse Is Prevalent in Nursing Home Residents with Alzheimer’s

Antipsychotic drugs are sometimes given to patients living in long-term care facilities to calm behaviors associated with Alzheimer’s or memory and behavior illnesses. They are also overly prescribed to residents who may be marked unruly or disruptive. Care staff are known to seek out specific medications to make these patients easier to handle, or quiet them and make them sleepy. Doctors may rely heavily on the recommendation of nurses and other care staff when making these medication decisions.

These drugs can be dangerous when used without a physician or family’s knowledge or consent, a haphazard tactic given that the mismanagement of these drugs has been known to cause sudden death. This practice, also known as chemical restraint, is unfortunately not new although Federal law prohibits the use of antipsychotic drugs or psychoactive drugs solely for the convenience of medical staff, and to sedate a patient. Additionally, consent must be given in order to use chemical restraints.

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Discussion Questions for Alzheimer’s and Brain Awareness Month

Alzheimer’s disease is not a normal part of the aging process. For the millions of Americans who have been diagnosed with the debilitating memory and behavior illness – life is not easy. According to the Alzheimer’s Association, those with declining cognitive abilities impact an estimated 230,000 people in Illinois, which is expected to rise nearly 13 percent by 2025. Dementia, a form of Alzheimer’s, is one of the only top-10 causes of death in the U.S. that cannot be prevented, cured, or slowed. While the issue is important every month, June is a special time to push greater education and raise support for Alzheimer’s and Brain Awareness Month.

  1. Is dementia the same as Alzheimer’s?
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